Monthly Archives: April 2016

Cannabinoid Medicine’s rapid success through continued growth

There is a lot of talk in the media these days about Medicinal cannabis and how successful these clinics might be.  Canada’s largest and most reputable is Cannabinoid Medical Clinics (CMC); headquartered in Toronto this clinic has, in the past 10 months gone from one clinic in downtown Toronto with two physicians to 6 clinics with upwards of 25+ physicians from Edmonton, Alberta through to St. John’s, Newfoundland with further expansion of another 6+ clinics in the remainder of 2016.

It is CMC’s mission to continue providing the same education, experience and quality patient care nationwide that has become synonymous with their name in this rapidly growing market.

Through the hard work and perseverance of the entire CMC team over the last year, CMC Toronto has become the largest and most preferred cannabinoid medical clinic company in the country.  In the month of March alone, they had a record of over 1,000 patient visits.

With this increased focus on supporting growth through quality systems, protocols and an excellent standard of patient care across the country, there is every reason to believe that CMC will continue to see exponential growth both organically and through strong partnerships.

Time to champion regionalization of Licensure

This April 15, 2016 Medical Post article by Dr. Sarah Giles once again addresses the high cost of credentialing and licensing for physicians seeking to do locum work in neighbouring health boards and provinces. CanAm has been out spoken on this issue. What the general public and government officials don’t realize is that we are talking about thousands for dollars not a few hundred. The redundancy is unreal and in no other profession is it tolerated. Why is it that the only government championing this issue is the smallest province of Canada? Prince Edward Island’s health minister appears to be the only brave government official to champion regionalization of Licensing Colleges.

See full article below:

‘Alphabet soup’ isn’t always easy to swallow

April 15, 2016 by Dr. Sarah Giles

Yet again, I’ve traveled to another province and paid a rather large sum of money to re-certify one of my alphabet courses. The “alphabet courses” is my name for those “mandatory” courses hospital administrators insist locums have up to date but look the other way when none of the physicians in their own ER department have done them in six years. I have quite a collection of these courses: BLS, ACLS, NRP, ALARM, PALS and ATLS, to name the big ones.

I think there is benefit in continuing education, reviewing changes in practice, and going through mock scenarios. I do, however, have some reservations about these courses:

1. Some of the courses are cash cows. They cost a lot of money to attend and for those of us who live outside major urban centres, they are difficult and expensive to get to. I do not believe the vast majority of courses need to be recertified in person or every two years. I think it is likely possible to read the text, write a test, and Skype into a few mock scenarios to prove one’s abilities in a given area.

2. There is an inherent bias in these American-made courses against rural and remote care provision. Basically, in these texts, if you don’t have a CT scanner, thoracic surgeon, interventional radiologist or high-level NICU within your facility, you need to drop everything and call in a plane. Now, that’s often the right thing to do but in rural and remote Canada, there are some opportunities to watch stable patients and to use clinical judgment that these U.S.-based practitioners, who face far more lawsuits than Canadian practitioners, are unwilling to consider.

3. The course faculty are almost exclusively Ivory Tower practitioners because the courses rarely come to the places I work and it’s cheaper to get to a big city than it is to travel to another small town where the courses may have local doctors running them. We need big-city specialists to help our patients but I become enraged when every story coming from the course faculty is about screw-ups in the periphery. I’ve never heard a story about a remarkable save from a resource-limited environment and I think the instructors are often disrespectful of the work remote and rural practitioners do. Of course, I’m not exactly part of the solution but in my defense, becoming a course instructor would require me to spend a lot of time in major urban centres and I would likely have to spend even more time there in order to teach the minimum number of courses needed to stay current.

4. I realize that we need to break the material down somehow, but it seems unrealistic to look at trauma and resuscitation without looking at cardiac rhythms. We need courses that allow us to bring these skills together. Courses such as the Comprehensive Approach to Rural Emergencies (CARE) are dreamy answers to this need but it doesn’t meet those alphabet soup needs, and it requires a hospital administration that is supportive and has money.

In the end, it’s probably best for me to try to recertify these courses at rural conferences, when the room is full of like-minded people. Unfortunately, it turns out that rural doctors who toil away in their small communities really need locums so they can leave to attend the big rural conferences, so I’m usually working during those events. I could try to help create a rural/remote supplement for these courses but I’m not sure I could win a conversation with the ivory tower academics when they often have big studies to back them up and I only have anecdotes.

Dr. Sarah Giles is locum family physician.

“Too many doctors” in Nova Scotia? It sure doesn’t feel that way.

Submitted by

Have you seen this article about how we have “too many doctors” in Nova Scotia?

I find this really bizarre, and I’d like to get your thoughts on it.  To me I see a real disconnect between the Liberal government and the Health Authority on this issue.

The Liberal government committed in their election platform in 2013 that every Nova Scotia would have a doctor.

For most people this means a family doctor or another type of primary care provider.

While the Liberals made a few small steps to encourage doctors to stay here, there are still thousands of Nova Scotians without a family doctor or a primary health care provider.

They are forced to emergency rooms, or go begging to doctors in Halifax – sometimes hundreds of kilometres from their home community.

The Health Authority uses the euphemism “unattached patients” or “orphan patients” but let’s be clear: these are people who do not have a family doctor, and have little prospect of getting one in the current environment.

Now these people are being told by the most senior doctor in the Province that we have “too many doctors.”

It sure doesn’t feel that way, especially in rural Nova Scotia.

As stated in the article, there are 20 current vacancies in Metro Halifax (or Central Zone) and – if you look at the Health Authority’s own website– there are currently family physician vacancies across the Province.

The vacancies stretch from Sydney to Yarmouth to Amherst.

This list excludes other specialists AND the 20 vacancies in Metro.  I count at least 25 communities here, and I expect some need 2 or more physicians to meet current needs.

So something doesn’t compute here.  We have “too many doctors” but 75 vacancies for family physicians today?

If this is true, what real, tangible steps is the Health Authority taking to move the so called “boutique physicians” out of Halifax?

Do Nova Scotians have to wait an entire generation for doctors to redistribute themselves?  Sounds sort of like a budget balancing itself.

I hope that Liberal MLAs are NOT bringing this message from Halifax home to their constituents,

“You can’t get primary care?  Hey relax, we have too many doctors anyway.”

For your reference, here are the communities that should just relax because we have “too many doctors”:

  • Barrington
  • Bridgewater
  • Chester
  • Digby
  • Kentville
  • Liverpool
  • Mahone Bay
  • Middleton
  • New Germany
  • Shelburne
  • Yarmouth
  • Weymouth
  • Antigonish Town/County
  • Baddeck
  • Glace Bay
  • Guysborough County
  • New Waterford
  • North Sydney
  • Richmond County
  • Sydney
  • Truro
  • New Glasgow
  • Amherst
  • Westville
  • Tatamagouche – CEC