#College of Physicians and Surgeons of Manitoba

[canadianabroadvery]

[college-girl199328]

Two University of Calgary researchers weren’t surprised when their survey of Alberta doctors showed biases against Indigenous patients, but they were shocked by some of the comments.

Pamela Roach and Shannon Ruzycki sent a survey in September 2020 to every licensed doctor in the province to determine their biases following high-profile deaths of Indigenous patients in Canada’s healthcare system.

“These types of comments demonstrate a fundamental lack of knowledge about what race is, what racism is like, what power is and what privilege is,” Ruzycki said in an interview.

One of the survey respondents — a white doctor — said he felt racism from Indigenous people, not the other way around.

“The most common sort of racism I have seen is an Indigenous person being racist in words and actions against white people. This is 100 times more common than the converse,” the doctor wrote, according to a study about the survey published in the online peer-reviewed journal BMJ Open last month.

Ruzycki and Roach said in some cases when people of privilege say they’re experiencing racism, it comes from a lack of understanding of the system of power.

There is already a power imbalance in the doctor-patient relationship, the researchers said, and that can pose a dangerous environment for Indigenous patients seeking medical help.

“We have so much evidence of the way Indigenous people are treated in the health-care system through the tragic deaths of people like Joyce Echaquan and Brian Sinclair,” said Roach, referring to the treatment of Indigenous patients in Quebec and Manitoba that created a significant public outcry.

The survey, which had 375 respondents out of about 12,000 that it was sent to, used a “feeling thermometer” approach in two questions that asked participants to indicate their agreement.

In the question that asked doctors if they preferred white or Indigenous people, 25 percent said they preferred white people. More than eight percent said that they felt unfavourable towards Indigenous people.

“(The participants) self-reported an explicit bias,” said Ruzycki. “It should be zero.”

Roach, who is a member of the Metis Nation of Alberta, said that the low survey response was likely due to the timing of when it was sent out, during the second wave of the COVID-19 pandemic, when hospitals were overburdened and many healthcare workers were feeling burnt out.

A favourable response rate for most surveys is about 20 percent, the researchers said, adding that asking difficult and straightforward questions about race was also a deterrent.

Ruzycki said the response to a demographic question in the survey was about 10 percent or just under 1,100 doctors.

“The first anti-Indigenous bias question, that number dropped to 375. When we asked an uncomfortable, challenging question, people opted out.”

Roach said that while it’s imperative to report cases of racism, it’s only the first step.

“Where we fall is what happens after reporting,” said Roach. “There need to be more reporting structures with accountability.”

The College of Physicians and Surgeons of Alberta has a complaints process for patients and outcomes vary depending on the unique circumstances of each case, said spokesperson Melissa Campbell.

In an email, Campbell said that the college had established an Indigenous Advisory Circle to help connect Indigenous physicians and patients.

“The work in this area is just beginning. But the goal is to listen to and learn from members of the circle. This will help us better understand and support Indigenous patients and better guide the physicians who care for them.”

Alberta Health Services spokesperson Kristi Bland said in an email that the agency also has a process for dealing with complaints. Bland added that the agency has established the Indigenous Wellness Core, formerly known as the Indigenous Health Program, which has dedicated staff who help Indigenous patients through the healthcare system.

[if-you-fan-a-fire]

“Austrian Jew Denied Permit,” Windsor Star. April 19, 1939. Page 11, ---- Manitoba House Is Leaving Status of Eye Specialist to Medicos --- WINNIPEG, April 19. - Shortly before proprogation late Monday night, the Manitoba Legislature killed a bill to admit to medical practice in Winnipeg, an Austrian Jewish refugee, Dr. George Kimel. On a motion of Dr. S. W. Fox, Social Creditor Gilbert Plains, the baill was given a six-months’ hoist by a 30-1 vote.

A recent resolution of the Manitoba College of Physicians and Surgeons voted against accepting refugee physicians for the medical role of the province.

‘The Legislature should exercise its sovereignty to do an elementary, simple act of justice,’ declared K. St. G. Stubbs, Independent, Winnipeg, who introduced the bill. It was not a case of ‘making a doctor out of someone who is not a doctor.’

Premier John Bracker did not like the idea of over-riding the regulations of the medical authorities.

Dr. Fox said the regulations should be regarded as a safeguard and protection to the public.

‘There is another way to meet the situation,’ he said, ‘and that is along regular lines.’

He believed the language qualifications’ could be waived.

Under the present rules of the college of physicians and surgeons applicants for registration must speak English or French. Dr. Kimel speaks only German.

[zee-man-chatter]

A doctor in Manitoba prescribed Ivermectin to a patient and was investigated by the College of Physicians. The doctor was not on board with the party line as far as Covid went, and was even so bold to go into the meeting maskless. The CBC never fails to disappoint, they called Ivermectin a animal de-wormer despite the fact that millions take it daily in sub-Saharan Africa and the drug won a Nobel prize. It's probably time to defund the CBC as they exercise no critical thought and just parrot out what the government tells them to..

[drwilsonasfora]

Remarkable Neurosurgeon, Dr. Wilson T. Asfora, Welcomes Patients at His Private Practice in Brookings and Sioux Falls, South Dakota, as well as Miami, FL

Wilson T. Asfora, MD, FRCSC, FAANS, FACS, is a top reproductive neurosurgeon surgeon who lends his skills and expertise to serve patients at his private practice with office locations in Brookings and Sioux Falls, South Dakota, as well as Miami, FL. He additionally can be found on staff at the Coral Gables Hospital, Westchester General Hospital in Miami, FL and Brookings Ambulatory Surgical Center in Brookings, SD. With twenty years of experience as a neurosurgeon, he specializes in all facets of his specialty. Prior to his current endeavors, he served as a neurosurgeon with Sanford Surgery (2007-2020), independent surgeon in Sioux falls, SD (1991-2007), and neurosurgeon with Sioux Falls Specialty Hospital. Furthermore, he has been a Clinical Professor of Adult and Pediatric Neurosurgery in the United States and Canada. His scope of practice encompasses functional neurosurgery including Deep Brain Stimulation for Movement Disorders, spine surgery, cerebrovascular surgery, radiosurgery, peripheral nerve surgery, as well as surgery to remove brain tumors, orbital tumors, and pituitary tumors. In addition to English, Dr. Asfora speaks Portuguese, French, and Spanish. For more information about Dr. Wilson T. Asfora, please visit https://www.wilsonasfora.com/.

