CMAJ Podcasts

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.Comments or questions? Text us.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 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.Comments or questions? Text us.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

Robert Kozak, a microbiologist at Sunnybrook Health Sciences Center, and Thomas Piggott, Medical Officer of Health, delve into the H5N1 virus and its recent human transmission cases. Kozak discusses symptoms and treatment options while stressing the importance of clinician awareness. Piggott emphasizes lessons learned from the COVID-19 pandemic, advocating for improved public health infrastructure and equitable care access. They also highlight the role of wastewater testing in monitoring outbreaks and the urgent need for ongoing vigilance in pandemic preparedness.

Nicholas Fabiano, a second-year psychiatry resident at the University of Ottawa, discusses his research on exercise as a viable treatment for depression, revealing it can be as effective as medication. He introduces the FITT principle for exercise prescriptions and emphasizes the need for realistic goals. Joining him is Michelle Fortier, a physical activity psychologist and professor, who advocates for including kinesiologists in primary care to help patients overcome exercise barriers. They highlight the 'commit 10' method, encouraging patients to start with just ten minutes of activity.

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.Comments or questions? Text us.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 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.comComments or questions? Text us.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 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.Comments or questions? Text us.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 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.For more information from our sponsor, go to md.ca/EC2024Comments or questions? Text us.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 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.Comments or questions? Text us.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.Comments or questions? Text us.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