CMAJ Podcasts

Canadian Medical Association Journal
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Jan 2, 2023 • 29min

Looking back, looking forward with CMAJ editors

On this special episode, Drs. Blair Bigham and Mojola Omole interview CMAJ editor-in-chief, Dr. Kirsten Patrick, and executive editor, Dr. James Maskalyk. They talk about the journal's accomplishments over the past year and some of the challenges related to its increased focus on social determinants of health and equity.In the year ahead, Drs. Patrick and Maskalyk say the journal will focus on exploring topics related to access to care, and particularly encourage the submission of articles that discuss bold solutions that can bring about wide-reaching systemic change.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
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Dec 19, 2022 • 37min

Canada’s primary care crisis: addressing the causes and finding solutions

A popular theory to explain the crisis in primary care in Canada is that newly graduating physicians simply do not see as many patients as previous generations. But recently published research has thoroughly debunked that myth. David Rudoler is the lead author of research published in CMAJ entitled Changes over time in patient visits and continuity of care among graduating cohorts of family physicians in 4 Canadian provinces that looked at the number of patient contacts for physicians at all career stages. He and his co-authors found no generational differences in family physician practice.On this episode, David Rudoler, who is an assistant professor in the faculty of health sciences at Ontario Tech University, tells Drs. Bigham and Omole that, while his research disproves the ‘lazy millennial physician’ trope, it does show that the number of patient contacts has declined for all primary care physicians over the years.Dr. Tara Kiran,  Fidani Chair in Improvement and Innovation at the University of Toronto and a family medicine physician at St. Michael's Hospital Academic Family Health Team, then talks to the hosts about what Canada can do to ensure that everyone in Canada has access to adequate primary care. Dr. Kiran is the author of a commentary in CMAJ entitled Keeping the front door open: ensuring access to primary care for all in Canada. Dr. Kiran argues that interprofessional team-based care, coupled with payment reform, has the potential to improve primary care capacity, access and outcomes for patients, as well as  provider well-being. She advocates for more radical reforms such as regionally organized after-hours care and neighbourhood-based primary care, models that currently exist in several European countries.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
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Dec 5, 2022 • 41min

Managing epistaxis and identifying who may have a bleeding disorder

An “old wives’ tale” has persisted in the treatment of anterior epistaxis. A practice article in CMAJ entitled, "Five things to know about anterior epistaxis" discusses what many are doing wrong and the proper way to treat anterior epistaxis. On this episode, co-author and rhinologist Dr. Leigh Sowerby elaborates on the causes and the full suite of options for treating this common cause for emergency department visits.Next, Drs. Bigham and Omole speak with Dr. Michelle Sholzberg, a hematologist and medical director of the coagulation laboratory at St. Michael's Hospital about how to determine if a patient may have a  bleeding disorder and needs investigation. Dr. Sholzberg discusses the usefulness of the INR and PTT and then goes on to call out structural sexism in hematology, and in the diagnosis of bleeding disorders, in particular. "Five things to know about anterior epistaxis"CMAJComments 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
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Nov 21, 2022 • 28min

Recognizing and addressing human monkeypox in Canada

A practice article in CMAJ presents 8 images of monkeypox mucocutaneous lesions presenting in Canadian patients from May to July 2022.  The images show a spectrum of common lesions seen in patients with human monkeypox during the 2022 outbreak in non-endemic countries. On this episode, Dr. Sharon Sukhdeo and Dr. Darrell Tan, two co-authors of the article discuss their intention that the image atlas be a necessary corrective to the proliferation of images from endemic countries seen early in the outbreak that primarily featured Black patients, often children. Host Dr. Mojola Omole speaks with these guests about the current epidemiology of human monkeypox in Canada, lessons learned from the 2022 outbreak, the importance of accurately describing who is at risk, and how generating awareness of monkeypox transmission in communities at risk may have slowed its spread.Dr. Sukhdeo is an infectious disease fellow at the University of Toronto, and Dr. Darrell Tan is an infectious disease physician at St. Michael's Hospital in Toronto.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
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Nov 7, 2022 • 31min

Exploring the promise of AI in medicine

Artificial intelligence, such as computer-aided detection and computer-aided diagnosis or differentiation uses complex algorithms to identify and characterize polyps in situ during screening for colorectal cancer.  Emergent evidence suggests that the performance of AI models is superior to current standards of practice.On this episode, Drs Bigham and Omole speak with Dr. Michael Byrne, co-author of a practice paper in CMAJ entitled Artificial intelligence in colorectal cancer screening. He argues that while artificial intelligence will not replace physicians, physicians who use AI will eventually replace physicians who don’t.Next they speak with Zayna Khayat, a future strategist and Vice President of Growth & Client Success at digital health solutions firm, Teladoc Health. She's also adjunct faculty at the Rotman School of Business. Zayna says that AI’s biggest impact on medicine will come from reducing costs and increasing the number of patients that can be guided through the system.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
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Oct 31, 2022 • 58min