Wilson T. Asfora, MD, FRCSC, FAANS, FACS, is a 1977-graduate of Federal University of Pernambuco in Recife, Brazil. While completing his medical degree, he obtained a rotating clerkship through scholarship at Oxford University Medical School in Oxford, UK (1976-1977). Dr. Asfora’s postgraduate training includes his urology residency in general surgery (Matarazzo Hospital, São Paulo, Brazil, 1978-1979) and his residency in neurosurgery (University of São Paulo, São Paulo, Brazil, 1980-1980). Dr. Asfora relocated to the United States in 1980, where he completed a straight surgical internship (Yale New Haven Hospital – Saint Raphael Campus, New Haven, CT, 1980-1981), residency in neurological surgery (University of Ottawa in Canada, 1981-1985), neurosurgery fellowship (UCSF Medical Center in San Francisco, CA, 1985-1986), and radiosurgery fellowship (Harvard University, Boston, Massachusetts, 1986-1987), and neurosurgery residency (University of Manitoba in Canada, 1987-1990). Dr. Asfora attained board certification in neurosurgery with both the American Board of Neurological Surgery and the Royal College of Physicians and Surgeons of Canada. For more information about Dr. Wilson T. Asfora, please visit https://www.findatopdoc.com/doctor/3037625-Wilson-Asfora-Neurosurgeon.

Licensed in the states of South Dakota, Florida, and California, Dr. Asfora remains an active member of the Congress of Neurological Surgeons, the South Dakota State Medical Association, the Royal College of Surgeons of Canada, North American Spine Society, the International Stereotactic Radiosurgery Society, the American College of Surgeons, the National Association of Spine Specialists, and the American Association of Neurological Surgeons. Wilson T. Asfora, MD, FRCSC, FAANS, FACS, is a Fellow, American Association of Neurological Surgeons (2010), fellow of the American College of Surgeons (2000), as well as Fellow of the Royal College of Physicians and Surgeons of Canada (1990). Over the years, he has authored 34 publications on various neurosurgery topics, including a book chapter on Spine Biomechanics. Holding 80 patents, the doctor has developed a number of medical devices that are used across hospitals worldwide. Some of these devices include The Dakota Knife, The Subdural Evacuating Port System (SEPS), and The Odontoid Curved Drill Guide. For more information about Dr. Wilson T. Asfora, please visit https://www.findatopdoc.com/doctor/3037625-Wilson-Asfora-Neurosurgeon.

[thuocphathaibinhduong-blog]

11 What you should find out before visiting Thu Dau Mot abortion Clinic in Phu Giao, Binh Duong

Abortion is legal in Binh Dương. You do not need the permission of a parent or partner to have an abortion.

We offer aspiration and medication abortions for people who live in Manitoba and surrounding areas. At Thu Dau Mot Clinic at Binh Duong, medication abortions are available for people who are up to 9 weeks pregnant and aspiration abortions are available for people who are up to 16 weeks pregnant.

For those who are over 16 weeks pregnant, we offer referrals to other services. Health Sciences Centre provides aspiration abortions for people up to 19 weeks and six days pregnant. There is no cost to have a medication or aspiration abortion at Thu Dau Mot Clinic at Binh Duong if you have a Manitoba Health Card or coverage from another province.

We provide safe, legal, and confidential services in a non-judgmental and supportive phongkhamphathaibinhduong.webflow.io/ setting. Our team of doctors, nurses, counsellors, and administrative staff are trained and experienced in providing compassionate and high-quality care. Our clinic is accredited by the College of Physicians and Surgeons of Manitoba and maintains the highest standards of medical care.

[vsplusonline]

Proposed B.C. change could put foreign-trained doctors to work during coronavirus pandemic

New Post has been published on https://apzweb.com/proposed-b-c-change-could-put-foreign-trained-doctors-to-work-during-coronavirus-pandemic/

Proposed B.C. change could put foreign-trained doctors to work during coronavirus pandemic

The organization that regulates B.C.’s doctors is considering a move that could allow more foreign-trained physicians to work.

The proposed changes by the College of Physicians and Surgeons of British Columbia would create a new registration class called “associate physician.”

READ MORE: Italy rushes 10K medical students into service during coronavirus outbreak, scrapping final exams

Associate physicians would have to practise under the supervision of a fully-certified doctor, would only be able to work in teams, and would not be licensed for independent practice.

1:45 USask med students start project to aid health care providers treating coronavirus patients

USask med students start project to aid health care providers treating coronavirus patients

The college says similar registration classes exist in Alberta, Saskatchewan, Manitoba and Nova Scotia.

In order to qualify, applicants would need to have a medical degree, at least two years of postgraduate training in a medical or surgical specialty, and have completed Licentiate of the Medical Council of Canada qualifying exams.

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READ MORE: McGill University students helping frontline health care workers in Montreal

Former NDP MLA Harry Lali has been among the voices calling for B.C.’s registration requirements for doctors eased as the COVID-19 pandemic strains health-care resources.

He said he welcomed the proposed changes, but that they don’t go far enough.

