CMAJ Podcasts (Canadian Medical Association Journal)
Explore every episode of CMAJ Podcasts
| Pub. Date | Title | Duration | |
|---|---|---|---|
| 14 Feb 2022 | Disseminated gonorrhea and rising rates of STIs | 00:36:55 | |
Reported gonorrhea cases have more than doubled in recent years. Untreated gonorrhea may occasionally cause potentially fatal conditions, such as infective endocarditis. In this episode, Dr. Carl Boodman, infectious disease and medical microbiology fellow at the University of Manitoba, discusses a case of disseminated gonococcal infection in a 54- year old man who presented to ER with a new heart murmur. The case was described in a recent CMAJ article, which explains that the patient had developed an aortic root abscess and a fistula from his right ventricle to the aortic root. Dr. Boodman tells Dr. Blair Bigham and Dr. Mojola Omole that, while severe cases of disseminated gonococcal infection such as this remain relatively rare, he is seeing more of them in Manitoba. He emphasizes the importance of detecting and treating gonococcal infection before it has a chance to progress. Gonorrhea is just one of the bacterial STIs on the rise. Drs. Bigham and Omole also speak with Dr. Jason Wong, a Public Health and Preventive Medicine specialist in BC, about what’s behind the rise in STIs and about what lessons can be learned from the relative decline in HIV infections. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 28 Feb 2022 | Redesigning the CTU and reimagining medical education | 00:35:25 | |
The clinical teaching unit is a widely-used clinical training model that requires reform to prepare physicians for practice in the 21st century. In a systematic review in CMAJ, Dr. Brandon Tang and co-authors identified practices in internal medicine clinical teaching units that contribute to improved clinical education and health care delivery. Dr. Tang, a PGY4 in general internal medicine at the University of Toronto, speaks with Drs. Blair Bigham and Mojola Omole about the findings of the review, his experience with CTUs, what inspired him to look into the research, and his thoughts on how CTUs can be reimagined to improve both learner and patient outcomes. Drs. Bigham and Omole then speak with Dr. Lisa Richardson, a clinician-educator in the U of T’s Division of General Internal Medicine, about other aspects of medical training that are due for a rethink. Dr. Richardson, who also practices at the University Health Network and is an Education Researcher at the Wilson Centre, argues that medical training needs to create space for learners to bring their whole selves to their educational experience, rather than struggle to conform to a narrower sense of what it means to be a physician. CMAJ is the journal of the Canadian Medical Association. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 09 Mar 2022 | Tackling carbon emissions in healthcare: from low-hanging fruit to systems change | 00:30:08 | |
Physicians working in hospitals see the mountains of medical waste generated each day. Meanwhile, the climate crisis challenges the medical system to reduce its contribution to greenhouse gas emissions. Globally, healthcare systems contribute as much carbon dioxide as the airline industry. In Canada, healthcare accounts for 4.6% of our total emissions. The problem is urgent, but potential solutions are both easier and more complex than many might think. Guests on this episode are advocates in the climate and health space. Dr. Samantha Green is the co-author of the CMAJ article, Five Things to Know About Metered Dose Inhalers and their Impact on Climate Change. She's a family physician at Unity Health Toronto and the climate and health lead at the University of Toronto's Department of Family and Community Medicine. In the article, she and her co-authors point out that pressurized metered-dose inhalers (pMDIs) are an important contributor to greenhouse gas emissions. Dr. Green says measurements done in the United Kingdom by the National Health Service found that MDIs contribute 3.1% of the entire health system's carbon emissions. One MDI contributes the equivalent of driving 290km by car. Meanwhile, dry powdered inhalers (DPIs) and soft mist inhalers (SMIs) are effective available alternatives with lower environmental impact. Dr. Green encourages physicians to make the switch for eligible patients and explains how her clinic has created resources to facilitate the prescribing change. Addressing such low-hanging fruit of climate action in the healthcare system is important but, according to Dr. Andrea MacNeill, reducing waste, changing prescriptions, and recycling are the tip of the iceberg. What’s really needed is profound systemic change. Dr. MacNeill argues that emissions are driven by a system focused on providing the most complex and carbon-intensive care. “New healthcare funding seems to go into very complex resource-intensive treatments that modify very advanced disease processes. And I would suggest that we need to shift that focus upstream and start to think, okay, could we have prevented this from ever happening? And in many cases, the answer to that is yes,” says Dr. MacNeill. Along with a focus on prevention, Dr. MacNeill argues healthcare systems need to put pressure on the supply chain, which accounts for the bulk of emissions. In England, the NHS is demanding that vendors match the NHS's climate target to decarbonize by 2030. Links to resources discussed on the episode: Inhaler Toolkit for Physicians Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 28 Mar 2022 | Recognizing and treating POTS | 00:26:40 | |
Postural orthostatic tachycardia syndrome (POTS) is a disorder that can profoundly affect patients' quality of life. Its main characteristic is tachycardia on standing without a drop in blood pressure. Patients complain of lightheadedness and palpitations when upright, which sometimes leads to syncope. This can cause substantial functional disability, which may be economically devastating. Despite these serious consequences for patients, diagnosis can be delayed up to 6 years. In this episode, Dr. Satish Raj, author of the recent CMAJ narrative review article Diagnosis and management of Postural Orthostatic Tachycardia Syndrome talks to our hosts about difficulties in making the diagnosis of POTS, its complex range of comorbidities, how patients are typically affected by the syndrome and treatment options. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 11 Apr 2022 | Is it time to replace high-stakes exams with graduated licensure? | 00:33:11 | |
COVID-19 disrupted the medical licensing examination system in Canada. During the pandemic, exams delivered by The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) were delayed, canceled or adapted, disrupting the lives of hundreds of physicians. However, those challenges prompted many to rethink the historical approach to medical licensure in Canada. In this episode, Drs. Brent Thoma and Teresa Chan discuss their proposal to shift away from all-or-nothing examinations and towards a system of graduated licensure. They are two authors of a recent CMAJ commentary entitled Replacing high-stakes summative examinations with graduated medical licensure in Canada. Dr. Thoma is an emergency and trauma physician in Saskatoon and an associate professor of emergency medicine at the University of Saskatchewan. Dr. Chan is an associate professor of medicine at McMaster University, where she is the Associate Dean of Continuing Professional Development. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 25 Apr 2022 | Lack of diversity in healthcare leadership | 00:31:05 | |
A study of more than 3000 health care leaders in Canada found that while gender parity was present, racialized executives were substantially under-represented. Diversity among health care leaders in Canada: a cross-sectional study of perceived gender and race was published in CMAJ. It found that at the ministry level fewer than 7 percent of health care leaders were racialized. The representation gap between racialized executives in healthcare and the racial demographics of the population it serves ranged from a low of 7.3% for Prince Edward Island to a high of 27.5% for Manitoba. The gap was highest in geographic locations with a greater percentage of racialized residents. On this episode, Drs. Omole and Bigham speak with the lead author of the study Anjali Sergeant, a final year medical student at McMaster University. She describes how researchers determined race, compares results in different parts of the country and discusses how closely the results of the study reflect what she is seeing in her medical school cohort. Drs Omole and Bigham also speak with Anna Greenberg, the Chief Regional Officer, Toronto and East for Ontario Health. Ms. Greenberg is also the agency’s Executive Lead for Equity, Inclusion, Diversity, and Anti-Racism. She discusses the efforts her agency is making to address this disparity. She also explains why it is important for healthcare leaders to ask themselves, “Why does this matter?” Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 09 May 2022 | Is it time to re-think the quality improvement enterprise? | 00:31:28 | |
In this episode, Dr. Kaveh Shonjania argues that despite the billions of dollars spent on clinical and quality improvement research, most of the interventions that are studied are shown not to work and those that do work produce only marginal benefits for some patients. Dr. Shojania is the Vice Chair of Quality and Innovation for the Department of Medicine at the University of Toronto and past Editor-in-Chief of BMJ Quality and Safety. He joins Drs. Blair Bigham and Mojola Omole to discuss a study published in CMAJ recently, entitled Inappropriate Use of Clinical Practices in Canada: A Systematic Review, in which the authors sifted through 174 studies to identify ineffective clinical practices that are either overused, effective practices that are underused, or other practices that are just misused.. Dr. Shojania wrote a short commentary related to the study, entitled What problems in health care quality should we target as the world burns around us? In which he called for health research resources to be shifted more towards research on the social determinants of health, for a greater return on investment. Drs. Bigham, Omole and Shojaniadiscuss how this might actually work in practice. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 23 May 2022 | What medical conditions and social factors increase the risk of drowning? | 00:25:55 | |
Drowning accounts for hundreds of deaths in Canada every year. A study published in CMAJ examines how pre-existing medical conditions contribute to drowning deaths. Drs Mojola Omole and Blair Bigham speak with the study’s lead author Dr. Cody Boone about what the study’s findings mean for physicians and patients. They then speak with Audrey Giles, a professor of human kinetics at the University of Ottawa, about the high rates of drownings experienced by Northern Indigenous communities in Canada. Professor Giles has spent decades working with people in Northern regions to adapt and customize water safety programs so that they meet communities’ specific cultural and practical needs. She discusses issues from cold water drowning to cultural safety. Links: The link between medical conditions and fatal drownings in Canada: a 10-year cross-sectional analysis Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 06 Jun 2022 | Preventing overdose harms with a safe supply of drugs | 00:31:44 | |
People who use drugs are at elevated risk of death due to the toxic illicit drug supply. Providing easy access to a supply of safe, clean substances may reduce overdose deaths, decrease harms associated with substance use, and improve users’ trust in addiction care. Safer Alternatives for Emergency Response (SAFER) is a low-barrier, flexible safe supply program that provides several replacement options for people who use illicit drugs, including fentanyl, and is integrated with other healthcare and social services.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 20 Jun 2022 | Suicidality crisis among transgender adolescents | 00:31:45 | |
The author of a new study in CMAJ says the risk of suicidality among transgender youth, “is really a crisis.” The research entitled Suicidality among sexual minority and transgender adolescents drew its data from the 2019 Canadian Health Survey on Children and Youth, a carefully-conducted cross-sectional survey. The researchers used a sub-sample of 6800 15-17 year olds. On this episode, Drs. Blair Bigham and Dr. Mojola Omole discuss the implications of the study’s findings with one author, Mila Kingsbury. They then speak with Dr. Tyler Black, medical director of the pediatric psychiatric emergency inpatient unit at British Columbia Children's Hospital. He discusses the research on transgender teens in the broader context of what’s known about suicide risk amongst adolescents in Canada. This episode focuses extensively on the issue of suicide. If you are in crisis: Call 911 or go to the nearest hospital. Call the Canada Suicide Prevention Service (available 24/7) at 1-833-456-4566. For residents of Quebec, call 1 866 APPELLE (1-866-277-3553). Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 04 Jul 2022 | Fixing the problem of drug shortages in Canada | 00:29:25 | |
Drug shortages are a persistent problem in Canada and around the world. They interfere with patients’ ability to consistently take medication to manage chronic diseases. And they disrupt urgent care as critical drugs like epinephrine and propofol face shortages. The COVID-19 pandemic led to concerns that the pandemic would exacerbate existing issues with drug shortages in Canada. Canadian policy-makers responded with several important measures in March 2020 in an attempt to ensure a steady supply of medication. On this episode, Mina Tadrous discusses the impact of those measures as well as the ongoing challenges to Canada’s supply of pharmaceuticals. Mina Tadrous is coauthor of the paper, “COVID-19 in the prevalence of drug shortages in Canada,” published in CMAJ. He's an assistant professor at the University of Toronto. Drs. Bigham and Omole also speak with Andrew MacIsaac about the role Canadian manufacturing can play in easing the problem of drug shortages. Andrew Maclsaac is the CEO of Applied Pharmaceutical Innovation, or API. API is partnered with University of Alberta to create the Canadian Critical Drug Initiative. One of its goals is to make Canada less vulnerable to drug shortages. Links: COVID-19 in the prevalence of drug shortages in Canada Canadian Critical Drug Initiative Applied Pharmaceutical Innovation Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 18 Jul 2022 | Does bodychecking experience really reduce concussions? | 00:21:17 | |
In an effort to reduce the high burden of injury in Canadian youth ice hockey, most associations have restricted bodychecking nationally among leagues for younger players (age 11–12 yr), as well as in certain nonelite divisions of play in older age categories (age 13–17 yr.) This has been shown to be associated with reduced rates of injury, including concussion. However, despite the evidence, some argue that gaining earlier bodychecking experience may protect young players from injuries, including concussions, later on when they progress to play in leagues where bodychecking is allowed. A study published in the CMAJ entitled Bodychecking experience and rates of injury among ice hockey players aged 15–17 years found the opposite, however. Players with more experience in bodychecking had a greater incidence of concussion. On today’s episode, Drs. Omole and Bigham speak with two authors of the study. Paul Eliason is a postdoctoral fellow in the Sport Injury Prevention Research Centre at the University of Calgary and Carolyn Emery is a physiotherapist and epidemiologist at the University of Calgary. They discuss the new study’s findings and their implications for policy in youth hockey. They also explore how hockey compares to other contact and non-contact sports and discuss how to keep kids both active and safe in sport. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 25 Jul 2022 | Special Episode - Depression in pregnancy and the postpartum period: should we screen everyone? | 00:25:18 | |
The short answer to this question, according to a new guideline published in CMAJ, is “No.” In this special episode, CMAJ editor in chief, Dr. Kirsten Patrick, talks to Dr. Eddy Lang, lead author of the guideline entitled Recommendation on instrument-based screening for depression during pregnancy and the postpartum period produced by the Canadian Task Force on Preventive Health Care. They discuss why there’s not enough evidence to support a recommendation to screen routinely, why that doesn’t mean that depression in pregnancy and the postpartum period is not important to diagnose, and in what circumstances use of a screening instrument might be helpful. Blair and Jola will be back next episode. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 01 Aug 2022 | Encore Presentation: Recognizing and Treating POTS | 00:26:40 | |
This is an encore presentation of our most popular episode of the past year. Despite these serious consequences for patients, diagnosis can be delayed up to 6 years. In this episode, Dr. Satish Raj, author of the recent CMAJ narrative review article Diagnosis and management of Postural Orthostatic Tachycardia Syndrome talks to our hosts about difficulties in making the diagnosis of POTS, its complex range of comorbidities, how patients are typically affected by the syndrome and treatment options. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 15 Aug 2022 | Hot Flash: Experiencing menopause in medicine | 00:32:08 | |
