Podcasts about cmaj

Send us a textOn this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham explore how changes to mifepristone regulation have reshaped abortion access in Ontario. Unlike most other countries, Canada allows the drug to be prescribed by any physician or nurse practitioner and dispensed by any community pharmacy, without additional restrictions or special certifications. The discussion draws on the article Changes in local access to mifepristone dispensed by community pharmacies for medication abortion in Ontario: a population-based repeated cross-sectional study, recently published in CMAJ.Dr. Laura Schummers, reproductive epidemiologist and lead author of the study, explains how the 2017 policy change contributed to a significant shift in abortion access. Before mifepristone, abortion care in Ontario was concentrated in fewer than 100 clinics, most of them in urban centres. Within five years of the regulatory change, the percentage of Ontario abortion service users with local access rose from 37% to 91%. Dr. Schummers also notes that this shift happened even though only one in five pharmacies dispensed the drug. She describes how earlier work demonstrating the safety of medication abortion helped support these policy changes.Dr. Wendy Norman, a professor of family practice at UBC and co-author on the CMAJ study, outlines what clinicians need to know about prescribing mifepristone. She explains that it can be safely offered without ultrasound or lab testing in many cases, and that virtual care is a viable model for appropriate patients. Dr. Norman also provides practical advice on gestational age limits, follow-up requirements, and how to identify patients at risk for ectopic pregnancy.This episode offers physicians a clear picture of how a regulatory approach that treats mifepristone like any other prescription medication has expanded abortion access across Ontario—and what it takes to incorporate this care into practice.For more information from our sponsor, go to MedicusPensionPlan.comJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textThis episode of the CMAJ Podcast examines how recent changes to U.S. federal research funding are affecting the global scientific landscape—and what they could mean for Canada. The discussion focuses on indirect costs, talent retention, and whether Canada is positioned to step into any gaps left behind. The hosts speak with two guests who have written recent articles in CMAJ offering insight into how policymakers and institutions in Canada might respond.Dr. William Ghali, vice president of research at the University of Calgary, outlines how indirect research costs are funded in both countries and explains why the proposed U.S. cuts—though now on hold—would have had severe consequences for American institutions. He also discusses the strength of Canadian research infrastructure, recent federal budget commitments, and the challenges of recruiting U.S.-based researchers without stronger domestic supports.Dr. Kirsten Patrick, editor-in-chief of CMAJ, expands on the policy shifts required to improve Canadian research capacity. She calls for reforms to indirect cost funding and a reassessment of how Canada prioritizes health research—highlighting the gap between identifying systemic problems and investing in studies that offer practical solutions. She also reflects on the broader implications of editorial independence in a politically pressured environment.The episode raises timely questions for policymakers: Is Canada prepared to fill the gap left by a potential U.S. withdrawal from medical research leadership? Are we investing strategically in infrastructure, talent, and funding priorities to meet this moment? And what will it take to ensure Canadian research moves from identifying problems to generating meaningful solutions?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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textIt'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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textA 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textA 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textA 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textAn 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textMedicine 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Un nouvel épisode du Pharmascope est disponible! Pour ce 150e épisode, Nicolas, Isabelle et Olivier, inspirés par une nouvelle série documentaire, discutent d'andropause. Cette première partie est consacrée à tenter de démystifier l'andropause et à comparer les différentes formulations de testostérone. Les objectifs pour cet épisode sont les suivants: Discuter de l'épidémiologie et de l'étiologie de l'andropause Expliquer la présentation clinique et l'évaluation de l'andropause Comparer les avantages et désavantages de chaque formulation de testostérone dans le but de procéder à une décision partagée sur le choix d'une formulation de testostérone Ressources pertinentes en lien avec l'épisode  Série documentaire « L'andropause sans tabou ». Disponible sur l'EXTRA d'ICI TOU.TV Salonia A et coll. Paediatric and adult-onset male hypogonadism. Nat Rev Dis Primers. 2019 May 30;5(1):38. Lajeunesse-Viens G. Andropause : Vérités et conséquences. Médecin du Québec, mai 2020, 35-39. (réservé aux abonnés) Dugré N, Fillion M. Docteur, j'ai besoin de testostérone! Médecin du Québec, mai 2020, 29-33. (réservé aux abonnés) Morales A et coll; Canadian Men's Health Foundation Multidisciplinary Guidelines Task Force on Testosterone Deficiency. Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline. CMAJ. 2015 Dec 8;187(18):1369-1377. Rastrelli G, Maggi M, Corona G. Pharmacological management of late-onset hypogonadism. Expert Rev Clin Pharmacol. 2018 Apr;11(4):439-458.