[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]

“The three criteria that are listed by the college … specifically exclude medical residents, and I think that’s not fair,” Lali told CFJC.

“So, basically, we’re taking foreign-trained doctors that are from foreign counties over those who are Canadians.”

2:00 A group of Queen’s medical students organize to make masks for front line health care workers

A group of Queen’s medical students organize to make masks for front line health care workers

On Thursday, provincial health officer Dr. Bonnie Henry appeared cool to the idea of changing the way the province certifies its doctors.

READ MORE: Provinces try to recruit retired doctors as coronavirus spreads in Canada

“A time of crisis is not necessarily the time we want to modify the requirements people need to have to ensure they can practise in a safe way in this province,” Dr. Henry said.

The college says the proposed changes were included in new draft bylaws drawn up in 2019, but that Minister of Health Adrian Dix had asked it to post them on March 31 with a sped-up timeline for consultation.

That consultation period will now close on April 15.

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[insurancepolicypro]

Readers And Tweeters Take Dialysis Suppliers To Activity: Nowhere However In The USA

Letters to the Editor is a periodic function. We welcome all feedback and can publish a variety. We edit for size and readability and require full names.

The Undue Pressure Of Dialysis

That is prison, and the dialysis firms aren’t the one ones plundering the general public (“Invoice Of The Month: First Kidney Failure, Then A $540,842 Invoice For Dialysis,” July 25). In case you have no medical insurance coverage and go to a physician or hospital for medical care, you get charged tenfold what they settle for from insurance coverage firms. No correctly run well being care facility or physician is shedding cash by accepting the agreed charges that the insurance coverage firms pay. It’s completely outrageous to cost individuals who can least afford to pay as much as 10 instances the insurance coverage costs. This rip-off has existed for many years and Congress has completed nothing to guard shoppers. My understanding is that no different nation permits this discrimination in opposition to the poor. It’s time this outrageous exploitation of shoppers be terminated.

— Jorg Meister, Middlegrove, N.Y.

Instruments like this are, sadly, essential to navigating the bewildering course of that’s making an attempt to acquire medical care.

— David W.S. Lieberman (@DwsLieberman) July 25, 2019

— David W.S. Lieberman, Somerville, Mass.

That is in response to the invoice of Sovereign and Jessica Valentine. It’s ridiculous that Fresenius can cost them $14,000 per session when dialysis in Mexico utilizing the identical dialysis machines and procedures runs $400 USD per session. I take my mom there regularly for trip, and we pay money for her dialysis periods.

—Martina Patella, Oakland, Calif.

That is simply insane. How can this occur in a so-called first world nation?

— Andrea Hilderman (@northarcagri) July 26, 2019

— Andrea Hilderman, Manitoba, Canada

I used to be appalled to learn your article on dialysis. I’ve an expensive good friend who constructed, opened and now operates a dialysis middle in Thessaloniki, Greece. His father is a kidney specialist of 30+ years. He wrote the string under about dialysis in Greece once I forwarded the story to him:

“In case you have insurance coverage dialysis is free Zero Free of charge The typical worth that dialysis services in Greece cost the Greek NHS is round 136 euros.

If a affected person who doesn’t have insurance coverage goes to a dialysis facility, he will probably be charged round 200 euros [about $223 in the United States]. That will probably be an amazing day for the ability.”

— Jerry Efremides, New York Metropolis

PBMs Put Sufferers In A Pickle

In addition to the delay of generic medicine to market (“California Invoice Would Combat Offers That Delay Generic Medicine,” Aug. 1), the pharmacy profit managers (PBMs) have offers with the producers, and pharmacies aren’t allowed to dispense a brand new generic as a result of the PBM won’t enable it to occur. Presently, there are Medicare plans that won’t pay for generic Ventolin or Advair and demand that we dispense the model title. It prices sufferers extra, the plan extra, and pharmacies lose by shelling out the brand-name medicine.

— David Smith, A & O Clinic Pharmacy, Salinas, Calif.

Profitable The Match Recreation

This isn’t information (“American Medical College students Much less Seemingly To Select To Grow to be Major Care Docs,” July three). Medical college students have been selecting the higher-end specialties over major care for many years. I’ve been within the well being care business for over 40 years and have labored with actually 1000’s of physicians as an govt at Cedars-Sinai Medical Middle and at my two firms, Observe Administration Data Corp. and Flash Code Options LLC. My daughter and her husband are each radiation oncologists. Board certification in the next specialty leads to increased revenue and higher profession selections. Why accept household follow in case you could be an orthopedic surgeon?

— James B. Davis, president and CEO of Observe Administration Data Corp., Beverly Hills, Calif.

I feel a discount within the quantity of doctor time devoted to administration duties (i.e. paperwork and EMR) must be rethought. Though folks have excessive pupil mortgage debt, as a physician we make greater than minimal wage so it shouldn’t be the largest deterrent.

— Jacqueline Ivey-Brown, MD (@JIveybrown) July 9, 2019

— Dr. Jacqueline Ivey-Brown, Chicago

Meds And Momentary Psychological Lapses

I learn your Navigating Growing older column about what number of drugs have an effect on older adults (“Widespread Medicines Can Masquerade As Dementia In Seniors,” July 18). I’m 85 and had two knee alternative surgical procedures. Each time I’ve to go to the dentist, I have to take 4 amoxicillin antibiotic tablets one hour earlier than the dentist appointment. I seen that after I took these antibiotics, my reminiscence grew to become very unhealthy. After a couple of days, I felt like myself once more.

— Janet Gileno, Bomoseen, Vt.

Widespread Medicines Can Masquerade As Dementia In Seniors https://t.co/6gAdUyMCmQ by way of @khnews – as a geriatrician, I have been preaching this to my sufferers for years. Once I speak to AARP teams and counsel that the “PM” medicine may not be secure, I get soiled seems. Unfold the phrase!