When contemplating issues of diversity and inclusion, medicine needs to consider menopause. A commentary in CMAJ argues that discussion about and, where needed, accommodation of menopause is a necessary step toward providing women physicians with a supportive and comfortable work environment. On this episode, Drs. Bigham and Omole speak with the lead author of the commentary “Hot Flash: Experiencing menopause in medicine.” Dr. Marie Christakis is an OB-GYN at St Michael’s hospital in Toronto. She has completed a fellowship in Menopause and Mature Women’s Health at Mount Sinai Hospital. They discuss why there has been little discussion on the effect, and potential burden, of menopause on mature- or potentially peak-career women physicians. And they explore what needs to be done to better support physicians through menopause. Drs. Bigham and Omole also speak with Dr. Kim Wynd, an anesthesiologist who practices in Peterborough Ontario, about her experiences during menopause. Dr. Wynd began having symptoms of perimenopause in her early 40s at a time when her practice was thriving. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 29 Aug 2022 | Clearing Misconceptions about Functional Neurological Disorders | 00:35:14 | |
Functional Neurological Disorders (FND) make up a significant portion of referrals to neurology, maybe as high as 30%. However, misconceptions regarding these disorders remain across medicine, and patients are frequently dismissed as “faking it.” FND are neuropsychiatric conditions in which patients experience neurologic symptoms due to a “functional” disruption of brain networks rather than a “structural” disorder of the nervous system. On this episode, Drs Bigham and Omole speak with Peter Gill, a patient with FND. Mr. Gill describes his seven-year journey to diagnosis and his recent success with various approaches to therapy. Next, Drs Bigham and Omole speak with Dr. Matthew Burke, a cognitive neurologist at Sunnybrook Hospital in Toronto and an expert in FND. They discuss the current understanding of the disorder, diagnostic criteria and therapeutic options. Functional neurologic disorder associated with SARS-CoV-2 vaccination Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 12 Sep 2022 | Urgent need to improve organ donation experience for donor families | 00:38:11 | |
Many families of organ donors describe feeling alone and abandoned at the moment when their loved one is taken to the operating room for donation. Heather Talbot says she and her family were left on their own as her son was wheeled into the OR. The experience left her thinking, “Well, they got what they wanted and they’ve moved on.” A qualitative study in CMAJ examined the experiences of donor families. They found that many families felt unsupported at critical transition periods. Authors of The experiences of family members of deceased organ donors and suggestions to improve the donation process conducted 271 in-depth interviews with family members of organ donors. On this episode, Drs Bigham and Omole speak with the study’s lead author Dr. Aimee Sarti. Dr. Sarti is an ICU physician in Ottawa. But first, they speak with Heather Talbot. Ms. Talbot’s son Jonathan became an organ donor after his death in 2009. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 26 Sep 2022 | How to be better at diagnosing rare conditions. | 00:33:32 | |
Hereditary angioedema (HAE) is a rare autosomal dominant disorder characterized by recurrent episodes of painful swelling without urticaria that leads to substantial morbidity and even mortality if left untreated. On this episode, Dr. Victoria Cook, an immunologist working in Victoria, BC, describes the case of a woman who had 6 emergency department presentations, 1 hospital admission and saw 5 different specialists over 11 months before finally being diagnosed with HAE. Drs. Bigham and Omole, then speak with Dr. Ed Etchells about how physicians can work to strip away biases and cognitive obstacles that can prevent timely diagnoses of rare and challenging conditions. Dr. Etchells works in the division of General Internal Medicine at Women's College Hospital in the University of Toronto. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 10 Oct 2022 | Optimizing care for patients experiencing sickle cell crises. | 00:41:37 | |
Several hospitals are known for providing particularly excellent care to people experiencing a sickle cell crisis. For example, the ER at UHN meets a key recommendation from the 2017 Ontario Clinical Handbook that patients receive analgesia within 30 minutes of triage. The handbook also recommends that centres support patients’ individual coping strategies through ready access to food, phone chargers and blankets. Many ERs are not meeting this standard. A general lack of awareness about sickle cell disease among physicians, misplaced suspicion about drug-seeking and other biases lead to lengthy delays in patients receiving treatment. On today’s episode, Drs Bigham and Omole speak with Dr. Jennifer Bryan, a founding member of the UHN Emergency Department Sickle Cell Working Group, an emergency physician at UHN and the co-chair of the 2022 Sickle Cell Summit being organized by the Sickle Cell Awareness Group in Ontario. They also speak with Lance Archer, a patient and sickle cell disease advocate about his varied experiences seeking care for painful flare-ups. These interviews prompt a spirited, impromptu “M&M round” in the discussion between the co-hosts as Dr. Bigham reflects on a recent experience of treating a patient with sickle cell disease in an overly-busy ER. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 24 Oct 2022 | Ensuring equitable access to cancer care for Black populations | 00:39:51 | |
Black and immigrant populations are disproportionately underrepresented in regular screening for cancer. Race-based data from Canada are minimally-available, but research from the United States and Europe has shown that the lifetime risk of developing prostate cancer is much higher among Black people compared to white people and Black people who do get the disease tend to have more aggressive tumors and to present at a later stage. On this episode, Drs Omole and Bigham speak with Kikachukwu Otiono, lead author of an analysis in CMAJ titled, Prostate cancer screening in Black men in Canada: a case for risk-stratified care. Ms. Otiono is a final-year medical student at McMaster University in Hamilton. She argues that Black patients should be understood to be at a potentially higher risk for developing prostate cancer and physicians should screen them earlier than guidelines currently recommend, based on evidence from other jurisdictions. They also speak with Dr. Doreen Ezeife, the author of another analysis in CMAJ entitled, Ensuring equitable access to cancer care for Black patients in Canada. Dr. Ezeife describes the barriers to receiving optimal cancer care for Black patients in Canada and discusses the steps that can be taken to ensure more equitable access. Dr. Ezeife also makes the case for the collection of race-based data in Canada to improve understanding of the challenges that minority populations face in accessing medical care. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 31 Oct 2022 | Special Episode: Tackling anti-Black racism in medicine | 00:58:26 | |
Efforts to combat anti-Black racism in Canadian healthcare are underway but much remains to be done to dismantle the ideas, systems and implicit biases that underpin this specific form of discrimination. On this special one-hour episode, Drs Omole and Bigham explore the history of anti-Black racism in Canada’s medical schools, in particular at Queen’s University, where a ban on Black students was only formally lifted in 2018. They also explore solutions, including the development of a curriculum at Queen’s aimed at addressing anti-Black racism. Drs. Omole and Bigham speak with Dr. Sabreena Lawal, a co-author of a paper in CMAJ entitled: Anti-Black racism and medical education: a curricular framework for acknowledging and learning from past mistakes. They then explore the broad set of challenges still facing medicine in Canada and the efforts still needed to address anti-Black racism, with two Black physician leaders, Dr. Onye Nnorom and Dr. Kannin Osei-Tutu. Dr. Osei-Tutu is an acute-care hospitalist physician in Calgary. He is the anti-racism and EDI Strategic Advisor to the CEO of the Royal College of Physicians and Surgeons of Canada. Dr. Nnorom is an Assistant Professor at the University of Toronto and is the co-lead of the Black Health Education Collaborative, which played a major role in the CMAJ special issues on anti-Black racism. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 07 Nov 2022 | Exploring the promise of AI in medicine | 00:30:34 | |
Artificial intelligence, such as computer-aided detection and computer-aided diagnosis or differentiation uses complex algorithms to identify and characterize polyps in situ during screening for colorectal cancer. Emergent evidence suggests that the performance of AI models is superior to current standards of practice. On this episode, Drs Bigham and Omole speak with Dr. Michael Byrne, co-author of a practice paper in CMAJ entitled Artificial intelligence in colorectal cancer screening. He argues that while artificial intelligence will not replace physicians, physicians who use AI will eventually replace physicians who don’t. Next they speak with Zayna Khayat, a future strategist and Vice President of Growth & Client Success at digital health solutions firm, Teladoc Health. She's also adjunct faculty at the Rotman School of Business. Zayna says that AI’s biggest impact on medicine will come from reducing costs and increasing the number of patients that can be guided through the system. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 21 Nov 2022 | Recognizing and addressing human monkeypox in Canada | 00:28:09 | |
A practice article in CMAJ presents 8 images of monkeypox mucocutaneous lesions presenting in Canadian patients from May to July 2022. The images show a spectrum of common lesions seen in patients with human monkeypox during the 2022 outbreak in non-endemic countries. On this episode, Dr. Sharon Sukhdeo and Dr. Darrell Tan, two co-authors of the article discuss their intention that the image atlas be a necessary corrective to the proliferation of images from endemic countries seen early in the outbreak that primarily featured Black patients, often children. Host Dr. Mojola Omole speaks with these guests about the current epidemiology of human monkeypox in Canada, lessons learned from the 2022 outbreak, the importance of accurately describing who is at risk, and how generating awareness of monkeypox transmission in communities at risk may have slowed its spread.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 05 Dec 2022 | Managing epistaxis and identifying who may have a bleeding disorder | 00:40:39 | |
An “old wives’ tale” has persisted in the treatment of anterior epistaxis. A practice article in CMAJ entitled, "Five things to know about anterior epistaxis" discusses what many are doing wrong and the proper way to treat anterior epistaxis. On this episode, co-author and rhinologist Dr. Leigh Sowerby elaborates on the causes and the full suite of options for treating this common cause for emergency department visits. Next, Drs. Bigham and Omole speak with Dr. Michelle Sholzberg, a hematologist and medical director of the coagulation laboratory at St. Michael's Hospital about how to determine if a patient may have a bleeding disorder and needs investigation. Dr. Sholzberg discusses the usefulness of the INR and PTT and then goes on to call out structural sexism in hematology, and in the diagnosis of bleeding disorders, in particular. "Five things to know about anterior epistaxis" Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 19 Dec 2022 | Canada’s primary care crisis: addressing the causes and finding solutions | 00:37:01 | |
A popular theory to explain the crisis in primary care in Canada is that newly graduating physicians simply do not see as many patients as previous generations. But recently published research has thoroughly debunked that myth. On this episode, David Rudoler, who is an assistant professor in the faculty of health sciences at Ontario Tech University, tells Drs. Bigham and Omole that, while his research disproves the ‘lazy millennial physician’ trope, it does show that the number of patient contacts has declined for all primary care physicians over the years. Dr. Tara Kiran, Fidani Chair in Improvement and Innovation at the University of Toronto and a family medicine physician at St. Michael's Hospital Academic Family Health Team, then talks to the hosts about what Canada can do to ensure that everyone in Canada has access to adequate primary care. Dr. Kiran is the author of a commentary in CMAJ entitled Keeping the front door open: ensuring access to primary care for all in Canada. Dr. Kiran argues that interprofessional team-based care, coupled with payment reform, has the potential to improve primary care capacity, access and outcomes for patients, as well as provider well-being. She advocates for more radical reforms such as regionally organized after-hours care and neighbourhood-based primary care, models that currently exist in several European countries. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 02 Jan 2023 | Looking back, looking forward with CMAJ editors | 00:29:23 | |
On this special episode, Drs. Blair Bigham and Mojola Omole interview CMAJ editor-in-chief, Dr. Kirsten Patrick, and executive editor, Dr. James Maskalyk. They talk about the journal's accomplishments over the past year and some of the challenges related to its increased focus on social determinants of health and equity. In the year ahead, Drs. Patrick and Maskalyk say the journal will focus on exploring topics related to access to care, and particularly encourage the submission of articles that discuss bold solutions that can bring about wide-reaching systemic change. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 16 Jan 2023 | Diagnosing, assessing and treating long COVID | 00:33:27 | |
Diagnosing long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is challenging for clinicians. With up to 200 possible symptoms, heterogeneous presentations and no definitive diagnostic test, the diagnosis is a clinical one. In this episode, Dr. Kieran Quinn, a general internist and palliative care physician at Mount Sinai and Bridgepoint Hospitals in Toronto, emphasizes the importance of judicious diagnostic testing in patients with suspected long COVID. The episode also features the personal experience of Suzie Goulding, the founder of COVID Long Haulers Canada, a support group for people struggling with long COVID, who shares her journey with the illness and her ongoing recovery process. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 30 Jan 2023 | Diagnosing, treating and living with migraine | 00:36:33 | |
Migraine is a common condition that affects around 12% of adults, with a higher prevalence in women (18%) than men (6%). Global burden of disease estimates in 2019 found migraine to be the leading cause of disability in women aged 15-49 years and the second leading cause of disability overall. On this episode, Drs. Mojole and Bigham interview three authors of two review articles on the topic published in CMAJ, which focus on diagnosis, acute treatment and prevention of migraine. Dr. Velina Tzankova is a neurology resident at the University of Toronto; Dr. Werner Becker is a neurologist and the founding director of the Calgary Headache Assessment and Management Program, and currently professor emeritus in the Department of Clinical Neurosciences at the University of Calgary; and Dr. Tommy Chan is a neurologist and director of John H. Kreeft Headache Clinic at University Hospital in London, Ontario. As well, Drs. Bigham and Omole interview two women who have battled severe migraine since childhood: psychologist, Dr. Shanthy Edward, and med student, Zikra Awosanmi. They discuss the impact migraine headaches have had on their lives, the challenges they have faced accessing adequate treatment, and their thoughts on what physicians could better understand about this disabling condition. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 13 Feb 2023 | Virtual versus in-person consultation: getting the mix right | 00:34:50 | |
Early in the COVID-19 pandemic, Ontario saw a 5600% increase in virtual visits to health care practitioners, while in-office visits decreased by 79% from the previous year. In 2018, only 4% of family physicians in Canada were offering video visits while, at the peak of the pandemic, about 80% of primary care visits were being delivered virtually in Ontario. Media reports at the time suggested patients were substituting emergency department (ED) visits when in-person consultations were unavailable, leading to additional strain on already stretched ED resources. A research paper published in CMAJ looked at whether this shift in care was in fact taking place. Dr. Hemant Shah is an internal medicine physician and hepatologist at Toronto General Hospital and co-author of the study entitled Association between virtual primary care and emergency department use during the first year of the COVID-19 pandemic in Ontario, Canada. On today’s episode, Dr. Shah discusses the study’s surprising findings with hosts Dr. Blair Bigham and Dr. Mojola Omole. Drs Omole and Bigham then speak with Toni Leamon, the CMA’s patient voice chair, a member of CMA's Virtual Care Taskforce and a co-author of the CMA's Virtual Care Companion for Patients. She offers the patient’s vision of high quality virtual care. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 27 Feb 2023 | Understanding parents’ concerns about vaccinating their children against SARS-CoV-2 | 00:32:39 | |
Uptake of the SARS-CoV-2 vaccine for children aged 5–11 years has been lower than anticipated in Canada. Although research has explored parental intentions toward SARS-CoV-2 vaccination for children, the drivers of parents’ decisions to seek vaccination for their children - or not - have not been studied in-depth. A research paper published in CMAJ, entitled Parents’ perspectives on SARS-CoV-2 vaccinations for children: a qualitative analysis, sought to explore parents’ decision-making. It was a collaboration between physicians, social scientists and research scientists. On this episode, four of the paper’s authors discuss their findings with hosts, Drs. Omole and Bigham. They emphasize the importance of existing trusting relationships between parents and their primary care providers when it comes to making difficult healthcare decisions for children. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 13 Mar 2023 | Redesigning streets to make them safe for bikes, e-scooters, and pedestrians | 00:34:47 | |