Send us a textOn 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/jobyouwantJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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 resultsJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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.caJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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/medicalstudentsFor more information from our sponsor, visit rainbowhealthontario.caJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Wie eng die Darmgesundheit mit Deiner Fitness verknüpft ist, deckte die Wissenschaft erst im letzten Jahrzehnt auf. So bringen Forscher u.a. Übergewicht und Herz-Kreislauf-Erkrankungen mit einer gestörten Darmflora in Verbindung. Je fitter Dein Darm-Mirkobiom, desto fitter kannst Du sein. Du lebst im Einklang mit Billionen von Mikroorganismen. Sie bevölkern Darm und Magen, Mund und Rachen, Nase und Haut. Heute wissen wir, dass Dein Immunsystem, Dein Hormonsystem und Dein Gehirn auf diese Bakterien angewiesen ist. Dabei begünstigt der typsich-westliche Lebensstil Störungen im Darm-Mikrobiom, die weitreichende Folgen haben können – auch beim Erreichen von Fitnesszielen, aber vor allem im Leben. Es ist also eine gute Idee, Deinen Darmbakterien etwas Pflege zukommen zu lassen. Hier sind 6 bewährte Mittel, die Dir dabei helfen. ____________

Send us a textOn 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/jobyouwantFor more information from our sponsor, visit rainbowhealthontario.caJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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.For more information from our sponsor, go to Rainbow Health Ontario.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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn 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.For more information from our sponsor, go to medicuspensionplan.comJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Kennedy Dunn, 3rd year medical student at Howard U and Dr. Bianca Campbell, PharmD and 3rd medical student at Howard U discuss Passion, Patience and what it means to be human in the 3rd episode of Stranger Fruit Vol II.   Timestamps: 0:00 The Intersection of Passion and Patient Care in Medicine 8:10 Patient-Centric Perspectives & Self-Care for Healthcare Providers 15:56 Navigating Career Passion, Patience, and Opportunities 26:16 Challenges and Growth in Medical Careers and Personal Well-being 40:42 Embracing Individuality and Professional Identity in Health Fields   References:  Bush G, Luu P, Posner MI. Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci. 2000 Jun;4(6):215-222. doi: 10.1016/s1364-6613(00)01483-2. PMID: 10827444. Casey, B. J., Giedd, J. N., & Thomas, K. M. (2000). "Structural and functional brain development and its relation to cognitive development." Biological Psychology, 54(1-3), 241-257. Delgado, M. R., Nearing, K. I., LeDoux, J. E., & Phelps, E. A. (2008). "Neural circuits for affective learning and memory: The amygdala and beyond." Current Opinion in Neurobiology, 18(2), 161-170. DiMatteo MR, Sherbourne CD, Hays RD, Ordway L, Kravitz RL, McGlynn EA, Kaplan S, Rogers WH. Physicians' characteristics influence patients' adherence to medical treatment: results from the Medical Outcomes Study. Health Psychol. 1993 Mar;12(2):93-102. doi: 10.1037/0278-6133.12.2.93. PMID: 8500445. Frank, M. J., Seeberger, L. C., & O'Reilly, R. C. (2004). "By carrot or by stick: Cognitive reinforcement learning in Parkinsonism." Science, 306(5703), 1940-1943. Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995 May 1;152(9):1423-33. PMID: 7728691; PMCID: PMC1337906. Street RL Jr, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2009 Mar;74(3):295-301. doi: 10.1016/j.pec.2008.11.015. Epub 2009 Jan 15. PMID: 19150199. Suchman AL, Markakis K, Beckman HB, Frankel R. A model of empathic communication in the medical interview. JAMA. 1997 Feb 26;277(8):678-82. PMID: 9039890. Intro Music: Bosch's Garden - by Kjartan Abel. This work is licensed under the following: CC BY-SA 4.0 Attribution-ShareAlike 4.0 International.