— James Richardson, MD, MPH (@DocRock54) July 18, 2019

— Dr. James P. Richardson, Baltimore

Weighing Prices And Advantages Of Intravenous Iron

I really feel your article about iron infusions (“Infusion Remedies — Wanted or Not — Can Deplete Sufferers’ Wallets” Aug. 2) was biased. The article didn’t focus on the explanations a doctor would possibly select to make use of IV iron to deal with a affected person versus oral iron – oral iron is just not nicely tolerated and within the presence of irritation within the physique is just not nicely absorbed. There are blood administration packages in america that commonly use IV iron to deal with anemia to lower the affected person’s threat for a blood transfusion. Though the price of IV iron differs from one drug to a different (the inexpensive medicine, akin to Ferrlecit, require a number of infusions), if you add up the associated fee, it consists of not solely the administration of the drug, however the nursing time and pharmacy preparation time for the medicine.

One additionally should think about the chance for response when selecting a selected type of IV iron. Anaphylactic reactions can happen in sufferers receiving IV iron. Injectafer is likely one of the medicine we use frequently as a result of different types of IV iron have a higher threat for response. One should think about the added value of treating an anaphylactic response in a affected person. Injectafer is a longer-acting type of IV iron; slow-release preparations akin to ferric carboxymaltose (Injectafer) are first taken up by macrophages, the shell is digested, and the iron is launched slowly over few days versus near-immediate iron launch present in different preparations that result in extra opposed reactions.

Though your story supplied the expertise of a single affected person, it didn’t report the “entire” story about why physicians use IV iron. I obtain no incentive for utilizing one drug over one other and should think about the affected person’s medical situation and the dangers related to giving IV iron. IV iron will appropriate iron ranges extra quickly in sufferers since you can provide the next focus of the drug, versus oral iron, which may take upward of a pair months to enhance iron ranges. With out actually figuring out the doctor’s rationale for utilizing IV iron within the case of the affected person within the article, the writer drew conclusions with out having all of the information. I agree that we actually want to have a look at well being care prices, however the writer of the article additionally failed to say Large Pharma’s position in driving up the price of well being care.

— David J. Sterken, Grand Rapids, Mich.

Medicare pays $1,600/vial for this. If neither Medicare nor non-public insurance coverage had been concerned to “negotiate” for the affected person, these would promote for lower than $100/vial. What a rip-off. Infusion Remedies — Wanted or Not — Can Deplete Sufferers’ Wallets https://t.co/wUob0POGwO

— Jim McMullen (@jimmcmullenkc1) August three, 2019

— Jim McMullen, Kansas Metropolis. Mo.

As a Board Licensed Oncology Pharmacist (BCOP), hematology/oncology is my subject. Our establishment used the cheaper iron (Venofer, which, at a low dose of 100 mg, must be given extra usually) for years. Medicare stopped paying for it as a result of the cost was lower than $100 — for some purpose, the federal insurance coverage program won’t hassle to pay for lower-cost IV medicine. Severely. We switched our formulary iron to Injectafer, 750 mg per vial (value to us ~$100-$750/vial, and the cost to sufferers per vial is about $1,000 and up), as a result of we had been reimbursed by Medicare for the Injectafer (as a result of it’s greater than $100).

You might be spot-on: The USA doesn’t give our wholesome iron-deficient sufferers sufficient time to profit from oral iron. We inject IV iron for iron-deficiency anemia even when the affected person doesn’t endure from something apart from unhealthy lab assessments.

Most hospitals and ambulatory care facilities base their formulary selections largely on reimbursement. Medicare can’t bid for drug pricing and doesn’t have a nationwide formulary. It is a critical error on the a part of the legislature and prices billions of or extra in taxpayer cash that goes instantly into the pocket of the pharmaceutical business. Not paying for lower-cost IV medicine is only one very small instance. It’s horrible for the sufferers who should bear the price of this discrepancy.

Reimbursement is a posh situation lately in no small half to the waste of the federal government.

— Mary Davis, Bellingham, Wash.

Infusion remedy is the tip of the iceberg for pricey therapies and surgical procedures with no profit to sufferers. #evidencebasedmedicine should be mandated to keep away from fraud, misinformation and deceptive sufferers

— Nicolas Argy, MD, JD (@NicolasArgy) August 2, 2019

— Dr. Nicolas Argy, Boston

Shefali Luthra’s article on intravenous iron is rife with error. The pricing is just not shut, relative prices are fallacious, and the implication of inappropriate use could also be appropriate solely primarily based on totally usurious costs listed.

Greater than 70% of these prescribed oral iron (PO) report important gastrointestinal (GI) perturbation, intolerance and non-adherence. PO iron causes diarrhea and constipation, gastric cramping, metallic style and thick, inexperienced tenacious stool. A yr of remedy is required to switch shops and proper hemoglobin concentrations, all of which could be completed with IV iron in 30 minutes. For folks with hereditary bleeding issues, there may be zero credible expectation oral iron can sustain with losses since 10% (most) of PO is absorbed and PO raises a protein, hepcidin, which blocks iron absorption for 24 to 48 hours, making sufficient repletion unrealistic.

InjectaFer is the most costly iron. It prices $843 for 750 milligrams. Primarily based on the preponderance of printed proof, a gram of iron in a single dose is about all we are able to make the most of. The beneficial dose of InjectaFer is 1,500 mg, $1,686 for a course (not vial) of iron. I feel that wastes 500 mg, and there may be double-blind, potential proof supporting that conclusion. It prices $100 for an workplace go to, chair time nursing and IVs, which takes 15 minutes. For those who go to twice, that’s a further $100.The fees you talked about counsel that an establishment in New York is fleecing its purchasers or insurance coverage firms. That is usury and must be investigated and stopped.