The use of electric scooters (e-scooters) has witnessed a substantial surge globally. However, the presence of these motorized vehicles on sidewalks poses a significant risk to pedestrians. A recent practice paper published in CMAJ describes the case of a 68-year-old woman who suffered serious injuries while walking on a city sidewalk after being hit by an e-scooter traveling at approximately 30 km/h. While the authors of the paper recognize e-scooters as a popular, efficient and green form of transportation, they argue effective policies are needed to mitigate risks associated with their use. On this episode, Drs. Blair Bigham and Mojola Omole speak with Zach Williams, the director of policy and government partnerships and Jamie Perkins the director of communications for Superpedestrian. Superpedestrian is an e-scooter company that spun off from the MIT Sensible City Lab. They discuss the necessary changes to urban infrastructure as well as the responsibilities of e-scooter providers to ensure safety for riders and pedestrians. The discussion then shifts to Catherine McKenney, a former Ottawa city councilor and mayoral candidate, who proposed substantial investments in biking infrastructure during their campaign. They argue that debates about safe urban transit have become too polarized and that it is not a matter of being for or against cars, but rather about finding effective solutions to make transportation safe and efficient for all users. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 27 Mar 2023 | How to diagnose and manage polyneuropathy | 00:25:50 | |
Clinicians may find diagnosing polyneuropathy challenging due to the vague and insidious onset of symptoms. Identifying signs consistent with polyneuropathy and determining which investigations to conduct and when to be concerned can be daunting. Polyneuropathy involves simultaneous dysfunction of multiple peripheral nerves, with the most common form being distal symmetric polyneuropathy. Symptoms primarily occur distally, mainly at the bottom of the feet, and progress proximally. Sensory symptoms are more frequent than motor symptoms and signs. Patients with distal symmetric polyneuropathy may experience neuropathic pain, impairments in walking, and distal motor function, significantly impacting their quality of life. Dr. Ario Mirian, a fifth-year neurology resident at the University of Western Ontario's Schulich School of Medicine and Dentistry, is the lead author of a review article in CMAJ entitled "Diagnosis and management of patients with polyneuropathy". In this episode, Dr. Mirian presents a practical approach to diagnosing and managing polyneuropathy while highlighting 'red flags' that should prompt clinicians to investigate potentially serious underlying causes, such as malignancy or vasculitis. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 10 Apr 2023 | Diagnosing, treating and living with endometriosis | 00:38:02 | |
Many patients report their symptoms of endometriosis are often dismissed by healthcare providers as “normal” dysmenorrhea. This worldwide trend results in delays to diagnosis that are estimated to range from 6 to 11 years from symptom onset. On this episode, Drs. Bigham and Omole speak with Dr. Catharine Allaire, a clinical professor at UBC's Department of Obstetrics and Gynaecology and co-author of the review in CMAJ entitled “Diagnosis and management of endometriosis”. Dr. Allaire discusses the challenges and delays in diagnosing endometriosis, its symptoms and causes, and the different varieties of the condition. She also explains the role of imaging in diagnosing endometriosis and how it can be managed through various treatment options from hormone therapies to surgery. Drs. Bigham and Omole also speak with Hannah Robinson, an emergency department nurse who has struggled with endometriosis for seven years. She describes the challenges she faced receiving a diagnosis and accessing care. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 24 Apr 2023 | Rethinking preoperative anemia: Challenging WHO guidelines and targeting hemoglobin levels in major elective surgery | 00:35:29 | |
An estimated 23%-45% of patients undergoing major surgery have anemia, with the most common causes being iron deficiency anemia and anemia of inflammation or chronic disease. Next, Drs. Bigham and Omole take a critical look at the WHO guideline which sets a lower hemoglobin threshold of 120 g/L for female bodies. They speak with Dr. Michelle Sholzberg, the head of hematology-oncology and the director of the Hematology Oncology Clinical Research Group at St. Michael's Hospital in Toronto. Dr. Sholzberg argues that the WHO's sex-based hemoglobin thresholds for diagnosing anemia perpetuate structural discrimination in medicine, as they normalize anemia in females and are based on outdated data with a high risk of bias. Dr. Sholzberg describes how the policies and clinical practices following the biased thresholds may impact health-related quality of life, cognitive function, and the health of pregnant individuals and their babies. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 22 May 2023 | Genetic Perils: Allopurinol Hypersensitivity Syndrome and Personalized Medicine | 00:33:22 | |
Allopurinol hypersensitivity syndrome (AHS) affects approximately 1 in 1,000 patients prescribed allopurinol, with reported mortality rates between 20% and 25%. The risk of AHS is nearly 100 times higher in carriers of the HLA-B*58:01 allele than in noncarriers. Populations with a high allele frequency include Han Chinese (6%-8%), Korean (12%), and Thai (6%-8%) people. In this episode, Drs. Wid Yaseen and Jonathan Zipursky discuss their paper published in CMAJ, titled "Five things to know about…allopurinol hypersensitivity syndrome". Dr. Jonathan Zipursky is a general internist, clinical pharmacologist, and clinician scientist at Sunnybrook Health Sciences Centre. Dr. Yaseen is a second-year internal medicine resident physician at the University of Toronto. They argue that the syndrome's frequency is often underestimated and emphasize the importance of genetic testing in susceptible populations. Next, Dr. David Juurlink broadens the discussion beyond allopurinol to describe other common medications whose effectiveness and safety are significantly influenced by genetic predispositions. Dr. Juurlnk is a staff internist and head of division of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto. He is also a medical toxicologist at the Ontario Poison Centre. He explores the need for expanded genetic testing to protect patients and ensure proper dosing. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 08 May 2023 | How to Prevent Fragility Fractures: A Guideline for Family Doctors | 00:23:12 | |
Fragility fractures are a major health concern for older adults and can result in disability, admission to hospital and long-term care, and reduced quality of life. The Canadian Task Force on Preventive Health Care guideline published in CMAJ provides evidence-based recommendations on screening for primary prevention of fragility fractures. In this special episode of the CMAJ podcast, CMAJ editor-in-chief Dr. Kirsten Patrick speaks to Dr. Roland Grad, a family physician and an author of the new guideline, about the evidence reviews conducted by the task force, the main points of the new guideline, and how family doctors can use it in practice.
The guideline recommends screening females over 65 using the FRAX tool without bone mineral density (BMD) as a risk assessment first strategy. Dr. Grad emphasizes the importance of shared decision making, which can be facilitated using the Fragility Fracture Decision Aid, which incorporates the FRAX tool. This online, interactive tool helps guide discussions with patients about their fracture risk and potential benefits of preventive treatment. Links to resources mentioned in the interview: Canadian Task Force on Preventive Healthcare guideline Fragility Fractures Clinician Infographic Fragility Fracture Decision Aid Article in Journal of Systematic Reviews Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 05 Jun 2023 | Expanding screening of hypertension patients for primary aldosteronism | 00:21:45 | |
On this episode, Dr. Greg Hundemar, co-author of the practice paper in CMAJ “Screening for primary aldosteronism in primary care” discusses primary aldosteronism, its implications and the need to expand screening guidelines. Primary aldosteronism, also known as primary hyperaldosteronism or Conn's syndrome, is an endocrine disorder where the adrenal glands secrete too much aldosterone, leading to hypertension. This condition was once thought to be a rare cause of hypertension, but recent research shows that it may account for 10-20% of cases. Classic symptoms of primary aldosteronism include hypertension, low potassium, and metabolic alkalosis. Patients with this condition are at a disproportionately high risk for cardiovascular disease, rapid decline in kidney function, and higher mortality, independent of blood pressure. Early diagnosis and targeted treatments can significantly improve outcomes. Dr. Hundemar stresses the importance of screening more people with hypertension for primary aldosteronism to diagnose and treat the condition earlier. Current guidelines recommend screening for those with severe or resistant hypertension, hypertension with low potassium, or hypertension with an adrenal nodule. However, Dr. Hundemar advocates for expanding screening for primary aldosteronism in patients with hypertension, as doing so can potentially identify a large number of undiagnosed cases. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 19 Jun 2023 | Time for a reset: menopause and hormone replacement therapy | 00:32:26 | |
Many women complain that physicians are reluctant to treat menopause with the full range of available therapies, often dismissing symptoms as 'natural' and something to be endured. A review article in CMAJ finds that physician fears around menopausal hormone therapy and lack of knowledge regarding treatment options often impede patients from receiving treatment. On this episode, Drs. Mojola Omole and Blair Bigham speak with Dr. Iliana Lega, the lead author of the review entitled "A pragmatic approach to the management of menopause." Dr. Lega is a Clinician Scientist and Endocrinologist at Women’s College Hospital in Toronto. She encourages physicians to update their therapeutic understanding of menopause and to initiate conversations with women about the symptoms of perimenopause as they enter their forties. Drs. Omole and Bigham also hear from Janet Ko, the co-founder and president of the Menopause Foundation of Canada. She shares her personal experience of receiving a delayed diagnosis of perimenopause and the impact of hormone replacement therapy on her well-being. Ms. Ko also shares the results of the foundation's study on women's experience receiving care for menopause, and reports that 72 percent of women found medical advice to be unhelpful or only somewhat helpful. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 03 Jul 2023 | Optimizing nonsurgical management of major hemorrhage | 00:29:16 | |
Major hemorrhage is life-threatening and can occur in a variety of clinical settings. A review paper in CMAJ, entitled "Nonsurgical management of major hemorrhage," advocates for the implementation of massive hemorrhage protocols across all types of hospitals to optimize patient care. Dr. Jeannie Callum, the article's lead author and the Director of Transfusion Medicine at Kingston's Health Sciences Centre speaks with Drs. Blair Bigham and Mojola Omole about her work standardizing massive hemorrhage protocols throughout Ontario. Dr. Callum shares the transformative moment that inspired her to develop a province-wide protocol, starting from the point of roadside patient care. She then details the critical need for precision in managing major hemorrhage, emphasizing a rapid response within the "golden hour." Dr. Callum outlines key components of care such as swift administration of tranexamic acid and the detection of coagulopathy. She then simplifies the main elements of a massive hemorrhage protocol into what she calls "the seven 'T’s." In rural settings, Dr. Callum identifies the need for a simplified protocol due to constraints like smaller medical teams and a lack of comprehensive laboratory tests. Despite these challenges, she recommends innovative solutions like the immediate administration of tranexamic acid and encourages physicians to educate themselves about novel point-of-care testing technologies such as viscoelastic testing. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 24 Jul 2023 | Radon and lung cancer: A call to action for physicians and policymakers | 00:35:15 | |
Radon gas exposure is the leading cause of lung cancer in non-smokers, accounting for approximately 3,000 cases annually in Canada. A “Five things to know about…” paper in CMAJ entitled “Radon and lung cancer risk" encourages physicians to ask patients to test their home and workplace for the invisible gas. Dr. Silvina Mema and Greg Baytalan are co-authors of the article, and on this episode, they detail the significant public health risk radon poses, the relative ease of testing, and the cost of successful mitigation. They argue that family doctors and specialists play a critical role in creating awareness about radon gas and reducing its impact on patient health and the public healthcare system. Next, Dr. Aaron Goodarzi advocates for changes to cancer screening guidelines to include individuals with elevated lifetime radon exposure. Dr. Goodarzi is the Scientific Director of the Evict Radon national study. He points out that 40% of people who experience lung cancer will never be eligible for current screening programs because they don't use enough tobacco. Dr. Goodarzi goes on to describe the many ways public policy can be used to reduce the risk of radon exposure, from updated building codes to mandatory testing of public spaces like daycares, and financial assistance for radon gas mitigation. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 07 Aug 2023 | The power of narrative medicine | 00:32:37 | |
The award-winning essay in the CMAJ, "Sometimes, often," beautifully showcases the power of narrative to forge a deep connection between physicians and patients. The article clearly resonated with our readers, as it was the most-read humanities piece this year. On this episode, the author, Dr. Simran Sandhu, delivers a powerful reading of her article. She then speaks with Drs. Blair Bigham and Mojola Omole about what inspired her to write the essay and how storytelling enables her to build deeper connections with her patients, and in turn, find meaning in her practice. Next, Dr. Indu Voruganti joins the conversation. She is a radiation oncologist and instructor in the Narrative-Based Medicine Program at the University of Toronto. Dr. Voruganti describes narrative medicine as a tool for combating burnout and promoting empathy in medical practice. She advocates for creating space for reflection and vulnerability, and argues that narrative medicine has the potential to enhance both patient care and physician well-being. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 21 Aug 2023 | Encore: Diagnosing, treating and living with migraine | 00:36:38 | |
== This is an encore presentation of an episode originally published on Jan 30, 2023 == On this episode, Drs. Mojole and Bigham interview three authors of two review articles on the topic published in CMAJ, which focus on diagnosis, acute treatment and prevention of migraine.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 25 Dec 2023 | ENCORE: Smartphones, social media and poor mental health | 00:35:21 | |
On this episode, we revisit and update one of the most-read articles on the CMAJ website. The article is titled, “Smartphones, social media use, and youth mental health.” It reviews the extensive literature linking poor mental health in adolescents with smartphone and social media use. The article details a variety of studies that implicate smartphone and social media use in increased mental distress, self-injurious behaviour, and suicidality among youth. It also indicates that there's a dose-response relationship, with the effects appearing to be most pronounced among girls. The lead author of the paper is Dr. Elia Abi-Jaoude. He is a psychiatrist and researcher at The Hospital for Sick Children in Toronto. He delves into recent research exploring how social media and smartphone use negatively impact the mental health of young individuals.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 18 Sep 2023 | EDs in crisis: causes and solutions | 00:34:28 | |
Canada’s emergency departments are in crisis: hospital occupancy rates exceed 90% for many days in a row, and many Canadian hospitals have been exceeding 100% occupancy for months on end. As a result, quality of care has decreased, staff retention has become problematic and overcrowding of emergency departments, a symptom of the problem, is assured. On this episode, Drs. Omole and Bigham speak with Dr. Catherine Varner, an emergency physician in Toronto, deputy editor of CMAJ, and author of two editorials in the journal detailing the state of Canada’s emergency departments, the causes of the crisis and possible solutions. Joining the conversation is Dr. David Petrie, an emergency physician in Halifax and co-chair of the Canadian Association of Emergency Physicians’ EM:POWER Task Force on the Future of Emergency Care who explores what a whole system approach to resolving this pressing issue might look like. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 02 Oct 2023 | Tick-borne illnesses: an evolving health concern | 00:32:58 | |