Special Episode: Tackling anti-Black racism in medicine

Efforts to combat anti-Black racism in Canadian healthcare are underway but much remains to be done to dismantle the ideas, systems and implicit biases that underpin this specific form of discrimination.On this special one-hour episode, Drs Omole and Bigham explore the history of anti-Black racism in Canada’s medical schools, in particular at Queen’s University, where a ban on Black students was only formally lifted in 2018.They also explore solutions, including the development of a curriculum at Queen’s aimed at addressing anti-Black racism. Drs. Omole and Bigham speak with Dr. Sabreena Lawal, a co-author of a paper in CMAJ entitled: Anti-Black racism and medical education: a curricular framework for acknowledging and learning from past mistakes.They then explore the broad set of challenges still facing medicine in Canada and the efforts still needed to address anti-Black racism, with two Black physician leaders, Dr. Onye Nnorom and Dr. Kannin Osei-Tutu.Dr. Osei-Tutu is an acute-care hospitalist physician in Calgary. He is the anti-racism and EDI Strategic Advisor to the CEO of the Royal College of Physicians and Surgeons of Canada.Dr. Nnorom is an Assistant Professor at the University of Toronto and is the co-lead of the Black Health Education Collaborative, which played a major role in the CMAJ special issues on anti-Black racism.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
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Oct 24, 2022 • 40min

Ensuring equitable access to cancer care for Black populations

Black and immigrant populations are disproportionately underrepresented in regular screening for cancer. Race-based data from Canada are minimally-available, but research from the United States and Europe has shown that the lifetime risk of developing prostate cancer is much higher among Black people compared to white people and Black people who do get the disease tend to have more aggressive tumors and to present at a later stage.On this episode, Drs Omole and Bigham speak with Kikachukwu Otiono, lead author of an analysis in CMAJ titled, Prostate cancer screening in Black men in Canada: a case for risk-stratified care.  Ms. Otiono is a final-year medical student at McMaster University in Hamilton. She argues that Black patients should be understood to be at a potentially higher risk for developing prostate cancer and physicians should screen them earlier than guidelines currently recommend, based on evidence from other jurisdictions.They also speak with Dr. Doreen Ezeife, the author of another analysis in CMAJ entitled, Ensuring equitable access to cancer care for Black patients in Canada. Dr. Ezeife describes the barriers to receiving optimal cancer care for Black patients in Canada and discusses the steps that can be taken to ensure more equitable access.  Dr. Ezeife also makes the case for the collection of race-based data in Canada to improve understanding of the challenges that minority populations face in accessing medical 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
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Oct 10, 2022 • 42min

Optimizing care for patients experiencing sickle cell crises.

Several hospitals are known for providing particularly excellent care to people experiencing a sickle cell crisis.  For example, the ER at UHN meets a key recommendation from the 2017 Ontario Clinical Handbook that patients receive analgesia within  30 minutes of triage. The handbook also recommends that centres support patients’ individual coping strategies through ready access to food, phone chargers and blankets.Many ERs are not meeting this standard. A general lack of awareness about sickle cell disease among physicians, misplaced suspicion about drug-seeking and other biases lead to lengthy delays in patients receiving treatment.On today’s episode, Drs Bigham and Omole speak with Dr. Jennifer Bryan, a founding member of the UHN Emergency Department Sickle Cell Working Group, an emergency physician at UHN and the co-chair of the 2022 Sickle Cell Summit being organized by the Sickle Cell Awareness Group in Ontario.They also speak with Lance Archer, a patient and sickle cell disease advocate about his varied experiences seeking care for painful flare-ups. These interviews prompt a spirited, impromptu “M&M round” in the discussion between the co-hosts as Dr. Bigham reflects on a recent experience of treating a patient with sickle cell disease in an overly-busy ER. CMAJComments 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
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Sep 26, 2022 • 34min

How to be better at diagnosing rare conditions.

Hereditary angioedema (HAE) is a rare autosomal dominant disorder characterized by recurrent episodes of painful swelling without urticaria that leads to substantial morbidity and even mortality if left untreated.On this episode, Dr. Victoria Cook, an immunologist working in Victoria, BC, describes the case of a woman who had 6 emergency department presentations, 1 hospital admission and saw 5 different specialists over 11 months before finally being diagnosed with HAE.Drs. Bigham and Omole, then speak with Dr. Ed Etchells about how physicians can work to strip away biases and cognitive obstacles that can prevent timely diagnoses of rare and challenging conditions. Dr. Etchells works in the division of General Internal Medicine at Women's College Hospital in the University of Toronto.Article discussedTranscriptCMAJ 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
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Sep 12, 2022 • 38min

Urgent need to improve organ donation experience for donor families

Many families of organ donors describe feeling alone and abandoned at the moment when their loved one is taken to the operating room for donation. Heather Talbot says she and her family were left on their own as her son was wheeled into the OR. The experience left her thinking, “Well, they got what they wanted and they’ve moved on.”A qualitative study in CMAJ examined the experiences of donor families. They found that many families felt unsupported at critical transition periods. Authors of The experiences of family members of deceased organ donors and suggestions to improve the donation process conducted 271 in-depth interviews with family members of organ donors.On this episode, Drs Bigham and Omole speak with the study’s lead author Dr. Aimee Sarti. Dr. Sarti is an ICU physician in Ottawa. But first, they speak with Heather Talbot. Ms. Talbot’s son Jonathan became an organ donor after his death in 2009.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

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