White Coat, Black Art

A shortage of anesthesiologists in Canada often means postponed operations and procedures. But some hospitals are using anesthesia assistants (AAs) to get more patients into surgeries and routine procedures needing sedation. Dr. Brian Goldman observes AA Rob Bryan during a colonoscopy at an Ontario hospital to find out what he does. And Nova Scotia pediatric anesthesiologists Dr. Sally Bird and Dr. Mathew Kiberd say AAs have become an essential part of their anesthesia team.  

It may seem counterintuitive, but hospital emergency rooms can be hazardous to the health of elderly patients. An innovative geriatric multidisciplinary ER team at St. Mary's Hospital in Montreal is getting elderly patients discharged quickly and safely, saving them from preventable harms and the hospital millions in preventable admissions.

A growing number of young people in Canada are being diagnosed with colorectal cancer, and their needs often differ from older patients. Melissa Grof​f was diagnosed at age 34, with three small kids, in the prime of her career.​​ ​She​ says she would have benefitted from more age-appropriate care. Sunnybrook's Young Adult Colorectal Cancer Clinic offers this care including support for mental health, sexual health, body image issues and family planning.

Palliative physician Dr. Samantha Winemaker says her line of work has a branding problem. Instead of thinking of it as "the Grim Reaper service" to be called in at the 11th hour, she says patients benefit from a palliative approach as soon as they're faced with a life-limiting illness. "Dr. Sammy" meets a new patient and his family for the first time - showing how her person-centered care treads the fine line between honesty and hope. 

Dr. Tara Kiran, a family physician and researcher from Toronto, dives into the world of primary care in the Netherlands. She discovers a system that excels with 24/7 access to care and efficient triage through dedicated call centers, lightening the load on emergency services. The discussion highlights the cultural significance of house calls and the pivotal role of practice assistants, which allow GPs to focus on complex cases. Kiran draws compelling comparisons to Canada, advocating for systemic reforms to enhance primary care accessibility and patient outcomes.

Kay Dingwell, an ER physician from Summerside, PEI, passionately discusses the burdensome requirement of sick notes for minor illnesses. She highlights the frustration patients face when forced to obtain notes that doctors dislike writing. Dingwell argues that such policies overwhelm an already strained healthcare system. The conversation delves into the impact on low-wage workers, presenteeism, and the evolving legislative landscape in Canada aimed at eliminating unnecessary sick note demands. Advocating for change, she emphasizes the need for a more compassionate approach to sick leave.

Discover how Denmark has achieved remarkable primary care access, with over 98% of its population linked to healthcare providers. Personal stories illustrate the stark contrasts between the Canadian and Danish systems, highlighting long wait times in Canada versus immediate access in Denmark. Delve into the enriching Danish concept of 'hygge' and how it influences well-being. Insights from general practitioners reveal the importance of patient relationships and system efficiency, offering a roadmap for potential improvements in Canadian healthcare.

Adam Killick, a CBC producer, candidly shares his quest for an ADHD diagnosis in middle age. He reflects on a lifetime of struggles, from childhood confusion to adult challenges with impulsivity and focus. The conversation navigates the complexity of being a gifted student while grappling with disruptions. Adam discusses the emotional toll of potential diagnosis, the societal stigma around mental health, and the hope and anxiety tied to seeking help. His story highlights the importance of understanding and seeking support for those with adult ADHD.

Dr. Ainsley Gray, a psychiatrist specializing in ADHD, breaks down the growing awareness of undiagnosed adult ADHD and its tell-tale signs. She highlights how symptoms can often be masked, especially in women, affecting self-esteem and life quality. The conversation touches on the implications of diagnosis, coping strategies, and the importance of comprehensive assessments. Dr. Gray also emphasizes the effectiveness of combining medications with behavioral interventions, stressing the need for workplace support and accurate diagnosis.

Faced with a life-limiting illness, most Canadians would like to die at home. But only 13% are offered the palliative support to do so, which Dr. Sammy Winemaker wants to change. The palliative home care physician introduces us to the family of patient Shelley McCarthy two years after her death at home from thyroid cancer. They say a palliative approach should be offered early and include everyone.