In this episode, Drs. Blair Bigham and Mojola Omole speak with two leading experts: Dr. Samira Jeimy, an allergist, and Dr. Isaac Bogoch, a specialist in infectious diseases, about the increasing prevalence of allergies and infections in Canada attributed to insects. Dr. Jeimy authored the article in the CMAJ titled “Five things to know about… tick-borne red meat allergy (α-gal syndrome)”. Dr. Jeimy describes how tick bites introduce a carbohydrate, alpha-gal, leading the human body to manifest allergic reactions to red meat. She underscores the diagnostic challenges associated with this allergy due to its delayed reactions and the spectrum of symptoms, which can range from mild to critical. Dr. Bogoch shifts the focus to the expanding footprint of tick and other insect-borne diseases in Canada, such as Lyme disease, anaplasmosis, and babesiosis. He attributes this surge to the climatic shift towards warmer temperatures and abbreviated winters. He emphasizes the indispensability of preventive measures, including vigilant tick checks, use of repellents, and donning protective clothing. Both experts stress the urgency of heightened education, rigorous surveillance, and enhanced testing methodologies. As ticks and insects advance further north, physicians need to be alert to this emerging health challenge. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 16 Oct 2023 | Promoting health equity in primary care | 00:34:36 | |
In this episode, Dr. Blair Bigham and Dr. Mojola Omole speak with two co-authors of a new guideline published in CMAJ entitled "Preventive care recommendations to promote health equity". Dr. Nav Persaud and Dr. Aisha Lofters explain the importance of embedding health equity into healthcare and discuss specific ways public policy and individual primary care physicians can work together to promote equity in their practices. The conversation highlighted some key recommendations such as:
Overall, Drs. Persaud and Lofters advocate for a shift towards recognizing that inequities in health outcomes exist and that primary care physicians need to embed equity into their healthcare practices. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 30 Oct 2023 | New guidelines for alcohol use disorder | 00:30:24 | |
In this episode, Drs. Blair Bigham and Mojola Omole delve into the pressing issue of alcohol use disorder (AUD) in Canada with Dr. Evan Wood, the lead author of the “Canadian guideline for the clinical management of high risk drinking and alcohol use disorder” published in CMAJ. They explore the concerning prevalence of AUD in Canada, contrasting it with other countries and shedding light on the diagnostic criteria that underscore the significance of assessing clinically significant impairment or distress. Dr. Wood clarifies the hurdles faced in identifying and treating AUD, highlighting the shortfall in healthcare provider education and resources. He underscores the importance of routine screening for alcohol use by physicians and offers invaluable tips to improve recognition of this pervasive disorder. Dr. Wood outlines the recommended pharmacotherapies as stipulated in the guideline. He points out the frequency with which ineffective, or even harmful, treatments are prescribed for mood symptoms related to AUD and calls on physicians to follow evidence-based approaches. Dr. Wood concludes by emphasizing the necessity of constructing a comprehensive system to tackle alcohol use disorder head-on in Canada, fostering a thorough understanding of this widespread health challenge among the medical community. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 13 Nov 2023 | Recommendations on SARS-CoV-2, influenza and RSV vaccinations | 00:32:04 | |
On this episode, Drs. Mojola Omole and Blair Bigham speak with two vaccine experts about the necessity, timing and availability of vaccines as we move into the season when influenza, RSV and COVID-19 are on the rise. Dr. Scott Halperin, co-author of a CMAJ practice paper on SARS-CoV-2 vaccination in pregnancy, emphasizes the importance of vaccination to protect against COVID-19 infection during pregnancy. He notes that while there is awareness among healthcare practitioners, it is crucial to continually highlight and reemphasize the importance of vaccination during pregnancy. The risk of severe outcomes from COVID-19 is higher in pregnant individuals compared to non-pregnant individuals. Vaccination during pregnancy not only protects the mother but also transfers antibodies to the fetus, providing protection in the first few months of life. Next, Dr. Trevor Arnason, Associate Medical Officer of Health with Ottawa Public Health, discusses the availability and administration of fall vaccines. He explains that the influenza vaccine is recommended for everyone over six months of age, with a higher dose available for older adults. The SARS-CoV-2 vaccine can be administered at the same time as the influenza vaccine, as there is now sufficient data on its safety. The RSV vaccine, currently approved for individuals over 60, is not government-funded and may not be accessible to everyone. Dr. Arnason emphasizes the importance of getting both the influenza and SARS-CoV-2 vaccines, particularly for high-risk groups such as young children, older adults, and individuals with underlying health conditions. In summary, both Drs. Halperin and Arnason argue it is crucial for healthcare providers to educate and encourage their patients, especially pregnant individuals, to get vaccinated. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 27 Nov 2023 | The rapid evolution and enhanced capabilities of virtual urgent care | 00:36:11 | |
On this episode, Drs. Blair Bigham and Mojola Omole delve into the evolution and advancements in virtual urgent care since the COVID-19 pandemic. The discussion centers around the study published in CMAJ entitled "Healthcare utilization and outcomes of patients seen by virtual urgent care versus in-person emergency department care," which analyzed patient usage and outcomes during the height of the pandemic. The study didn’t specifically track how many patients were redirected from emergency departments (ED) to virtual care. However, it found that around 80% of patients seen via virtual urgent care didn't require an immediate ED visit, suggesting that virtual care likely reduced some emergency presentations. However, it also noted that virtual urgent care didn't always prevent subsequent hospital visits. Importantly, the study reflects a specific period and doesn't capture the current state of virtual urgent care.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 11 Dec 2023 | Pharmacogenomic testing: billion-dollar savings in depression treatment | 00:26:55 | |
On this episode, Drs. Blair Bigham and Mojola Omole discuss the CMAJ paper "Cost-effectiveness of pharmacogenomic-guided treatment for major depression". The paper examines the potential of pharmacogenomic testing in the treatment of major depression and its implications for health care costs. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 04 Sep 2023 | Smartphones, social media and poor mental health | 00:36:33 | |
On this encore episode, we revisit and update one of the most-read articles on the CMAJ website. The article is titled, “Smartphones, social media use, and youth mental health.” It reviews the extensive literature linking poor mental health in adolescents with smartphone and social media use. The article details a variety of studies that implicate smartphone and social media use in increased mental distress, self-injurious behaviour, and suicidality among youth. It also indicates that there's a dose-response relationship, with the effects appearing to be most pronounced among girls. The lead author of the paper is Dr. Elia Abi-Jaoude. He is a psychiatrist and researcher at The Hospital for Sick Children in Toronto. He delves into recent research exploring how social media and smartphone use negatively impact the mental health of young individuals.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 15 Jan 2024 | ASA: a simple, effective and underused treatment for preeclampsia | 00:36:47 | |
On this episode, Dr. Emmanuel Bujold addresses the gross underutilization of acetylsalicylic acid (ASA) in Canada during pregnancy, a treatment highly effective in preventing preterm preeclampsia among those at risk. Dr. Bujold is an OB-GYN in Quebec City and a professor of Obstetrics & Gynecology at Laval University's School of Medicine. He is a co-author of the commentary in CMAJ entitled, “Screening for preeclampsia risk and prophylaxis with acetylsalicylic acid”. Dr. Bujold presents evidence showing ASA's effectiveness in preventing more than 80% of severe preeclampsia cases. He advises that high-risk pregnant women take ASA up to 36 weeks of gestation, with ongoing research potentially adjusting this recommendation. Dr. Bujold describes a simple, relatively inexpensive, and widely available testing protocol that can effectively predict preeclampsia in the first trimester and that starting aspirin before 16 weeks of pregnancy can prevent severe cases. Next, Dr. Modupe Tunde-Byass, an OB-GYN based in Toronto and the inaugural president of the Black Physicians of Canada, emphasizes the disparities in pregnancy outcomes among racialized communities, particularly the higher rates of morbidity and mortality among Black women. She advocates for the implementation of race-based data collection in healthcare to better understand and address these disparities, highlighting the importance of tailored medical approaches to improve outcomes for these communities. This podcast has been sponsored by PrescribeIT. Click here for more information. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 29 Jan 2024 | More than just novel obesity treatments | 00:37:31 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the practice article in the journal entitled, “Five things to know about…Novel obesity treatments". They discuss the impact of new medications like semaglutide and tirzepatide in treating obesity with Dr. Shohinee Sarma, the lead author. Dr. Sarma explains the significant effects these drugs have on weight loss and cardiometabolic health. They also discuss how these treatments can be combined with behavioral therapies for improved results, while considering potential side effects and complications. Next, Dr. Ashley White, a family physician and diplomate of the American Board of Obesity Medicine, emphasizes the need for a comprehensive approach to obesity management. She stresses the importance of establishing realistic expectations with patients, addressing self-image concerns, and considering the long-term impacts on metabolic health. The conversation also touches on the societal biases and stigmas around obesity, highlighting the necessity for a change in how physicians and society view this medical condition. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 12 Feb 2024 | Exclusion of people with disabilities in medicine | 00:38:03 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole examine an article published in CMAJ titled, 'Tackling barriers to Canadian medical school admissions for students with disabilities.' The analysis highlights how medical education has historically devalued or excluded trainees with disabilities and emphasizes the need for more flexible and inclusive admission processes. Next, the hosts speak with Dr. Caroline Bowman, a family physician who developed multiple sclerosis mid-career, to discuss her initial symptoms, her fears and concerns, and the impact of MS on her ability to work as a family physician. She also talks about the challenges she faced in accepting her disability and the shame associated with it. Dr. Bowman offers her thoughts on how the medical profession can be more accommodating and understanding towards physicians with disabilities, and the benefits that both physicians and patients can gain from addressing shame and creating a more compassionate culture in medicine. The discussion acknowledges how strains in the medical system reduce flexibility and challenge its capacity to make systemic changes. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 26 Feb 2024 | Opioid poisonings: shortfalls in treatment and new threats | 00:38:22 | |
On this episode of the CMAJ Podcast, Dr. Catherine Varner, deputy editor of CMAJ, sits in for Dr. Blair Bigham and joins Dr. Mojola Omole to explore two articles published in the journal that highlight troubling findings concerning the treatment of opioid use disorder. They begin with a study that revealed significant gaps in treatment for opioid overdose patients, where only 5.5% received opioid agonist therapy within a week of their hospital visit. This comes five years after the release of guidelines for opioid use disorder management in Canada, which recommended starting opioid agonist therapy, specifically Suboxone, in patients with opioid use disorder. One of the paper’s co-authors, Dr. Jessica Kent-Rice, a PGY5 resident in emergency medicine and toxicology fellow at the University of Toronto, dissects the complexities of treating opioid use disorder in the emergency department and makes a passionate plea for physicians to increase their prescriptions of these life-saving therapies. Transitioning to the second article, the hosts examine the presence of xylazine, a veterinary sedative, in the illicit opioid supply. Dubbed the "zombie drug" due to its effects on people's skin and prolonged effects during overdose, xylazine is raising alarm bells among emergency physicians. However, the article's co-author, Dr. Peter Wu, an internist and clinical pharmacology and toxicology physician at the University Health Network in Toronto, advocates for a balanced response. He cautions against excessive concern, noting that treatment continues to revolve around providing supportive care. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 11 Mar 2024 | Building patient trust in health care | 00:38:40 | |
On this episode, Dr. Blair Bigham and Dr. Mojola Omole explore two articles in CMAJ focused on the critical importance of trust in the health care system. They speak with Louis Lochhead, who shares his experiences navigating the health care landscape as a caregiver after his wife's serious accident, which resulted in a coma lasting nearly two months. Lochhead highlights the difficulties in building trust with the medical team, pointing to challenges in communication and empathy. He recounts moments where the lack of clear, compassionate communication from health care providers compounded the stress and uncertainty of the situation, leaving him feeling isolated and disconnected from the decision-making process regarding his wife's care. Next, Dr. Omole and Dr. Bigham speak with Dr. François Lamontagne, an intensive care specialist, who offers insights into how health care professionals can better connect with families and build trust, especially when faced with uncertain diagnoses or prognoses. He emphasizes the importance of acknowledging the inherent unpredictability of medicine and the value of being transparent about known facts and areas of ambiguity. Dr. Lamontagne suggests that by engaging in open, honest dialogues that respect the family's perspective and concerns, health care providers can create a more supportive environment that encourages shared decision-making. This approach not only helps in building trust but also empowers families during challenging times, making them feel valued and part of their loved one's care journey. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 25 Mar 2024 | Diagnosing rare and common infections in returning travellers | 00:30:33 | |
On this episode, Dr. Blair Bigham and Dr. Mojola Omole explore a clinical case involving a rare infection in a returned traveler, highlighting the critical role of travel history in diagnosing unusual diseases. They discuss the case of a woman in her 60s who presented with fever and ankle pain after returning from India. Initial concerns for septic arthritis led to further investigation when standard treatments failed to alleviate her symptoms. Dr. Mara Waters is the lead author of the clinical case entitled “Melioidosis with septic arthritis in a returning traveller,” published in Canadian Medical Association Journal (CMAJ). She details the steps the infectious diseases team took to ultimately identify the infection as caused by Burkholderia pseudomallei. Dr. Waters, an infectious diseases fellow at the University of Toronto, describes the challenges of diagnosing and treating melioidosis, emphasizing the importance of considering travel history and the evolving geography of infectious diseases. She highlights the broader implications of climate change on the spread of infectious diseases and the interconnectedness of human, animal, and environmental health. Following the case discussion, Dr. Jeffrey Pernica, a specialist in infectious diseases and tropical medicine, offers a refresher on common infections in returning travelers, such as malaria, dengue, and typhoid. He stresses the importance of considering these more prevalent conditions when evaluating a returning traveller with fever, providing practical advice on diagnosis and management. This episode serves as a reminder of the complexities of diagnosing travel-related infections and the need for clinicians to be vigilant about travel history, especially in the context of global travel resurgence and the impacts of climate change on infectious disease patterns. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 08 Apr 2024 | Diagnosis and treatment of anorexia nervosa in adolescent males | 00:38:10 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole closely examine anorexia nervosa in male adolescents, a topic that frequently escapes notice. Their discussion highlights the disorder's prevalence, especially among high-risk groups like LGBTQ+ individuals and those from varied racial and ethnic backgrounds. It also underscores the severity of anorexia nervosa in young males and stresses the critical need for early recognition and intervention. This episode features an in-depth conversation with Sterling Renzoni, a fourth-year biochemistry student at Trent University, who shares his personal journey through diagnosis, treatment, and recovery from anorexia nervosa. Sterling's narrative provides valuable insights into the complexities of identifying and treating the disorder in males, highlighting the societal and personal challenges that can impede recognition and care.