Send us a Text Message.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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a Text Message.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. Madelynn Hannah provides critical insights into the stark differences between nicotine exposure from vaping versus traditional cigarettes, highlighting the unexpectedly high nicotine concentrations found in many vaping products. She also shares her clinical experiences managing adolescents in nicotine withdrawal and the practical challenges of using nicotine replacement therapy (NRT). 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.For more information from our sponsor, go to medicuspensionplan.comJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we discuss the practice of involuntary hospitalization (also referred to as involuntary commitment or certification) with two special guests and fellow podcast creators — Jesse Mangan and Dr. Jim McQuaid. Their podcast, Committable, focuses on the topic of involuntary commitment and features stories from people with lived experience as a window into complex conversations with attorneys, physicians, psychologists, and more. Jesse Mangan is the producer of Committable and someone who has experienced involuntary hospitalization. Dr. Jim McQuaid is an Assistant Professor of Sociology at Framingham University. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Appreciate the individual and societal functions of involuntary hospitalization Understand the potential benefits and risks associated with involuntary hospitalization from the perspective of health care professionals as well as service users and the community at large Describe actions you can take as a practitioner (who has the power to certify) that may better serve your community and those you care for Identify meaningful ways to continue the conversation about these issues in medical education or training and beyond *This episode was recorded in 2021. Through a saga involving lost and recovered audio files, we're thrilled to finally be able to release it, and believe that the topic is just as timely and relevant as ever! Guests: Jesse Mangan and Dr. Jim McQuaid Hosts: Anita Corsini, Nikhita Singhal, Gray Meckling, and Alex Raben Audio editing by: Nikhita Singhal Show notes by: Nikhita Singhal Interview content: Introduction - 00:34 Committable podcast trailer - 01:52 Guest introductions - 04:26 Learning objectives - 07:22 Defining terms and setting the context - 08:11 Jesse's experience - 12:03 Exploring the functions of involuntary hospitalization - 23:06 Power differentials and the importance of humility - 41:05 Training considerations - 45:18 False divide between patients and providers - 51:39 Primary prevention and public health - 55:57 Professional identity formation - 57:57 Societal functions and processes - 01:05:00 Building trust - 01:11:57 Legal safeguards - 01:20:20 Alternative approaches/systems - 01:30:11 Rosenhan experiment - 01:37:12 Final thoughts - 01:39:21 End credits - 1:43:50 Resources: Committable podcast website: https://sensiblenonsense.squarespace.com PsychEd Episode 18: Assessing Suicide Risk with Dr. Juveria Zaheer On Being Sane in Insane Places References: Jaeger S, Hüther F, Steinert T. Refusing medication therapy in involuntary inpatient treatment—a multiperspective qualitative study. Front Psychiatry. 2019 May 9;10:295. https://doi.org/10.3389%2Ffpsyt.2019.00295 Johansson IM, Lundman B. Patients' experience of involuntary psychiatric care: good opportunities and great losses. J Psychiatr Ment Health Nurs. 2002 Dec;9(6):639-47. https://doi.org/10.1046/j.1365-2850.2002.00547.x McGuinness D, Murphy K, Bainbridge E, Brosnan L, Keys M, Felzmann H, Hallahan B, McDonald C, Higgins A. Individuals' experiences of involuntary admissions and preserving control: qualitative study. BJPsych Open. 2018 Nov 16;4(6):501-509. https://doi.org/10.1192%2Fbjo.2018.59 Ontario Hospital Association. A Practical Guide to Mental Health and the Law, Fourth Edition. Toronto: Ontario Hospital Association; 2023. Available from: https://www.oha.com/Legislative%20and%20Legal%20Issues%20Documents1/A%20Practical%20Guide%20to%20Mental%20Health%20and%20the%20Law%2c%20Fourth%20Edition%2c%202023.pdf Paksarian D, Mojtabai R, Kotov R, Cullen B, Nugent KL, Bromet EJ. Perceived trauma during hospitalization and treatment participation among individuals with psychotic disorders. Psychiatr Serv. 2014 Feb 1;65(2):266-9. https://doi.org/10.1176%2Fappi.ps.201200556 Rosenhan DL. On being sane in insane places. Science. 1973 Jan 19;179(4070):250-8. https://doi.org/10.1126/science.179.4070.250 Sposini FM. Confinement and certificates: consensus, stigma and disability rights. CMAJ. 2020 Nov 30;192(48):E1642-E1643. https://doi.org/10.1503/cmaj.201750 For more PsychEd, follow us on Instagram (@psyched.podcast), X (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

Send us a Text Message.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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

More and more Canadians are unable to access public primary healthcare, according to a study published in the Canadian Medical Association Journal at the beginning of December, 2023. In fact, about 20% of Canadians have no family doctor at all, and many more have irregular access to clinicians. The CMAJ study compares the Canadian primary care system with New Zealand and eight countries in Europe including France, Germany, Italy and the UK. Dr Tara Kiran is the senior author of the study and a family physician and scientist at St. Michael's Hospital and the University of Toronto.