The well being economist Richard Pollock is mistaken. IV iron is extensively utilized in Nice Britain and this can be very probably, not unlikely, a affected person with power blood loss would get IV iron, regardless of signs. That being stated, Ferinject, the European title for InjectaFer, prices $140 per gram and well being suppliers don’t must cope with the ridiculous 750 mg vial we do. Feraheme prices $466 for 510 mg and requires two vials for a gram (1,020 mg). 4 insurers enable me to offer 1,020 mg in a single 30-minute infusion: the Blues, MedStar, Precedence Companions and Cigna. The remaining, together with Medicare and Medicaid, require two visits. The one profit is to our follow, which will get $100 for the fully pointless second go to. Regardless of making it clear the only 1,020 mg infusion is simply as secure and efficient, you halve the variety of IVs and possibilities for minor reactions. It’s not coated, I’ve no selection. A 3rd get it as soon as; two-thirds, twice. We cost $932 plus a 6% markup to cowl nursing prices and paraphernalia.

INFeD, or low molecular weight iron dextran, prices $243 per gram, comes as 100 mg vials and requires 10 vials for 1 gram. It takes an hour and is simply as secure and efficacious.

The writer is mistaken about Venofer, iron sucrose and Ferrlecit, ferric gluconate. You’ll be able to’t give greater than 200-250 mg as a result of the sugar that carries iron does a lot much less tightly than the carbohydrate cores of InjectaFer, Feraheme and INFeD. To provide a gram takes 4 to 5 visits. I by no means use these medicine for that purpose, however I’ve no criticism of nephrologists who use them in dialysis with thrice-weekly visits. Venofer is $600 per gram (positively greater than INFeD) and Ferrlecit $1,000 per gram.

The medical system you wrote is screwing the group. IV iron is an unmet want. Oral iron can’t sustain with losses in irregular uterine bleeding, be absorbed after bariatric surgical procedure, makes inflammatory bowel illness worse as a result of it’s instantly poisonous to the intestinal epithelium and makes the fallacious micro organism develop, and most of all doesn’t get to infants within the third trimester when the fetal mind wants iron for regular improvement. IV iron is a godsend for hundreds of thousands.

— Dr. Michael Auerbach, Baltimore

Right By Levels

The article “‘Local weather Grief’: Fears About The Planet’s Future Weigh On Individuals’ Psychological Well being” (July 18) stated a latest report by the Intergovernmental Panel on Local weather Change predicts that “by 2040 the Earth will heat by 2.7 levels Fahrenheit (1.5 levels Celsius).” Because the report’s opening web page (to which you hyperlink) says, by 2040 the Earth may have warmed by 2.7F above preindustrial ranges. That’s complete warming over 200 years, not future warming within the subsequent 22 years.

The report additionally offers little assist for the acute claims which have terrified so many individuals — and, even much less excusably, terrified so many kids. That is additionally true of many experiences by the foremost local weather businesses.

The IPCC is the most important and best-run venture of its variety, ever — an evaluation of present science, which is then summarized for non-scientists. The tragedy is that its work has been largely deserted for propaganda that exaggerates and even ignores the findings. I imagine this has prompted the gridlock in U.S. local weather coverage, in order that we’re not solely unprepared for future excessive climate, however for the inevitable repeat of previous excessive climate.

— Larry Kummer, editor of the Fabius Maximus web site, Davenport, Iowa

Editor’s observe: Heat thanks for stating the error. Our article has been up to date.

I imply, I would confer with extra as a crippling anxiousness than “grief” however as long as there’s a medical time period for it, positive: https://t.co/tphhE3J2R9

— Michelle Mills (@mlmills) July 18, 2019

— Michelle Mills, Chicago

For good purpose, we’re anxious about local weather change. Nevertheless it’s a slippery slope from saying we’re distressed, to declaring being concerned is a psychological well being dysfunction, to creating a pseudoscientific psychological dysfunction to proposing a remedy to cal not act. https://t.co/ySRVxxYaok

— James C.Coyne (@CoyneoftheRealm) July 21, 2019

— James C. Coyne, Philadelphia

Incrementally Exploited By Politicians

My copay requirement of $7,500 plus a month-to-month fee should be paid earlier than my insurance coverage pays any bills. This isn’t well being care. On paper I’ve well being care; however the actuality is I can’t afford to make use of it. It merely would cease me from chapter in case of an emergency. Nonetheless, these politicians and attorneys are making hundreds of thousands and getting quite a lot of publicity with each petition they file (“Biden’s ‘Incremental’ Well being Plan Nonetheless Would Be A Heavy Raise,” July 22).

I really feel the politicians ought to have the identical well being care selections because the American folks. This could assist them make higher selections. Democrats and Republicans know well being care within the U.S. is unaffordable. They need to all be fired for not doing their job.

I additionally imagine they need to be capable to serve solely two phrases, similar to the presidential workplace. Politicians deal with their place as a life-style as a substitute of a job.

— Catherine Mossner, Gladwin, Mich.

The Battle For Uniform Excellence In Tribal Care

I’m half Inupiaq Eskimo from northwestern Arctic Alaska. The article “How The Japanese Cherokee Took Management Of Their Well being Care”(July 22) states that the Cherokee benchmarked a program developed by Southcentral Basis, a Tribal Well being Group initially created by an ANCSA (Alaska Native Claims Settlement Act) company however allowed to function as a Public Regulation 93-638 entity. Awarded largely no-bid contracts via the Indian Well being Service, Southcentral Basis legally represents solely shareholders of Cook dinner Inlet Area Inc. — not all Alaska Native peoples.

To say SCF and different Alaska Natives run this system could also be partly correct, but it surely doesn’t give credit score to priceless contributors who served for many years guaranteeing we understood and applied packages designed for all cultures — even households associated to non-Indian Well being Service beneficiaries.