This podcast has been sponsored by the Yarmouth Region Medical Professional Recruitment Partnership. Click here for more information. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 22 Apr 2024 | Confronting the high stakes of incivility in health care | 00:37:19 | |
On this episode of the CMAJ Podcast, Dr. Eve Purdy makes it clear what’s at stake when it comes to incivility in medicine. "It's very simple. Incivility kills patients, and that needs to be the single line of every healthcare leader responsible for managing and leading teams.” Dr. Purdy joins Dr. Sarah Kim and hosts, Drs. Blair Bigham and Mojola Omole, for an urgent panel discussion that looks into the deep-seated reasons behind incivility in medical settings. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 06 May 2024 | Navigating the complex relationship between palliative care and MAiD | 00:34:55 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore the intricate relationship between medical assistance in dying (MAiD) and palliative care in Canada. They focus on a qualitative study titled "Perspectives of Canadian healthcare leaders on the relationship between medical assistance in dying and palliative and end-of-life care services: a qualitative study," which interviewed 36 professionals from both fields. The study reveals significant gaps in collaboration and coordination, leading to feelings of exclusion among MAiD providers. Dr. Gilla Shapiro, a co-author of the study, discusses the diverse perspectives of health leaders on the integration of MAiD and palliative care services. She highlights the challenges posed by geographical, institutional, and personal factors in standardizing the relationship between these services. Dr. Shapiro shares insights into the initial tensions and the gradual improvements in cooperation, stressing the necessity for enhanced education, reduced stigma, and improved communication with patients to foster a collaborative environment that prioritizes their welfare. Following this, the conversation shifts to Dr. Christopher Blake, a palliative care physician from Peterborough, Ontario. Dr. Blake shares his surprise at the study's finding that support for physician assisted dying among MAiD and palliative care practitioners is lower than that of the general population. He articulates a clear distinction between the objectives of palliative care and MAiD, the need for a seamless transition between services, and the ethical implications when patients are moved from palliative care to MAiD without adequate support. Dr. Blake advocates for robust funding for coordination and the establishment of clear standards across healthcare services, highlighting the importance of a unified approach in end-of-life care. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 20 May 2024 | Constructive conversations on CanMEDS revisions | 00:43:32 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the heated debate over proposed updates to the CanMEDS framework. The controversy ignited when an interim report placed principles of equity, social justice, and anti-racism at the heart of the framework, rather than medical expertise. Dr. Kannin Osei-Tutu, author of a commentary in CMAJ, proposes a new model for CanMEDS that places shared humanity and compassion at the centre. He argues that the current model of medical education and practice needs to be reimagined, as it has resulted in gross systemic inequities in health outcomes that urgently need to be addressed. He calls for expanding and enriching the concept of medical expertise to incorporate principles of inclusive compassion and social justice. Dr. Philip Berger agrees on the need for healthcare to be free from bias, discrimination, systemic injustice, and racism but criticizes Dr. Osei-Tutu’s model and the interim CanMEDS revisions for not placing medical expertise at the centre of physician competency. Dr. Berger, a Toronto family physician and member of the Canadian Medical Hall of Fame, is noted for his long history of advocacy on behalf of marginalized groups. He argues that failing to place medical expertise at the centre of CanMEDS is a fatal flaw, as it undermines the credibility of physicians, thereby reducing their influence, which is essential for effective social justice advocacy. Throughout the discussion, the hosts and guests stress the importance of maintaining civil dialogue and prioritizing the improvement of healthcare outcomes for marginalized populations. For more information from our sponsor, go to medicuspensionplan.com Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 03 Jun 2024 | Responding to rising measles rates in Canada | 00:31:38 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle an unexpected yet urgent topic: the resurgence of measles. With rising cases globally and in Canada, they discuss the implications and necessary actions for healthcare professionals. Dr. Sarah Wilson, a public health physician at Public Health Ontario, provides a comprehensive overview of the current measles situation. She explains the factors contributing to the increase in cases, including disruptions to immunization services during the COVID-19 pandemic and preexisting trends in declining vaccine acceptance. Dr. Wilson also highlights the severe complications of measles, especially for vulnerable groups such as children under five, pregnant individuals, and those who are immunocompromised. The conversation shifts to practical steps for healthcare providers. Dr. Wilson details the importance of considering measles in differential diagnoses for patients with fever and rash, particularly those with relevant exposure histories. She emphasizes the need for appropriate diagnostic testing and discusses the public health response, including the administration of immune globulins for high-risk contacts. The key practical step for controlling measles is, of course, widespread immunization. Dr. Samira Jeimy, an assistant professor and the program director for the division of Clinical Immunology and Allergy at Western University. She offers an overview of the vaccine including its effectiveness and safety, despite persistent misinformation. Dr. Jeimy explains the vaccination schedule for children and the importance of booster doses for adults, especially before travel to areas with active outbreaks. She also details the role of vaccination given within 72 hours of an exposure to reduce the risk of infection or lessen the severity of measles if infected. Throughout the episode, the hosts and guests emphasize the need for improved communication and trust-building between healthcare providers and patients when addressing vaccine hesitancy. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 17 Jun 2024 | Integrating exercise into depression care | 00:33:10 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the evidence supporting exercise as an effective treatment option for mild to moderate depression. They explore how exercise might be used effectively and the challenges involved in implementing it for patients. Dr. Nicholas Fabiano, a second-year psychiatry resident at the University of Ottawa, is co-author of the paper "Exercise as treatment for depression." He surveys the evidence showing that exercise can be as effective as antidepressants and psychotherapy for mild to moderate depression. He explains the FITT principle (frequency, intensity, type, and time) for prescribing exercise and stresses the need for setting realistic goals. Dr. Fabiano's article recommends physicians reference a practical guide for exercise for people who have depression, written by Dr. Michelle Fortier and colleagues. Dr. Fortier, a physical activity psychologist and professor at the University of Ottawa’s School of Human Kinetics, offers her perspective on encouraging patients with depression to include exercise as part of their overall treatment plan. She suggests bringing kinesiologists into primary care to help patients overcome barriers to exercise. Dr. Fortier talks about the importance of small, manageable steps and using motivational interviewing techniques to engage patients. She also discusses the "commit 10" approach, which encourages patients to start with just ten minutes of activity over a two week period. Throughout the episode, the hosts and guests stress the importance of empathy, realistic goal setting, and systemic support to make exercise a practical treatment option for depression. They highlight the overall benefits of movement for both mental and physical health and advocate for a more integrated approach to patient care.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 01 Jul 2024 | Understanding and Preparing for H5N1 | 00:31:05 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the latest concerns surrounding the H5N1 virus. They explore the current state of its transmission, symptoms and treatments. They also assess our pandemic preparedness and whether we are applying the lessons learned from COVID-19 to this new potential threat. Dr. Robert Kozak, a microbiologist at Sunnybrook Health Sciences Center and co-author of the article "Five things to know about highly pathogenic avian Influenza A: H5N1 Virus," addresses the recent cases of H5N1 transmission from dairy cattle to humans, explaining the symptoms and severity of the infections. He also discusses the current treatments available, the potential for human-to-human transmission, and the need for increased awareness among clinicians. Dr. Thomas Piggott, the Medical Officer of Health and CEO of the city and county of Peterborough, Hiawatha, and Curve Lake First Nation Public Health, provides insights on pandemic preparedness. He reflects on the lessons learned from the COVID-19 pandemic and evaluates whether we are better equipped to handle another pandemic. Dr. Piggott stresses the importance of maintaining public health infrastructure, enhancing surveillance methods like wastewater testing, and ensuring equitable access to care for all populations. Throughout the episode, the hosts and guests highlight the need for ongoing vigilance, improved public health measures, and a proactive approach to pandemic preparedness. They advocate for sustained investment in public health resources and infrastructure to better manage and mitigate future health crises. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 15 Jul 2024 | Groundbreaking advancements in HIV treatment and prevention | 00:44:54 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore groundbreaking advancements in HIV treatment and prevention. They examine various innovative approaches that are transforming the landscape of HIV care. Dr. Darrell Tan, a clinician scientist at St. Michael's Hospital and associate professor at the University of Toronto, discusses the article he co-authored, "Long-acting injectable antiretroviral therapy for HIV-1 infection in adults." He explains the newly approved long-acting injectable cabotegravir for PrEP, an integrase inhibitor administered as a deep intramuscular injection administered every two months. Dr. Tan highlights its superior effectiveness compared to daily oral PrEP, emphasizing its adherence benefits and potential to revolutionize HIV prevention. Additionally, he covers the long-acting injectable treatment regimen for HIV, which combines cabotegravir with rilpivirine, administered as two intramuscular injections every one to two months. This regimen offers an alternative to daily oral medication, easing the treatment burden for individuals living with HIV. Dr. Maxime Billick, a graduating infectious diseases fellow at the University of Toronto and co-author of "HIV postexposure prophylaxis-in-pocket," introduces the concept of "PIP" (prophylaxis-in-pocket). She explains how this approach allows individuals who might rarely have high-risk encounters to keep a 28-day supply of PEP (post-exposure prophylaxis) on hand, enabling immediate use after potential HIV exposure. Dr. Billick discusses the importance of ongoing patient-provider relationships and the role of PIP in empowering patients to proactively manage their sexual health. Throughout the episode, the hosts and guests explore the challenges and opportunities presented by these new treatments. They emphasize the importance of accessibility, awareness, and the need to address health inequities in HIV prevention. The conversation underscores the potential of these advancements to significantly impact public health and improve the quality of life for individuals at risk of or living with HIV. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 29 Jul 2024 | Innovative solutions to a vexing issue: “social admissions” | 00:36:15 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle the complex issue of "socially admitted" patients, sometimes uncharitably referred to as "granny dumping." They explore the factors leading to these non-acute medical admissions, the challenges faced by healthcare providers and innovative solutions to the problem. Dr. Jasmine Mah, a geriatrics fellow at Dalhousie University, shares insights from her qualitative study published in CMAJ, titled "Managing “socially admitted” patients in hospital: a qualitative study of healthcare providers' perceptions". She provides examples of typical “social admissions”, such as patients with chronic conditions whose care circumstances have changed, and highlights the high mortality rates associated with these cases. The discussion moves to the attitudes of healthcare providers towards “socially admitted” patients, the systemic failures leading to these admissions, and potential solutions. Dr. Mah emphasizes the need for better understanding and support for these patients, suggesting systemic changes like integrating social vulnerability into case mix indices and improving community care to prevent unnecessary hospital admissions. Dr. Andrew Boozary, a primary care physician and executive director of the Gattuso Center for Social Medicine at University Health Network in Toronto, expands on these ideas in an editorial response. He underscores that these issues are not personal failures but policy failures, advocating for increased support roles like peer support workers and social medicine navigators. Dr. Boozary highlights the importance of innovative team-based care models to address the gaps in the current healthcare system. Throughout the episode, the hosts and guests call for a more integrated and empathetic approach to patient care, stressing the need for systemic changes to better manage “socially admitted” patients and improve overall healthcare outcomes. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 12 Aug 2024 | Managing the serious risks of vaping among youth | 00:28:11 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole address the increasingly urgent issue of adolescent vaping. Rates of use of e-cigarettes containing nicotine by youth in Canada continue to be among the highest in the world. They speak with Dr. Madelynn Hannah, a clinical pharmacist, and Dr. Trisha Tulloch, a pediatrician specializing in adolescent and addiction medicine at CAMH and SickKids Hospital in Toronto. Both co-authors of the CMAJ article "E-cigarette use in adolescents.” Dr. Tulloch discusses the broader physiological impacts of nicotine on adolescents, including cardiovascular issues and the potential for seizures. She emphasizes the need for behavioral interventions and technological tools, such as mobile apps, to aid in vaping cessation. Dr. Tulloch also highlights the critical role of parental involvement in supporting youth through their journey to quit vaping. The conversation covers recent regulatory efforts, including Ontario's ban on vaping in schools, and calls for stronger enforcement and possible bans to protect young people. The guests argue for more stringent measures and better education to mitigate the health risks of vaping among adolescents. Throughout the episode, the guests underscore the urgent and serious nature of adolescent vaping, and the need for immediate action. They advocate for a multifaceted approach that combines policy responses, such as increased taxation with comprehensive education for parents and young people about the dangerous and addictive nature of vaping. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 26 Aug 2024 | ENCORE: Confronting the high stakes of incivility in health care | 00:37:55 | |