Send us a Text Message.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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

​F Ashley. ​“Gender self-determination as a medical right.” (2024) CMAJ, 196, E833–35 Abstract: In this article, I argue that the principle of gender self-determination grants trans people have a presumptive right to gender-affirming care, and that physicians should accordingly rethink barriers to gender-affirming care. By considering gender self-determination as a presumptive right, physicians are more likely to avoid unnecessary barriers to care. This presumption can be rebutted by showing that encroachments are adequately justified by clear and compelling evidence. Many common barriers to gender-affirming care—such as rigid age requirements and the requirement that adolescents prove several years of gender incongruence—do not satisfy this threshold. (Link to paper)

Send us a Text Message.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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a Text Message.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.For more information from our sponsor, go to scotiabank.com/physiciansJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a Text Message.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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a Text Message.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.comJoin 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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 Aalamanian, 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. Aalamanian 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.For more information from our sponsor, go to md.ca/EC2024Join 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.Next, Drs. Omole and Bigham speak with Dr. Basil Kadoura, an adolescent medicine physician at BC Children's Hospital and the lead author of the article in CMAJ entitled, "Anorexia nervosa in adolescent males." He discusses diagnostic challenges, the distinct clinical presentation in males versus females, and the need for tailored approaches for effective treatment. Kadoura's insights contribute to a nuanced understanding of anorexia nervosa's impact on male adolescents and the critical role of healthcare professionals in facilitating early intervention and support.This episode is structured to provide medical professionals with a deeper understanding of anorexia nervosa in male adolescents, underscoring the need for awareness and specialized care approaches. It serves as a resource for clinicians seeking to enhance their diagnostic and treatment strategies for this often-overlooked condition.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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.This podcast has been sponsored by MD Financial Management. 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Contributors: Kali Olson PharmD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode of Pharmacy Phriday, Dr. Kali Olson joins Dr. Travis Barlock and Jeffrey Olson in studio to discuss a variety of interesting topics in the form of a segment show. Dr. Kali Olson earned her Doctorate of Pharmacy from the University of Colorado, Skaggs School of Pharmacy and completed a PGY1 residency at Detroit Receiving Hospital and a PGY2 residency in Emergency Medicine at Denver Health. She now works as an Emergency Medicine Pharmacist at Denver Health.  In segment one of the show, Kali and Travis answer the Get-To-Know-You questionnaire. In segment two, they work together to answer a series of pharmacy-based riddles. In segment three they play a “Balderdash” like game in which they guess the definitions of medical jargon. In segment four they play the Number Needed to Treat game, invented by the AFP podcast. And in segment five they work together to answer a question about a far-out scenario involving medications and time travel!   References ·       American Family Physician Podcast, https://www.aafp.org/pubs/afp/multimedia/podcast.html ·       Gragnolati, A. (2022, May 5). The Yuzpe method of emergency contraception. GoodRx. https://www.goodrx.com/conditions/emergency-contraceptive/yuzpe-method ·       Manikandan S, Vani NI. Holiday reading: Learning medicine through riddles. CMAJ. 2010 Dec 14;182(18):E863-4. doi: 10.1503/cmaj.100466. PMID: 21149530; PMCID: PMC3001539. ·       Riddle Me This: Mixing Medicine, https://peimpact.com/riddle-me-this-mixing-medicine/ ·       https://thennt.com/nnt/corticosteroids-treatment-kawasaki-disease-children/ ·       https://thennt.com/nnt/aspirin-acute-ischemic-stroke/ ·       https://thennt.com/nnt/tranexamic-acid-treatment-epistaxis/ ·       https://thennt.com/nnt/antibiotics-culture%e2%80%90positive-asymptomatic-bacteriuria-pregnant-women/   Produced, Hosted, Edited, and Summarized by Jeffrey Olson MS2 | Additional editing by Jorge Chalit, OMSII  

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. They are joined by Shira Gertsman, the lead author and a medical student at McMaster University, who shares her personal battle with Crohn's disease and the hurdles she encountered applying to medical school. Gertsman underscores the critical need for accommodations for individuals with disabilities and the importance of greater representation and understanding within the medical field.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.This podcast has been sponsored by MD Financial Management. 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.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.You can find Blair and Mojola on Twitter @BlairBigham and @DrmojolaomoleTwitter (in English): @CMAJ Twitter (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

More and more Canadians are unable to access public primary healthcare, according to a study published in the Canadian Medical Association Journal at the beginning of December. In fact, about 20% of Canadians have no family doctor at all, and many more have irregular access to clinicians. The CMAJ study compares the Canadian primary care system with New Zealand and eight countries in Europe including France, Germany, Italy and the UK. Dr Tara Kiran is the senior author of the study and a family physician and scientist at St. Michael's Hospital and the University of Toronto.