Augusta Reimer is a kind of deserving credit score for this program. She was the primary feminine Alaska Native/American Indian chief of an Indian Well being Service division and was largely accountable for creating an environment of wellness and creativity. Reimer, from IHS, and Mike McKeown from the College of Alaska-Anchorage designed my diploma in human companies; she spent hours working with interns and volunteers educating them on legal guidelines impacting us. Everybody who contributed deserves to be cited precisely and never simply in a aspect observe as different “Alaska Natives.”

The federal government has been fairly first rate about encouraging native peoples’ self-determination, but it surely doesn’t come with out duty to observe the requirements of care and communication and the legislation to make sure the standard and longevity of our packages.

The Indian Well being Service was not accredited to offer care to non-Indian well being service beneficiaries. So the Nuka system of care — initially referred to as Nutuqsiivik, which suggests “new beginnings” — was created to assist determine gaps in information that had been boundaries to offering care to households with a number of well being care suppliers and well being and socioeconomic points.

Indian Well being Service packages have come a good distance, however consistency and uniformity amongst tribal areas is very regarding. Within the age of a one-payer assessment, transparency is critically necessary. So is accuracy. Knowledge and the shortage thereof could cause a myriad of well being and financial points the affected person or buyer might must cope with whereas their tribal group isn’t monitored or corrected when wanted. With out competitors, I concern, these packages don’t adequately respect affected person wants, needs and don’t have any actual incentive to enhance the standard of their care to be able to preserve their clients.

The Alaska legislature has created a committee particularly designed to coach lawmakers and the general public on points affecting the general public and the tribes as a result of there are such a lot of of us. These packages don’t stay in a vacuum, however fairly influence native financial improvement and regulatory management over your group. I encourage accountability amongst all events and the mirroring of the U.S. Structure and legal guidelines, so we’ve a authorized template to observe.

— Cheryl Bowie, Anchorage, Alaska

from insurancepolicypro http://insurancepolicypro.com/?p=212

[lorresidency-blog]

New Post has been published on http://www.residencylor.com/letter-of-recommendation-for-medical-residency-for-international-students-in-canada/

Letter of Recommendation for Medical Residency for International Students in Canada

If you are planning to apply to a medical residency program in Canada for international students, make sure to choose from the best programs we’re listing here. These residency programs in Canada will help students to become successful medical practitioners in the future. You can also check out UK medical residency for international students programs for more choices.

Canadian Medical Residency for International Students

University of Calgary: The offered residency for international medical students residency match in Canada provides students complete residency program in pursuing their medical dreams.

Application requirements for residency for international medical graduates in Canada

Have been awarded a medical degree.

Completed the residency training program in Canada or elsewhere.

Meet the college of physicians and surgeons of Alberta requirements, which include English language proficiency.

Conditions for Canadian Residency Programs for International Medical Graduates

For candidates outside Canada, credential and identity should be verified through Physician Credential Registry of Canada. All residents should be registered through the Office of Postgraduate Medical Education and pay the administrative and required fees.

Application Process

Applicants should submit a letter of application, which includes the application form, CV, and letters of reference. The application package will be forwarded to the appropriate department for review.

University of Montreal

The international medical students’ residency match in Canada allows applicants to have the best medical Canadian education. The international medical graduates’ residency program of the University of Montreal provides applicants the chance to experience the city. They are offering an excellent education in the field of medicine, and they place a greater emphasis on interdisciplinary approaches.

Application Requirements

All documents to be submitted should be official and original.

Submit letter of recommendation for the fellowship to support applicant’s application.

Submit a copy of the birth certificate that contains the applicant’s name, family name, date of birth, place of birth and sex. For applicants who do not have original documents, they need to attach a copy to their application and send the original document as early as possible.

For French citizens, they need to submit a copy of your French identity card or passport (front and back).

Original diplomas.

Application Process

Before submitting documents, applicants need to attach their identification sheet. The admission and recruitment have to make sure that documents received are filed with the correct application.

Upon arrival at the school, applicants should finalize their file at UdeM’s foreign student office by giving the entry documents before the start of the study. Failure to submit needed documents results in cancellation of the application.

McGill University

McGill University is a public research school that was established in 1821.

Eligibility Summary

Requires a permit to study abroad or in Canada

Has written MCAT in the last five years with results available before the deadline

Adheres to educational and general requirements

International candidates selected for admission should have a student authorization by the registration date. Applicants should prove to the Canadian Department of Immigration that they have enough funds to complete their medical program.

International applicants should submit their applications, an official or letter statement issued by authorities in their country that indicates their recognition of the medical degree awarded by the medical faculty.

Image credit: mtlblog.com

Application Process

McGill’s online application system automatically display program choices based on application type, citizenship status and level of education.

Education: Choose the highest education before starting the program at the university. Make sure that you do not choose the level of education you are planning to pursue in the institution.

Applications are being evaluated according to candidate category.

Academic evaluation: Evaluation of academic performance is conducted for complete applications. Academic records are ranked and evaluated in comparison with others.

Some Programs Offering Residency for International Students

University of Manitoba: the University of Manitoba is one of the best international medical residency programs you can choose from. The community medicine residency program is a 5-year program that was accredited by the Royal College of Physicians and Surgeons of Canada. Applicants need to apply through the Canadian Residency Matching Service to be eligible and give them the chance to work abroad.

Kazan State Medical University: KSMU internal medicine international medical residency medicine program is working closely with Royal College of Physicians and Surgeon’s of Canada (RCCI) to make sure rigorous standards are met. The institution plans to develop additional residency programs with the guidance of RCCI to ensure it benefits residents.