On this episode of the CMAJ Podcast, Dr. Eve Purdy makes it clear what’s at stake when it comes to incivility in medicine. "It's very simple. Incivility kills patients, and that needs to be the single line of every healthcare leader responsible for managing and leading teams.” Dr. Purdy joins Dr. Sarah Kim and hosts, Drs. Blair Bigham and Mojola Omole, for an urgent panel discussion that looks into the deep-seated reasons behind incivility in medical settings. Dr. Eve Purdy is an emergency medicine physician and applied anthropologist at Gold Coast Hospital and Health Service in Australia. She focuses on helping healthcare teams perform at their best. Dr. Sarah Kim is a family physician and an assistant professor in the Department of Family and Community Medicine at the University of Toronto. She's also the Medical Education Health Humanities Lead at Temerty Faculty of Medicine, where she researches the intersection of high performance and hierarchical systems. Together, they explore the structural failures, embedded cultures, and the detrimental role "a few bad actors" can have on the effectiveness of entire teams. The conversation underscores the importance of prioritizing healthy communication practices, cultivating respect within healthcare teams, and the essential role leadership needs to play in combating incivility to safeguard patient care. The episode begins with a conversation with Dr. Armand Aalamian, a family physician and executive director at the Canadian Medical Protective Association. He is a co-author of the article in CMAJ titled, "Five things to know about…Physician incivility in the health care workplace.” Dr. Aalamian reviews the evidence of the pervasive nature of incivility in health care, its detrimental effects on professional relationships, and its direct correlation to patient outcomes. The discussion not only highlights the problem but also proposes actionable solutions, emphasizing, once again, the role of leadership in fostering a culture of civility. This episode is structured to arm medical professionals with both an understanding of the causes of incivility and the skills to combat it. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 09 Sep 2024 | Meningitis B outbreaks: vaccination and risk in university settings | 00:30:49 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore the ongoing public health concern of meningococcal disease, focusing on meningitis B outbreaks in Canadian universities. They are joined by Dr. Cristin Muecke, a medical officer of health in Halifax, and Dr. Savita Rani, a public health specialist at the University of Saskatchewan. The episode also features the personal story of Megan Plamondon, a Queen’s University student who contracted invasive meningococcal disease. The discussion opens with a look at recent meningitis B outbreaks, including cases at Dalhousie University in 2022 and Queen’s University in 2023. The Halifax outbreak led to a targeted vaccination effort offering publicly funded MenB vaccines to students in congregate living environments, such as dormitories and residences. Dr. Muecke provides insights into the Halifax outbreak and the public health response that followed. She discusses the complexities of identifying and controlling meningococcal disease in university settings, where asymptomatic carriers of Neisseria meningitidis can unknowingly contribute to the spread of the infection. Dr. Rani expands on the current state of MenB vaccination, explaining why the vaccine is not included in routine immunization schedules and outlining the challenges of securing broader vaccine coverage across the country. She emphasizes the importance of early detection, given that meningitis can present with nonspecific symptoms which complicates diagnosis. Megan Plamondon’s story brings a lived experience perspective to the conversation, highlighting the severe impact of meningococcal disease and the critical need for prevention efforts, particularly among students entering congregated living environments for the first time. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 23 Sep 2024 | AI versus physicians: who’s better at spotting high-risk patients? | 00:32:53 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss how artificial intelligence (AI) significantly improves the identification of hospital patients at risk of clinical deterioration compared to physician assessments alone. They are joined by Dr. Amol Verma, a general internist at St. Michael’s Hospital in Toronto, an associate professor at the University of Toronto, and the holder of the Temerty Professorship in AI Research and Education, who shares findings from his recent CMAJ article, “Clinical evaluation of a machine learning-based early warning system for patient deterioration”. Dr. Verma explains how the AI system, ChartWatch, analyzes over 100 variables from a patient’s electronic medical record to predict deterioration more accurately than traditional early warning scores like the NEWS score. He discusses how the integration of AI into clinical workflows improves patient outcomes by complementing human decision-making, leading to better results than relying on physicians or AI alone. The episode also looks at the potential future of AI in medicine, with Dr. Verma sharing insights on how AI tools should be thoughtfully integrated to support clinicians without overwhelming them. He stresses the need for AI systems to fit seamlessly into clinical workflows, ensuring patient care remains the priority. While AI is currently a tool to assist clinicians, Dr. Verma argues that the full extent of AI's role in healthcare—and its impact on the physician's place within it—remains ultimately unknowable. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 07 Oct 2024 | Prioritizing pain management during IUD insertions and other gynecologic procedures | 00:36:38 | |
On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore effective ways to manage pain during intrauterine device (IUD) insertions. They also address a broader issue: how women’s pain is often neglected during gynecologic procedures, and the failure of physicians to adequately seek consent. They are joined by Dr. Kristina Arion, an obstetrician and gynecologist at the Children's Hospital of Eastern Ontario, and Dr. Nadia Von Benzon, a lecturer and social geographer at Lancaster University. The episode begins with Dr. Arion discussing the CMAJ article she co-authored, which outlines strategies for better management of pain during IUD insertions. She explains that the IUD is recommended as the first-line therapy for birth control and period management by the Canadian Pediatric Society and the Society of Obstetricians and Gynaecologists of Canada. Dr. Arion highlights how patient anxiety, lack of sedation options, and inconsistent practices contribute to unnecessary pain.Her key advice to doctors: listen to patients, explain each step of the procedure, and provide adequate pain management options. Dr. Von Benzon broadens the discussion beyond IUD pain management to the neglect of women’s pain and autonomy during other gynecologic and obstetrical procedures. Her research article "My doctor just called me a good girl, and I died a bit inside: From everyday misogyny to obstetric violence in UK fertility and maternity services," illustrates how women’s pain is frequently dismissed and their consent overlooked. She discusses the long-term impact of these practices, with some women opting out of future pregnancies due to trauma. She advises healthcare professionals to clearly explain procedures, seek consent, and prioritize patient comfort and autonomy. Dr. Omole and Dr. Bigham reflect on how patriarchal structures and time constraints within healthcare systems often lead to the failure to prioritize women’s pain and autonomy. The episode closes with a powerful call for healthcare providers to take the time to listen to their patients, ask questions, and ensure that consent and comfort are prioritized at every stage of care.
Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 14 Oct 2024 | Breaking the mold: embracing neurodiversity in medicine | 00:29:01 | |
On this episode of the CMAJ Podcast, Dr. Kirsten Patrick speaks with Dr. Shane Neilson, the author of a CMAJ Encounters article entitled, “Professional stigmatizations.” Dr. Neilson is a physician, writer, and academic, who shares his experiences navigating medical school and practice as a neurodiverse physician with bipolar disorder and autism. Dr. Neilson reflects on the challenges he faced during medical school, including a moment when a preceptor told him, "There’s something wrong with you," without offering any support or guidance. He shares how this, along with the pressure to conform to normative expectations in medicine, made his training difficult, especially without any accommodations for neurodiverse students. Dr. Patrick relates to these struggles, recounting her own experiences of feeling out of place in medical school. Together, they discuss how the culture of medical education at the time did not accommodate students who did not fit the traditional mold. Dr. Neilson notes that while there are "little teeny, tiny occasional tales of change" happening now, such as program directors becoming more aware of neurodiversity and making small accommodations for students, these changes are still incremental. He expresses hope that this will continue to evolve, leading to broader acceptance and support for neurodiverse individuals in the medical profession. He further argues that including neurodiverse physicians enriches the profession in several ways. By challenging rigid norms in medicine, neurodiverse individuals push the profession to be more inclusive and compassionate. They also provide care that is uniquely attuned to the needs of neurodiverse patients, offering identity-aligned support that can enhance patient satisfaction and outcomes. Dr. Neilson stresses that by fostering diversity, the profession not only lives up to its values but also improves care for all patients. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 21 Oct 2024 | Building support for pregnancy and parenthood in surgery | 00:33:05 | |
On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore the structural and cultural barriers faced by surgical residents and early career surgeons in balancing parenthood with their careers. The conversation centers around the points raised in the CMAJ article “Policies to better support childbearing surgeons”, which outlines the need for reforms to better accommodate surgical residents during pregnancy and early parenthood. The discussion highlights how surgeons experience higher rates of infertility and pregnancy complications, independent of age or other potential risk factors. Dr. Caroline Cristofaro and Dr. Maryse Bouchard, the article’s co-authors, propose solutions such as flexible call schedules, protected time for prenatal and postnatal appointments, and clear institutional guidelines supporting the needs of pregnant surgeons. Beyond structural barriers, the prevalent culture within surgical departments, such as the glorification of exhaustion and the perception that taking time off is a weakness or a burden to fellow residents, contributes to the unsupportive environment. The co-authors argue that gradual, transparent, and detailed policy reforms based on evidence are necessary to avoid resistance and ensure successful integration into surgical practice. Dr. Omole’s personal experience, marked by significant support from her department during her pregnancy and postpartum recovery, serves as an example of what a compassionate and well-supported environment can look like. Her story highlights how proactive leadership and peer support can make a profound difference, benefiting both surgeons and their patients. For more information from our sponsor, go to scotiabank.com/physicians. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 04 Nov 2024 | Compassionate and comprehensive care for early pregnancy loss | 00:45:31 | |
On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham speak with Dr. Sarina Isenberg and Dr. Modupe Tunde-Byass about the emotional and systemic challenges surrounding early pregnancy loss care in Canada. The conversation builds on themes from the recent CMAJ article, “Diagnosis and management of early pregnancy loss,” in which the authors advocate for a dedicated EPL pathway to care that bypasses the emergency department. Dr. Isenberg shares her personal experiences with early pregnancy loss and the stark disparity in care she received—from a lack of empathy in an emergency room to comprehensive support in a specialized clinic. Her story underscores the spectrum of care needed, particularly access to emotional support during one of the most vulnerable times in a patient’s life. Dr. Tunde-Byass, co-author of the CMAJ article and an obstetrician at North York General Hospital, highlights the success of dedicated early pregnancy loss clinics, which provide timely diagnosis, options for management, and a supportive environment. She emphasizes that emergency departments, often overstretched and lacking privacy, are not designed for the unique needs of early pregnancy loss patients. Instead, she argues for dedicated spaces staffed by trained personnel, including nurses and counselors, who can provide both medical care and emotional support. Together, they explore practical solutions, including integrated care pathways outside of emergency departments, self-referral options, and the provision of bereavement resources. Dr. Tunde-Byass advocates for a holistic approach that could be standardized across Canadian hospitals, enabling patients to access sensitive, informed care without the retraumatization that often comes from repeating their stories in high-stress environments. To learn more about exciting physician careers from our sponsor, Vancouver Coastal Health, visit vch.ca/jobyouwant Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 18 Nov 2024 | Exploring the link between diet and depression | 00:30:42 | |
On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham discuss the growing evidence around the impact of diet on mental health, particularly depression. The conversation is inspired by the CMAJ practice article, “Diet and depression,” co-authored by Dr. Nicholas Fabiano. Dr. Fabiano explains how the mechanistic connection between diet and depression is not well understood, but it is theorized that diets known to promote inflammation may play a part in exacerbating symptoms. He highlights findings from the SMILES trial, which demonstrated how dietary interventions like the Mediterranean diet—rich in leafy greens, fish, fruits, and whole grains—reduced depression symptoms in trial participants. Dr. Rachelle Opie, an accredited practicing dietitian and credentialed eating disorder clinician, offers practical advice on how physicians can coach patients toward dietary changes in a way that is inclusive, sustainable, and sensitive to individual needs. Drawing from her work on the SMILES trial, Dr. Opie highlights the importance of a whole-of-diet approach that prioritizes small, achievable changes, such as incorporating legumes, beans, or frozen and canned foods. She emphasizes trauma-informed, weight-neutral approaches to avoid triggering or alienating patients and encourages focusing on what patients can add to their diet rather than restricting foods. Together, the hosts and guests explore how subtle, realistic changes in dietary habits can provide meaningful improvements in mental health without placing undue pressure on patients. For more information from our sponsor, go to scotiabank.com/medicalstudents Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 02 Dec 2024 | Misdiagnosed and misunderstood: premenstrual dysphoric disorder | 00:34:33 | |
On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore Premenstrual Dysphoric Disorder (PMDD), a debilitating condition affecting 5% of people who menstruate, yet it is often misdiagnosed or misunderstood. The conversation builds on insights from the CMAJ article, “Five things to know about…: PMDD,” co-authored by Dr. Erin Brennand, an associate professor at the Cumming School of Medicine in Calgary. Abhi Bala shares her lived experience with PMDD, describing the profound impact of cyclical depressive symptoms, suicidal ideation, and emotional dysregulation on her life. Her journey from misdiagnosis to awareness highlights the importance of tracking symptoms and recognizing patterns linked to the menstrual cycle, which can lead to earlier diagnosis and treatment. Dr. Brennand explains how PMDD is frequently mistaken for depression or bipolar disorder, delaying accurate diagnosis and treatment. She highlights the importance of recognizing that PMDD's cyclical symptoms align specifically with the luteal phase—the final two weeks of the menstrual cycle. Dr. Brennand also discusses evidence-based treatments, including SSRIs, oral contraceptives, and, in severe cases, GnRH agonists. This episode provides valuable insights into diagnosing and managing PMDD, helping physicians better support their patients. For more information from our sponsor, visit rainbowhealthontario.ca Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 16 Dec 2024 | Scurvy and the challenge of food insecurity | 00:33:04 | |
On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore a surprising case of scurvy. The conversation builds on the CMAJ practice article “Scurvy in a 65-year-old woman with severely limited function and social supports,” co-authored by Dr. Sally Engelhart, an internal medicine specialist at Mount Sinai Hospital. Dr. Engelhart recounts the case of her patient, whose unexplained bruising and other symptoms led to a diagnosis of a rarely seen condition, scurvy. She explains how food insecurity and a diet lacking fruits and vegetables contributed to the patient’s condition and discusses the practical steps taken to diagnose and treat her. Dr. Gary Bloch, a family physician at St. Michael’s Hospital and Inner City Health Associates, expands on the broader issue of food insecurity as a driver of nutritional deficiencies. He shares actionable strategies for identifying at-risk patients and connecting them with community resources, while highlighting the importance of addressing the social determinants of health in medical practice. This episode offers valuable insights into recognizing and managing scurvy and other conditions linked to food insecurity, reminding physicians to think beyond the lab results Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 30 Dec 2024 | ENCORE: AI versus physicians: who’s better at spotting high-risk patients? | 00:32:46 | |