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.You can find Blair and Mojola on Twitter @BlairBigham and @DrmojolaomoleTwitter (in English): @CMAJ Twitter (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.The study suggests that implementing pharmacogenomic testing for adults with moderate to severe major depressive disorder in British Columbia could save the health system about $956 million over 20 years, equating to roughly $4,926 per patient.The hosts interview the study's authors, Dr. Jehannine Austin, Professor of Psychiatry and Medical Genetics at UBC, and Dr. Shahzad Ghanbarian, a mathematical modeler and research scientist, also at UBC.They explain how pharmacogenomic testing can reduce the often lengthy trial and error process of selecting medication for depression. The study demonstrates that this approach facilitates more effective early intervention, potentially reducing the number of patients with refractory depression by 37%. 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.You can find Blair and Mojola on Twitter @BlairBigham and @DrmojolaomoleTwitter (in English): @CMAJ Twitter (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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.Dr. Justin Hall, director of the Toronto Health Region's Virtual Urgent Care Program, describes how the service has developed since 2020. Key improvements include enhanced technology for a more seamless patient experience and additional capabilities like imaging and laboratory testing. Dr. Hall says the program now acts as a crucial link for patients without regular access to healthcare providers and can successfully address acute, non-life-threatening conditions.Drs. Bigham and Omole then speak with Mary Dimeo, a nurse practitioner working in the Toronto region's virtual urgent care service. She describes her role and experiences in the virtual environment. Ms. Dimeo says, typically only one patient per day needs to be referred to the emergency department which suggests the service helps divert patients from the hospital, especially those without family doctors or who cannot wait for an appointment.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.You can find Blair and Mojola on Twitter @BlairBigham and @DrmojolaomoleTwitter (in English): @CMAJ Twitter (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Why has there been an escalation of youth violence? Is the pandemic responsible for their actions? Mental health crisis in kids 10-18 surged. Girls seem to have been more affected than boys. Host Alex Pierson speaks with Natasha Saunders, a pediatrician at the Hospital for Sick Children and senior author of the second study published in the CMAJ. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Helena Esmonde is a vestibular physical therapist as well as the Chief Clinical Officer and co-founder of Vestibular First. Her mission includes making essential technology for vestibular care more affordable and improving vestibular education through monthly Journal Clubs, e-newsletters, social media, and continuing education courses. Helena's number one goal is to improve care for patients with vertigo, dizziness, and imbalance by supporting the clinicians who provide that very necessary care.Episode TakeawaysDizziness triage in the EDHow to assess vestibular diagnoses in the EDWhere and how to refer your ED patients with vestibular issuesConnect with HelenaTwitterInstagramWebsiteYoutubeResourceshttps://theeddpt.com/youre-the-dizziness-detective-in-the-ed/https://youtu.be/5m-CJ88fBRwKattah JC. Update on HINTS Plus, With a Discussion of Pitfalls and Pearls. J Neurol Phys Ther. 2019 Apr;43 Suppl 2:S42-S45.Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 2009 Nov;40(11):3504-10.Kim CH, Jeong H, Shin JE. Incidence of idiopathic benign paroxysmal positional vertigo subtype by hospital visit type: experience of a single tertiary referral centre. J Laryngol Otol. 2023 Jan;137(1):57-60.Newman-Toker DE, Kerber KA, Hsieh YH, Pula JH, Omron R, Saber Tehrani AS, Mantokoudis G, Hanley DF, Zee DS, Kattah JC. HINTS outperforms ABCD2 to screen for stroke in acute continuous vertigo and dizziness. Acad Emerg Med. 2013 Oct;20(10):986-96.Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ. 2011 Jun 14;183(9):E571-92.van Dam VS, Maas BDPJ, Schermer TR, van Benthem PG, Bruintjes TD. Two Symptoms Strongly Suggest Benign Paroxysmal Positional Vertigo in a Dizzy Patient. Front Neurol. 2021 Jan 14;11:625776.a