Before applying, make sure to know about the residency program international student pros and cons to determine whether studying abroad is the best solution for you. Lastly, make sure to submit complete documents to increase your chances of securing a spot in the residency program. Invest enough time to make sure all application materials are completed and submitted on time.

Are you ready to apply to a medical residency program in Canada for international students? Get started completing your best letters of recommendation today!

[therightnewsnetwork]

Her Doctor Gave Her Abortion Pills By Mistake and She Took Them, Thankfully Her Baby Survived

A pregnant woman in Winnipeg has suffered from a month of fears that her unborn baby boy would die after she said her doctor mistakenly gave her abortion drugs.

Serissa McKay, 21, is due July 16, and her unborn baby appears to be ok, Mims reports. However, the young mother has been worrying for nearly a month that her doctor’s alleged mistake would harm or kill her unborn son.

“You’re supposed to trust your doctor,” McKay said.

McKay said she received the abortion pills during a prenatal checkup on June 21 at her doctor’s office. Thinking that they were drugs routinely used in pregnancy, McKay said she went home and took them as instructed.

But what her doctor reportedly gave her was the abortion drug misoprostol, which induces labor, according to the Winnipeg Free Press. McKay said she was instructed to insert four pills in her vagina and wait several hours before taking several more.

McMaster University Professor Dusstin Costescu said McKay’s description of the pills and the method of taking them fits the description of misoprostol, an abortion drug which also is used as an ulcer medication.

Pro-life advocates may be familiar with the drug, which commonly is coupled with mifepristone (RU-486) to abort unborn babies in the first trimester. Doctors have developed a process for reversing RU-486 after the mother takes the abortion drug; however, the abortion reversal process does not work once the woman takes the second drug, misoprostol – the drug that McKay took.

Keep up with the latest pro-life news and information on Twitter. Follow @LifeNewsHQ

Costescu said the drug comes in two doses: 100 or 200 micrograms, and what McKay took was a much higher dose than doctors typically use.

“With labour induction at term, it can be used in as small as 25 to 50mg,” Costescu said. “So you use an eighth or even a 16th of the dose you use in first trimester.”

McKay said her doctor’s office quickly realized the mistake. She said they called her at home right after she had inserted the pills, and asked her to come to the office immediately and have them removed.

“I was pretty much in shock,” McKay said. “It didn’t really hit me until I actually got home.”

Here’s more from the Free Press:

She said the receptionist made her feel bad for not recognizing the pills or realizing they weren’t for her to take.

The Free Press is not naming the doctor or clinic because neither party could be reached for comment Wednesday.

“It was actually pretty painful,” McKay said of the removal process.

McKay said the doctor carried on as if it was a routine appointment, asking her if she had any questions or concerns.

“What will happen? I took pills that I wasn’t supposed to, so what should I watch for?” McKay said she asked the doctor.

She said the doctor told her to watch for cramping and signs of labour — and admitted the drugs had been intended for a woman who had suffered a miscarriage.

McKay said her doctor has not apologized or acknowledged how serious the mistake was. She filed a complaint with the College of Physicians and Surgeons of Manitoba.

She said she is not comfortable with her doctor, but she was told it may be too late for her to switch before she gives birth.

LifeNews has reported similar cases in the past. In February, a hospital in India also allegedly gave a pregnant woman abortion drugs by mistake. The mother, Dr. Tarannum Wasif Khan, a dentist from Kurla, India, claims one of her unborn twins died as a result of the mistake.

In 2015, a British woman said an OB-GYN clinic wrongly told her that her unborn baby had died and gave her abortion drugs to induce labor to expel her dead baby’s body. However, three weeks later, when the woman fainted and went to the hospital, they discovered that her unborn baby still was alive.

In a sickening case out of Australia several years ago, the Royal Women’s Hospital allegedly aborted the “wrong” twin. One of the unnamed woman’s twins was healthy, but the other had a congenital heart defect; and she chose to have the unhealthy twin aborted. However, something went wrong and doctors accidentally aborted the “wrong” baby, according to the allegations. In the end, both of the woman’s unborn babies ended up dying.

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from http://www.therightnewsnetwork.com/her-doctor-gave-her-abortion-pills-by-mistake-and-she-took-them-thankfully-her-baby-survived/

[jwbarker]

Dr. Alan Rich, the city's longest-serving physician, sent packing into retirement in 2011, presented with the Key to the City of Thompson

Dr. Alan Rich, the city's longest-serving physician, sent packing into retirement in 2011 by BRHA, presented with the Key to the City of Thompson

Dr. Alan Rich, left, receiving the Queen Elizabeth II Diamond Jubilee Medal last year in Swan River. Photo courtesy of Twyla Machan, Swan Valley Star & Times; Right a YellowPages ad for Dr.Rich’s office in the Professional Building in Thompson.

Thompson’s legendary, and at times controversial, Dr. Alan Rich, the city’s longest-serving physician who was sent packing from Thompson General Hospital…

[vsplusonline]

How to find a family doctor in each province and territory

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How to find a family doctor in each province and territory

A family doctor usually tackles any number of health concerns with patients: the flu, injuries, keeping up to date with shots and tests, referring you to a specialist and addressing mental health issues.     

Despite the importance of a family physician, almost 4.8 million Canadians don’t have one, which means they lack consistent access to a doctor who understands their specific needs — and this can impact health long-term, according to multiple studies in several countries.

READ MORE: Extended N.S. family prepares to lose family doctor and go on provincial wait list

“People who have a family doctor and see that same doctor regularly … are more likely to have better health outcomes,” said Dr. Tara Kiran, a Toronto-based family doctor. 

Having the continuity of a single provider over time means patients are more likely to get the screenings they need or have chronic conditions managed efficiently, said Kiran. They are also less likely to visit emergency rooms or be hospitalized, she added.