On this encore episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss how artificial intelligence (AI) significantly improves the identification of hospital patients at risk of clinical deterioration compared to physician assessments alone. They are joined by Dr. Amol Verma, a general internist at St. Michael’s Hospital in Toronto, an associate professor at the University of Toronto, and the holder of the Temerty Professorship in AI Research and Education, who shares findings from his recent CMAJ article, “Clinical evaluation of a machine learning-based early warning system for patient deterioration”. Dr. Verma explains how the AI system, ChartWatch, analyzes over 100 variables from a patient’s electronic medical record to predict deterioration more accurately than traditional early warning scores like the NEWS score. He discusses how the integration of AI into clinical workflows improves patient outcomes by complementing human decision-making, leading to better results than relying on physicians or AI alone. The episode also looks at the potential future of AI in medicine, with Dr. Verma sharing insights on how AI tools should be thoughtfully integrated to support clinicians without overwhelming them. He stresses the need for AI systems to fit seamlessly into clinical workflows, ensuring patient care remains the priority. While AI is currently a tool to assist clinicians, Dr. Verma argues that the full extent of AI's role in healthcare—and its impact on the physician's place within it—remains ultimately unknowable. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 13 Jan 2025 | Antimicrobial resistance and the shift to shorter courses of antibiotics | 00:39:58 | |
On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham explore the growing challenge of antimicrobial resistance and how shorter courses of antibiotics are reshaping prescribing practices. The conversation builds on insights from the CMAJ practice article “Five things to know about shorter courses of antibiotics” co-authored by Dr. Maria Ivankovic, an emergency physician at St. Joseph’s Health Centre in Toronto. Dr. Ivankovic explains why shorter courses of antibiotics are as effective as longer ones for many common infections and how this approach can reduce the risk of antimicrobial resistance and adverse effects for patients. She highlights key conditions with strong evidence for shorter durations and discusses practical strategies for implementing these changes in practice. Dr. Lynora Saxinger, an infectious diseases specialist and professor of medicine at the University of Alberta, broadens the discussion by examining the current state of antimicrobial resistance in Canada and globally. She explores the drivers of resistance, including unnecessary and inappropriate antibiotic use. Dr. Saxinger introduces the concept of the antibiotic footprint as an analogue to the carbon footprint, encouraging physicians to consider the collective impact of their prescribing decisions. This episode provides actionable advice for physicians looking to balance patient care with stewardship practices, helping to preserve the effectiveness of antibiotics for future generations. To learn more about exciting physician careers from our sponsor, Vancouver Coastal Health, visit vch.ca/jobyouwant Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 27 Jan 2025 | Diagnosing and managing necrotizing fasciitis | 00:34:38 | |
On this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham discuss necrotizing fasciitis, a diagnosis that can strike fear into the hearts of clinicians due to its rapid progression and devastating consequences. The discussion builds on insights from the CMAJ practice article, “Necrotizing soft tissue infections caused by invasive group A Streptococcus,” co-authored by Dr. Saswata Deb and Dr. Stephanie Mason. Dr. Deb, an emergency physician and clinician scientist at Sunnybrook Health Sciences Centre in Toronto, outlines the key clinical signs of necrotizing fasciitis, including pain out of proportion to physical findings and rapid hemodynamic deterioration. He emphasizes the importance of considering NSTI in the differential diagnosis for cellulitis and the need for prompt surgical consultation when red flags arise. Crucially, Dr. Deb explains that no imaging or laboratory tests can definitively rule in or rule out the diagnosis—only surgical exploration can confirm it. Dr. Mason, a burn and general surgeon at Sunnybrook’s Ross Tilley Burn Centre, provides a surgeon’s perspective on managing these infections. She addresses common missteps in diagnosis, the need for aggressive surgical debridement, and the role of multidisciplinary care in saving patients’ lives. She also discusses how surgeons can overcome their fear of creating extensive wounds, reassuring listeners that reconstruction is possible once the patient is stabilized. Together, the guests and hosts explore practical solutions to reduce delays in care, including the potential for institutional protocols—possibly a "code nec fasc"—to streamline decision-making and improve outcomes. For more information from our sponsor, go to md.ca/tax. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 10 Feb 2025 | Making healthcare accessible for patients with disabilities | 00:37:40 | |
Medicine remains frequently inaccessible to people with disabilities, despite their higher-than-average need for healthcare services. On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle the systemic barriers that patients with disabilities face, from inaccessible clinic spaces to discriminatory attitudes. The discussion is inspired by the CMAJ practice article, "Five ways to support people who use wheelchairs," authored by Dr. Lisa Freeman. Dr. Freeman, a public health and preventative medicine physician who uses a wheelchair, shares her lived experiences navigating a healthcare system riddled with obstacles. She introduces practical steps that physicians can take to make their practices more inclusive, such as improving communication, ensuring referrals are effective, and addressing physical accessibility. David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, explains the legal obligations that healthcare providers must meet to comply with human rights and accessibility laws. He offers actionable guidance on how physicians can reduce barriers, from small changes like posting signage to long-term planning for accessible infrastructure. This episode underscores that accessibility is both a legal requirement and a fundamental part of equitable patient care. It challenges physicians to take immediate steps toward making their practices more inclusive for patients with disabilities. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 24 Feb 2025 | The major benefits of exercise for older adults | 00:29:38 | |
An article in CMAJ, "Move more, age well: prescribing physical activity for older adults," found that regular physical activity can reduce all-cause mortality by 31%. As Canada’s population ages, maintaining physical activity is becoming an increasingly critical factor in healthy aging. On this episode, Dr. Samir Sinha, a geriatrician at Sinai Health and the University Health Network and co-author of the CMAJ article, explains the evidence supporting exercise as a tool for preventing frailty, cognitive decline, and chronic disease in older adults. He addresses common misconceptions about aging and physical activity, emphasizing that even small, progressive increases in movement can help people stay independent longer. Physiotherapist Steve Di Ciacca, program manager at the Canadian Centre for Activity and Aging at Western University, outlines practical ways clinicians can help older patients build movement into their daily routines. He discusses the role of social engagement, personalized goal-setting, and structured exercise programs in improving adherence. He also highlights evidence showing that a simple written prescription for physical activity can increase adherence by up to 10%. This episode provides evidence-based insights to help clinicians encourage physical activity in older patients, promoting better long-term health outcomes. For more information from our sponsor, go to md.ca/tax. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 10 Mar 2025 | More access, more deaths: alcohol’s impact in the COVID-19 pandemic | 00:31:12 | |
A new CMAJ study has found that alcohol-related hospitalizations and deaths in Canada surged during the COVID-19 pandemic. While overall alcohol consumption increased only modestly, the toll on the healthcare system was severe, with a 14% rise in hospitalizations and a 24% increase in deaths during the first two years of the pandemic. Researchers suggest that increased access to alcohol—through expanded retail hours and home delivery—contributed to these harms, particularly among heavier drinkers. Dr. Tim Stockwell, a scientist at the Canadian Institute for Substance Use Research and an emeritus professor at the University of Victoria, discusses the study’s findings and why even a small rise in alcohol consumption can lead to a disproportionate increase in harm. He explains how heavier drinkers, already at risk, were pushed beyond critical health thresholds, contributing to the sharp rise in hospitalizations and deaths. Dr. Adam Sherk, a senior scientist at the Canadian Centre on Substance Use and Addiction, examines the policy decisions that shaped alcohol access during the pandemic. While economic considerations played a role, he notes that governments were also reluctant to introduce new restrictions on alcohol at a time when the public was already under significant strain. He argues that a more balanced approach is needed in future public health crises—one that allows reasonable access to alcohol but uses measures like increased pricing and decreased availability to moderate its impact on the healthcare system. The findings underscore the need to rethink how alcohol policy is handled during public health emergencies—not just in terms of balancing health and economic interests, but also in managing public willingness to accept restrictions in times of crisis. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 24 Mar 2025 | The mortality risk and therapeutic potential of hallucinogens | 00:31:03 | |
A research article in CMAJ examines mortality risk among people hospitalized for hallucinogen use. The study found that individuals who required acute hospital care for hallucinogen-related issues had a nearly fivefold increase in mortality risk compared to the general population. Dr. Daniel Myran, a public health and preventive medicine physician, family physician, and researcher at the University of Ottawa, discusses the study’s findings and why the growing perception of psychedelics as therapeutic may be influencing increased use. He explains how individuals hospitalized for hallucinogen-related issues often have additional risk factors, including other substance use and underlying health conditions, which may contribute to their elevated mortality risk. Dr. Ishrat Husain, a senior scientist and the scientific head of the clinical trials unit at CAMH in Toronto, explores the controlled medical use of hallucinogens in treatment-resistant depression. He outlines the intensive screening and psychological support involved in clinical trials and compares psilocybin therapy to other treatments such as electroconvulsive therapy (ECT) and ketamine. While early evidence is promising, Husain cautions that psilocybin remains experimental and requires significant resources, raising questions about its future accessibility. The findings highlight the need for clear public health messaging and policy decisions that distinguish between medical and recreational use of hallucinogens. For more information from our sponsor, go to md.ca/tax. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 07 Apr 2025 | How short-term opioid prescriptions affect long-term outcomes | 00:36:57 | |
A recent article in CMAJ entitled Effect of emergency department opioid prescribing on health outcomes examines a key concern facing many clinicians: can a single opioid prescription for acute pain lead to long-term harm? This study aimed to clarify the risks and inform safer prescribing practices. Dr. Grant Innes, the study’s senior author, analyzed more than a decade of data from Alberta emergency departments to compare outcomes between patients who did and did not receive an opioid prescription. The study found no significant difference in rates of overdose, opioid use disorder, or death—challenging widely held fears about short-term opioid use. Innes notes that older and opioid-naive patients may be more vulnerable to adverse outcomes and encourages a balanced approach to pain management. Dr. Hance Clarke, director of pain services at Toronto General Hospital, emphasizes the importance of structured follow-up and monitoring, especially for patients at higher risk of persistent use. He outlines practical strategies for safe prescribing and highlights underused and emerging alternatives, including ketamine, IV lidocaine, nerve blocks, and sodium channel blockers now in development. Clarke warns against “opioid phobia” and calls for individualized care supported by systems that can detect early warning signs. The guests encourage physicians to not avoid prescribing opioids when clinically indicated, particularly in cases of severe acute pain. With thoughtful screening and mechanisms for follow-up, opioids can be relatively safe and effective. The goal is not zero prescribing, but safer, smarter prescribing. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 21 Apr 2025 | Perspectives on the new guideline for managing obesity in children | 00:31:24 | |
It’s been nearly two decades since the last Canadian clinical practice guideline on managing obesity in children. In that time, the science has advanced, treatment options have expanded, and the need for updated guidance has grown increasingly urgent. On this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with three guests who contributed to or were impacted by the new guideline published in CMAJ. Together, they explore how the recommendations address the complexity of pediatric obesity and what it takes to implement them in real-world settings. Dr. Geoff Ball, chair of the guideline steering committee, explains how the recommendations were shaped by evidence as well as the meaningful participation of parents and youth at every stage of development. He discusses how the panel weighed the benefits and risks of pharmacotherapy and bariatric surgery in the context of limited pediatric data and a rapidly evolving treatment landscape. Dr. Michelle Jackman, a pediatrician and clinical lead at the Pediatric Centre for Wellness and Health in Calgary, shares how her team delivers multi-component behavioural interventions, often in the absence of system-wide supports. She reflects on how the new guideline has prompted her to reconsider referral pathways for bariatric surgery and advocate more strongly for patients. Brenndon Goodman, a long-time patient advocate, offers his own experience navigating childhood obesity, including the emotional dimensions of eating, the impact of stigma, and the life-changing outcome of bariatric surgery. He calls for improved access to care and a stronger commitment to children and youth living with obesity. This episode highlights both the progress and the persistent barriers in treating childhood obesity. The new guideline affirms that obesity is a complex chronic condition and provides much-needed support for physicians caring for children and youth living with it. For more information from our sponsor, go to scotiabank.com/physicians. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 22 Nov 2021 | The inconvenience of motherhood to a medical career | 00:32:27 | |
One in four women physicians report a diagnosis of infertility. One reason for this is physicians tend to delay attempts to become pregnant until “the time is right” for their career. But, in the medical profession, it seems there is really no “good” time to have children. Parenthood, especially motherhood, is seen as an inconvenience during medical training and beyond. In this episode, Dr. Sophia Park speaks with hosts Dr. Mojola Omole and Dr. Blair Bigham about her personal struggle with infertility. And, Dr. Andrea Simpson, the lead author of a commentary in the CMAJ titled, “The inconvenience of motherhood during a medical career” calls for systemic change in medicine to support parenthood. Dr. Sophia Park is a medical biochemist at Royal Columbian Hospital and a Clinical Associate Professor at the UBC Department of Pathology and Laboratory Medicine. Dr. Andrea Simpson is an obstetrician and minimally invasive gynaecologic surgeon at St. Michael’s Hospital. She is also an assistant professor at the University of Toronto. She co-authored her commentary with Drs. Maria Cusimano and Nancy Baxter. It is published in CMAJ: https://www.cmaj.ca/content/193/37/E1465 Episode transcript: https://www.cmaj.ca/transcript-211255 ----------------------------------- This podcast episode is brought to you by Scotiabank Healthcare+. Learn more at: https://mdm.ca/promos/you-ve-come-a-long-way?utm_source=CMAJ&utm_medium=display&utm_campaign=CTP&utm_content=PHD ----------------------------------- This podcast episode is brought to you by Audi Canada. Get details of the Audi incentive program for CMA members at www.audiprofessional.ca. ----------------------------------- Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 06 Dec 2021 | The Rise Of Ketamine | 00:28:34 | |