This episode comes out for free on Thursday June 22nd 2023. You can listen to new episodes early and ad-free on Amazon Music — included with Prime. Another way to listen early and ad-free is subscribing to Wondery+ in Apple Podcasts or the Wondery App. *Content Warning: interpersonal violence, alcohol and substance use disorder, body-image abuse, emotional abuse, fatphobia, fraud, financial elderly abuse, disordered eating, anorexia, childhood abuse, gun violence, death, murder, police brutality, suicidal ideation. *Sources: Atypical anorexia information: https://childmind.org/article/what-is-atypical-anorexia-nervosa/ Negative impacts of fat shaming: Fat shaming is making people sicker and heavier Vogel L. CMAJ. 2019 Jun 10;191(23):E649. doi: 10.1503/cmaj.109-5758. PMID: 31182466; PMCID: PMC6565398.Lizzo's Official Website: https://www.lizzomusic.com/ Lizzo's Instagram: https://www.instagram.com/lizzobeeating/ Ruben's statement via youtube: https://youtu.be/jSForwD_lRA Vigil for #Justice4BobbyHenning 2/21/14 Paramount CA. By: inLeague Press 2014.Free and confidential resources + safety tips: somethingwaswrong.com/resources Artwork by the amazing Sara Stewart:@GreaterThanOkay - Instagram.com/greaterthanokaySee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

From Basel, Switzerland to the summer of love in San Francisco. What did we learn about LSD, and why did it fall out of favor in the US? Part 2 will explore what's next in research... Audio Correction: Colby misspoke 4:15: meant to say “Methergine is used for postpartum hemorrhage after delivery,” said “hemorrhage after bleeding” (which of course is redundant and a mistake). Article on Ergotamine association with the Salem Witch Trials (from the Outside Hustle, Colby's other blog): Blotter Art examples: https://keseyblotterart.com/ References: Bryant C, Clark J. “How LSD Works.” Stuff You Should Know [podcast] 5 May 2016. Dyck E. LSD: a new treatment emerging from the past. CMAJ. 2015 Aug 4;187(14):1079–80. doi: 10.1503/cmaj.141358. Epub ahead of print. PMID: 26243813; PMCID: PMC4592308. Dyck, E. (2006). ‘Hitting Highs at Rock Bottom': LSD Treatment for Alcoholism, 1950–1970. Soc. Hist. Med. 19: 313-329. [PDF] Gasser, P. et al. (2014). Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-threatening Diseases. J. Nerv. Ment. Dis. 202: 513-520. [Full text] Irwin, S. A., et al. (2013). Daily Oral Ketamine for the Treatment of Depression and Anxiety in Patients Receiving Hospice Care: A 28-Day Open-Label Proof-of-Concept Trial. J. Palliat. Med. 16: 958-965. [PDF] Pollen M. “How to Change Your Mind: What the New Science of Psychedelics Teaches us About Consciousness, Dying, Addiction, Depression, and Transcendence.” Penguin Press. New York. 2018. Sandison, R. A., et al. (1954). The therapeutic value of lysergic acid diethylamide in mental illness. J. Ment. Sci. 100: 491-507. [Summary] Sandison, R. A. & Whitelaw, J. D. A. (1957). Further studies of the therapeutic value of lysergic acid diethylamide in mental illness. J. Ment. Sci. 103: 332-343. [Summary] Sessa, B. (2008). Can psychedelic drugs play a role in palliative care? Eur. J. Pall. Care 15: 235-237. [PDF] Simmons, J. Q., et al. (1966). Modification of Autistic Behavior with LSD-25. Am. J. Psych. 122: 1201-1211. [Summary] Smart, R. G. & Storm, T. (1964). The Efficacy of LSD in the Treatment of Alcoholism. Quart. J. Alcohol 25: 333-338. [PDF] Smith, C. M. (1958). A New Adjunct to the Treatment of Alcoholism: The Hallucinogenic Drugs. Quart. J. Alcohol 19: 406-417. [PDF] Shroder T. “Apparently Useless: The Accidental Discovery of LSD. The Atlantic. 9 Sept 2014. Available at: https://www.theatlantic.com/health/archive/2014/09/the-accidental-discovery-of-lsd/379564/ Tanne, J. H. (2004). Humphrey Osmond. BMJ 328: 713. [Full text] Vollenweider F. X. & Kometer, M. (2010). The neurobiology of psychedelic drugs: implications for the treatment of mood disorders. Nature Rev. Neurosci. 11: 642-651. [PDF]