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“Many people feel like, oh, I just have a cough, this is a minor issue. And they just go to a walk-in-clinic. What happens then is that you are losing an opportunity to build a relationship with someone who will be there for you, as things evolve and change in your life,” she said. 

Finding a family doctor can be tough depending on where you live in Canada. Most physicians — 92 per cent — work in urban areas, making it often difficult to search for one in rural communities. 

Based on your region, there are different methods for finding a family doctor, explained Kiran. Here’s how to start your search. 

Why do I need a family doctor?

A family physician can find ways to enhance your health, even if the reason for your visit is seemingly minor, said Kiran. 

“When I see a patient for a sore throat or sore ankle, I often am also thinking about how can I help to keep them well in the future. Are there immunizations they need … or screening tests they are overdue for?” she said. “I usually take the opportunity to broach those.”

Mental health concerns are also a topic a family doctor can discuss with you, said Kiran. “Being able to divulge that kind of information is usually a lot easier when you have an established relationship with someone,” she said. 

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Chronic conditions, like asthma, will likely be managed more consistently under the care of a family doctor, said Dr. Kim Wintemute, a family doctor and assistant professor at the University of Toronto. 

READ MORE: Canadian doctors behind the curve on using technology to improve services: CIHI report

“So when that patient has an exacerbation of their asthma, and they go to the family doctor, they are going to be tuned in to what has worked in the past, what hasn’t worked, and what we should do now,” said Wintemute.

In contrast, a walk-in-clinic doctor is qualified but might not appreciate the nuances of a patient’s medical history, she explained. 

“What may end up happening is they may end up trying things that don’t work for that patient,” she said. 

Many often forget their medication history or what a medication was called, but a family doctor will have records in front of them, making it easier to determine what to prescribe, said Wintemute.

2:07 Lack of family doctors leads to lack of access to prescriptions for Nova Scotians

Lack of family doctors leads to lack of access to prescriptions for Nova Scotians

As Canadians, interactions with the health-care system will most often begin with a family doctor and they’re the ones to guide patients through that system, she said. 

“They not only know your medical history, they also know you,” she said. “When people have emotional upsets in life or difficult times … your family physician learns over time with you how you cope best, and help you through those times.”

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How do I find a family doctor?

The process to search for a family physician can vary, and potentially be more difficult, depending on where you live. 

Issues like lack of medical care and programming for Indigenous people in remote areas continue to be a concern, along with a lack of Indigenous health-care providers, Global News reported in 2018. 

Recruiting family physicians in rural areas continues to be a challenge, as some doctors may not want to put down roots or build their lives in sparsely populated areas. 

Even after most Canadians find a family doctor, only 31-46 per cent, depending on the province, could get a same-day or next-day appointment with their physician, according to a 2014 report by the Health Council of Canada.

Keeping these kinds of issues in mind, the best way to begin your search is to see if you live in a province that has a centralized waitlist for people who need a family doctor, said Kiran. 

READ MORE: Federal parties promise more family doctors — but that won’t necessarily improve access

“So there’s a number you can call, and they can try to find you a family doctor within your region,” she said. For instance, in Ontario you can call a government service called Health Care Connect, and they will put you on a waitlist, Kiran explained. 

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“How successful that process is in finding you a doctor probably depends to some degree on where you live in Ontario,” she said, adding it can be tougher in rural areas. 

Outside of the waitlist, Kiran recommends you approach the department of medicine at a university as they are training family doctors and it’s possible to connect with resident physicians at a teaching clinic. 

Residents are fully trained family doctors who are supervised by experienced medical professionals, she said. “Often resident patients are able to get excellent care,” she said.

Word of mouth also remains a less official, though effective, way of finding a doctor, said Wintemute.

“If you have family members or friends who do have a family doctor, sometimes you can ask through those people,” she said. “And if the doctor is not able to take on new patients, sometimes the doctor’s office will have a list of doctors who are, so they can direct people in that way.”

Once you do have a family doctor, it’s not essential to see them annually unless you are over the age of 65 or have ongoing health concerns, she said. 

“Every two to three years is good for most adults,” she said. 

How to find a family doctor in each province and territory: 

British Columbia: The B.C. College of Family Physicians recommends patients contact HealthLink BC at a toll-free number where a health service navigator can help provide information on how to find a doctor in your area.

Alberta: Patients can use the Find a Family Doctor tool provided by Primary Care Networks to see who is available in your area. The Find a Physician tool is also available on the College of Physicians and Surgeons of Alberta website. Contacting HealthLink Alberta is also an option to speak to someone who can guide you. Saskatchewan: The Saskatchewan Health Authority has a list of regions in the province and where doctors are accepting new patients. The College of Physicians and Surgeons of Saskatchewan also has a physician search tool available for patients.

Manitoba: The provincial government has a tool called the Family Doctor Finder where patients can register online or by phone so they can be connected with a clinic in the area.

Ontario: Patients can register with Health Care Connect to be put on a waitlist to find a doctor. They can also use the doctor search tool on the College of Physicians and Surgeons of Ontario website.  Quebec: The provincial government has a waitlist where patients can register. They can also register over the phone.  New Brunswick: The province has a registry called Patient Connect to match residents with a family doctor if they don’t already have one.  Nova Scotia: The province recommends patients call 811 or register with the Need a Family Practice Registry, which is a waitlist.  Prince Edward Island: Residents can join the Provincial Patient Registry and a doctor will be assigned when one becomes available.  Newfoundland and Labrador: Patients can search a list of family physicians in their area to find a family doctor that are taking new patients.  Yukon: The territory has a match service for patients needing a family doctor.  Northwest Territories: A list of physicians in the Northwest Territories can be found here and clinics can be contacted individually.  Nunavut: The territory’s Department of Health provides contact numbers and a map to health-care services where family physicians can be found.

© 2020 Global News, a division of Corus Entertainment Inc.

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