Pain is one of the most common complaints among patients visiting the ER, and pain management has become a quality of care indicator. But the options available for the treatment of acute pain that isn’t controlled by over-the-counter medications are limited. In this episode, Blair and Mojola speak to Dr. William Silverstein, a co-author of the practice article “Five things to know about the use of ketamine in the treatment of acute pain” about ketamine’s indications and contraindications, how to prescribe it in the ambulatory care setting, and practical steps physicians can take to add ketamine to their pain-busting arsenal. They also speak with Dr. Marshall Ross, a physician who also uses ketamine as an emergency physician, but has also pioneered its use in patients with treatment-resistant depression, using cutting edge techniques. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 13 Dec 2021 | Special Episode: 13 practical ways to address inequities worsened by COVID-19 | 00:21:46 | |
The pandemic recovery period presents an opportunity to address health inequities that have led to an unfair distribution of the burden and harms of COVID-19. New guidance for policy published in CMAJ proposes 13 practical ways to address inequities exposed and worsened by COVID-19 in the pandemic recovery period, based on evidence that was accumulating before the pandemic. In this special episode of the podcast, CMAJ interim editor-in-chief Dr. Kirsten Patrick talks to Dr. Nav Persaud, lead author on the new guideline, about its genesis, the evidence underpinning its recommendations, and the importance of positioning equity at the centre of policy-making as Canada emerges from the pandemic. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 20 Dec 2021 | How social interventions can be powerful medicine | 00:33:23 | |
One simple question can offer clinicians a powerful insight into the lives of their vulnerable patients. Asking, “Do you ever have trouble making ends meet at the end of the month” can help physicians identify significant barriers to restoring the health of their patients. The link between the social conditions in which we live and health outcomes is well-known. However, health provider action to address the social determinants of health is an emerging area of practice innovation and research. This episode looks at what social prescribing looks like in action and what the evidence tells us about its effectiveness. Drs. Mojola Omole and Blair Bigham speak with Janet Rodriguez, a patient at St. Michael’s Family Health Care Clinic in Toronto. She describes the profound impact social interventions had on her physical and mental health. They also speak with Dr. Gary Bloch, a family physician at St. Michael’s Family Health Care Clinic and a co-author of the analysis published in CMAJ titled “An Evidence-Based Guide to Social Interventions in Primary Care.” Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 03 Jan 2022 | Special Episode: Quick look ahead | 00:03:50 | |
The CMAJ podcast is taking a break for one episode as everyone enjoys their holidays and gets prepared for the year ahead. In this brief chat, Mojola and Blair preview some of the upcoming episodes and wish all our listeners a happy and safe holiday. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 17 Jan 2022 | Should remote residents be prioritized for kidney transplants? | 00:31:00 | |
People with kidney failure who live in rural and remote areas of Canada do not have the same access to the full suite of dialysis modalities as urban dwellers. Many need to relocate for life-sustaining renal replacement therapy. Often this means moving hours away from their home communities for months, sometimes years, at a time. In this episode, hosts Drs. Mojola Omole and Blair Bigham speak with Dr. Aaron Trachtenberg, a nephrologist at the University of Manitoba about his commentary in CMAJ, in which he and coauthors argued that patients who must leave their home communities for dialysis should be prioritized for the allocation of deceased donor kidney transplants. They also speak with Vanessa Tait whose father needed to relocate to Winnipeg, twelve hours away from his home community of O-pipon-na-piwin Cree Nation, for dialysis. Ms. Tait became a living donor to her father in an effort to bring him back home. She talks about the toll relocation takes on patients from remote communities. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 31 Jan 2022 | What’s driving Canada’s high rate of maternal trauma from operative vaginal delivery? | 00:36:57 | |
Operative vaginal delivery (OVD) is considered safe if carried out by trained personnel; however, the rate of maternal trauma following OVD in Canada greatly exceeds that of any other OECD country. In Canada, maternal trauma occurred in more than one-quarter of deliveries with forceps, whereas in the UK, the rate is 8%-12%, and in Australia, it sits at 9.3%-14.1%. A research study published in CMAJ found that rates of trauma following OVD in Canada are higher than previously reported, irrespective of region, level of obstetric care and volume of instrument use among hospitals. The authors argue these results support a reassessment of OVD safety in Canada. In this episode, Dr. Bigham and Blair and Dr. Mojola Omole speak with Dr. Giulia Muraca, the lead author of Maternal and neonatal trauma following operative vaginal delivery: a national cohort study. They explore possible causes for these troubling findings. They then speak with Dr. Nirmala Chandrasekaran, an OB/GYN and Maternal-Fetal-Medicine specialist at St. Michael’s hospital in Toronto. Dr. Chandrasakan trained in the UK, and she describes how exposure to OVD during residency differs in the two countries. She also discusses the vital role OVD plays in safe deliveries. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 19 Apr 2021 | Dépistage de la chlamydia et de la gonorrhée asymptomatiques en médecine de soins primaires | 00:18:08 | |
Dre Guylène Thériault explique les recommandations clé des nouvelles lignes directrices sur dépistage de la chlamydia et de la gonorrhée en médecine de soins primaires chez les personnes non connues comme appartenant à un groupe à risque.Dre Guylène Thériault est médecin de famille et membre du Groupe d’étude canadien sur les soins de santé préventifs. Dre Thériault enseigne aussi la médecine fondée sur les données probantes et la prise de décision partagée.Le Groupe d’étude canadien sur les soins de santé préventifs vient de publier les nouvelles lignes directrices dans le Journal de l’association médicale canadienne.Lignes directrices : https://www.cmaj.ca/lookup/doi/10.1503/cmaj.201967-fTranscription de la conversation: https://www.cmaj.ca/transcript-201967-f Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 21 Jun 2021 | Long-distance travel for birth for Indigenous people | 00:34:01 | |
New research shows that Indigenous People living in rural Canada are 16 times more likely to have to travel long distances to give birth compared to non-Indigenous people living in rural areas. In this podcast, Dr. Janet Smylie and Evelyn George explain these striking findings.Dr. Janet Smylie is Métis-Cree, a family practitioner and professor of public health at the University of Toronto. Evelyn George is a Nbissing registered midwife living in Syilx territory of British Columbia.They were two of the authors of a research article published in CMAJ:www.cmaj.ca/lookup/doi/10.1503/cmaj.201903Podcast transcript: www.cmaj.ca/transcript-201903-----------------------------------This podcast episode is brought to you by Shingrix. Learn more at:www.shingrix.ca/en-ca/index.html-----------------------------------This podcast episode is brought to you by Dr. Bill. Dr. Bill makes billing on the go easy and pain free. Start your 45-day free trial today: www.drbill.app/cmaj-----------------------------------Listen to Cold Steel, the official podcast of the Canadian Journal of Surgery: http://canjsurg.ca/podcasts-----------------------------------Subscribe to CMAJ Podcasts on Apple Podcasts or your favourite podcast app. You can also follow us directly on our SoundCloud page or you can visit www.cmaj.ca/page/multimedia/podcasts. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 19 Apr 2021 | Painful periods in adolescents | 00:10:40 | |
Dr. Olga Kciuk and Dr. Sari Kives talk about painful periods (dysmenorrhea) in teens – what causes it, how to diagnose it, how to rule out secondary causes, and how best to treat. Dr. Olga Kciuk is a fourth year resident in obstetrics and gynecology at the University of Toronto. Dr. Sari Kives is a gynecologist in Toronto, both at the Hospital for Sick Children and St. Michael's Hospital.They co-authored a practice article published in CMAJ:www.cmaj.ca/lookup/doi/10.1503/cmaj.201972Podcast transcript: https://www.cmaj.ca/transcript-201972-----------------------------------This podcast episode is brought to you by Shingrix. Learn more at:www.shingrix.ca/en-ca/index.html-----------------------------------This podcast episode is brought to you by Audi Canada. The Canadian Medical Association has partnered with Audi Canada to offer CMA members a preferred incentive on select vehicle models. Purchase any new qualifying Audi model and receive an additional cash incentive based on the purchase type. Details of the incentive program can be found at www.audiprofessional.ca.-----------------------------------Subscribe to CMAJ Podcasts on Apple Podcasts or your favourite podcast app. You can also follow us directly on our SoundCloud page or you can visit www.cmaj.ca/page/multimedia/podcasts. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 10 May 2021 | Alcohol use disorder & anticraving medication | 00:32:20 | |
Anticraving medications are a lesser-known therapy for patients with moderate to severe alcohol use disorder. In this podcast, Dr. Jon Mong and Dr. Paxton Bach explain how to recognize and diagnose moderate to severe alcohol use disorder and how to talk to patients about treatment options.Dr. Jon Mong is a general internist working at The Ottawa Hospital, with a clinical focus in addiction medicine. He is currently completing his Masters in Quality Improvement and Patient Safety through the University of Toronto's IHPME.Dr. Paxton Bach is a clinical assistant professor in the department of medicine at the University of British Columbia, and a general internist and addiction physician at St. Paul’s Hospital in Vancouver, BC. He additionally serves as the program director for the British Columbia Centre on Substance Use Clinical Addiction Medicine Fellowship Program.They co-authored, along with Dr. Keith Ahamad, a practice article published in CMAJ:www.cmaj.ca/lookup/doi/10.1503/cmaj.200895Podcast transcript: https://www.cmaj.ca/transcript-200895-----------------------------------This podcast episode is brought to you by Shingrix. Learn more at:www.shingrix.ca/en-ca/index.html-----------------------------------This podcast episode is brought to you by Audi Canada. The Canadian Medical Association has partnered with Audi Canada to offer CMA members a preferred incentive on select vehicle models. Purchase any new qualifying Audi model and receive an additional cash incentive based on the purchase type. Details of the incentive program can be found at www.audiprofessional.ca.-----------------------------------Subscribe to CMAJ Podcasts on Apple Podcasts, iTunes, Google Play, Stitcher, Overcast, Instacast, or your favourite aggregator. You can also follow us directly on our SoundCloud page or you can visit www.cmaj.ca/page/multimedia/podcasts. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 17 May 2021 | Critical race theory in medicine | 00:29:50 | |
Dr. Malika Sharma and Dr. Rahel Zewude explain the tenets of critical race theory. They also share how it has helped them tackle racism in the practice of medicine and how they've applied it to their professional and personal lives as physicians in Canada.Dr. Malika Sharma is an HIV and infectious diseases specialist and assistant professor in the Department of Medicine at the University of Toronto. Dr. Rahel Zewude is an internal medicine resident at the University of British Columbia and president of Black Physicians of British Columbia.They co-authored a humanities article published in CMAJ. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 12 Jul 2021 | Involving patients at CMAJ | 00:42:08 | |
In this episode, Dr. Kirsten Patrick, interim editor-in-chief, chats with Francine Buchanan about her experience as a patient partner. Francine is in a unique position at the intersection of caregiver for her medically fragile son, PhD candidate in health services research, and a patient and family advisor at The Hospital for Sick Children. She wrote a Humanities article published in CMAJ called "How are we going to do this?" https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210457Dr. Kirsten Patrick also chats with Victoria Saigle, Lead of Patient Involvement at CMAJ. Victoria shares the different ways patients have been contributing to the journal in recent months and plans for the future.CMAJ is launching a new article type called 360 Cases. CMAJ's first 360 Case explores the end of life of a woman who passed away suddenly after an unexpected serious diagnosis. The article is co-written by the woman's husband, her social worker, one of her nurses and the ICU physician who treated her at the end of her life. You can read the article on our website: https://www.cmaj.ca/lookup/doi/10.1503/cmaj.210463If you're interested in learning more about patient involvement, patient peer review, or patient authorship, contact Victoria: victoria.saigle@cmaj.caMore details are in CMAJ’s Statement of Purpose for Patient Engagement https://www.cmaj.ca/statement-purpose-patient-engagementCMAJ's themed issue on patient engagement at the journal: https://www.cmaj.ca/content/193/27Podcast transcript: https://www.cmaj.ca/transcript-210457-----------------------------------This podcast episode is brought to you by Audi Canada. The Canadian Medical Association has partnered with Audi Canada to offer CMA members a preferred incentive on select vehicle models. Purchase any new qualifying Audi model and receive an additional cash incentive based on the purchase type. Details of the incentive program can be found at www.audiprofessional.ca.-----------------------------------This podcast episode is brought to you by Shingrix. Learn more at:www.shingrix.ca/en-ca/index.html-----------------------------------Listen to Cold Steel, the official podcast of the Canadian Journal of Surgery: canjsurg.ca/podcasts-----------------------------------Subscribe to CMAJ Podcasts on Apple Podcasts or your favourite podcast app. You can also follow us directly on our SoundCloud page or you can visit www.cmaj.ca/page/multimedia/podcasts. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||
| 09 Aug 2021 | Adolescent contraception | 00:20:43 | |
Many options exist nowadays for teenagers choosing to be on hormonal contraceptives. They are generally categorized into SARCs (short-acting reversible contraceptives) and LARCs (long-acting reversible contraceptives). LARC methods are recommended as first-line contraceptives. These include intrauterine devices and a new option that gets implanted into the arm and lasts up to three years.In this episode, Dr. Margot Rosenthal, a fifth-year obstetrics and gynaecology resident, explains the different contraception options, which choice is best, and what side effects to watch out for.She co-authored a practice article with Dr. Sarah McQuillan. The article is published in CMAJ: https://www.cmaj.ca/lookup/doi/10.1503/cmaj.202413Podcast transcript: https://www.cmaj.ca/transcript-202413Calling all aspiring podcasters! Are you our next podcast host? CMAJ seeks a curious, astute and dynamic Canadian physician as the new voice of CMAJ Podcasts. For details and to apply:https://www.cmaj.ca/content/cmaj-podcast-host-----------------------------------This podcast episode is brought to you by Dr. Bill. Dr. Bill makes billing on the go easy and pain free. Start your 45-day free trial today: https://www.drbill.app/cmaj-----------------------------------This podcast episode is brought to you by Shingrix. Learn more at:https://www.shingrix.ca/en-ca/index.html-----------------------------------Listen to Cold Steel, the official podcast of the Canadian Journal of Surgery: https://canjsurg.ca/podcasts-----------------------------------Subscribe to CMAJ Podcasts on Apple Podcasts or your favourite podcast app. You can also follow us directly on our SoundCloud page or you can visit https://www.cmaj.ca/page/multimedia/podcasts. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast. | |||