CMAJ Podcasts Canadian Medical Association Journal

On this episode, Drs. Blair Bigham and Mojola Omole delve into the evolution and advancements in virtual urgent care since the COVID-19 pandemic. The discussion centers around the study published in CMAJ entitled "Healthcare utilization and outcomes of patients seen by virtual urgent care versus in-person emergency department care," which analyzed patient usage and outcomes during the height of the pandemic. 
The study didn’t specifically track how many patients were redirected from emergency departments (ED) to virtual care. However, it found that around 80% of patients seen via virtual urgent care didn't require an immediate ED visit, suggesting that virtual care likely reduced some emergency presentations. However, it also noted that virtual urgent care didn't always prevent subsequent hospital visits. Importantly, the study reflects a specific period and doesn't capture the current state of virtual urgent care.

Dr. Justin Hall, director of the Toronto Health Region's Virtual Urgent Care Program, describes how the service has developed since 2020. Key improvements include enhanced technology for a more seamless patient experience and additional capabilities like imaging and laboratory testing. Dr. Hall says the program now acts as a crucial link for patients without regular access to healthcare providers and can successfully address acute, non-life-threatening conditions.

Drs. Bigham and Omole then speak with Mary Dimeo, a nurse practitioner working in the Toronto region's virtual urgent care service. She describes her role and experiences in the virtual environment. Ms. Dimeo says, typically only one patient per day needs to be referred to the emergency department which suggests the service helps divert patients from the hospital, especially those without family doctors or who cannot wait for an appointment.

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 Twitter @BlairBigham and @Drmojolaomole

Twitter (in English): @CMAJ
Twitter (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

On this episode, Drs. Mojola Omole and Blair Bigham speak with two vaccine experts about the necessity, timing and availability of vaccines as we move into the season when influenza, RSV and COVID-19 are on the rise.


Dr. Scott Halperin, co-author of a CMAJ practice paper on SARS-CoV-2 vaccination in pregnancy, emphasizes the importance of vaccination to protect against COVID-19 infection during pregnancy. He notes that while there is awareness among healthcare practitioners, it is crucial to continually highlight and reemphasize the importance of vaccination during pregnancy. The risk of severe outcomes from COVID-19 is higher in pregnant individuals compared to non-pregnant individuals. Vaccination during pregnancy not only protects the mother but also transfers antibodies to the fetus, providing protection in the first few months of life. 


Next, Dr. Trevor Arnason, Associate Medical Officer of Health with Ottawa Public Health, discusses the availability and administration of fall vaccines. He explains that the influenza vaccine is recommended for everyone over six months of age, with a higher dose available for older adults. The SARS-CoV-2 vaccine can be administered at the same time as the influenza vaccine, as there is now sufficient data on its safety. The RSV vaccine, currently approved for individuals over 60, is not government-funded and may not be accessible to everyone. Dr. Arnason emphasizes the importance of getting both the influenza and SARS-CoV-2 vaccines, particularly for high-risk groups such as young children, older adults, and individuals with underlying health conditions.


In summary, both Drs. Halperin and Arnason argue it is crucial for healthcare providers to educate and encourage their patients, especially pregnant individuals, to get vaccinated.

CMAJ article SARS-CoV-2 vaccination in pregnancy

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 Twitter @BlairBigham and @Drmojolaomole

Twitter (in English): @CMAJ
Twitter (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

In this episode, Drs. Blair Bigham and Mojola Omole delve into the pressing issue of alcohol use disorder (AUD) in Canada with Dr. Evan Wood, the lead author of the “Canadian guideline for the clinical management of high risk drinking and alcohol use disorder” published in CMAJ. 


They explore the concerning prevalence of AUD in Canada, contrasting it with other countries and shedding light on the diagnostic criteria that underscore the significance of assessing clinically significant impairment or distress.


Dr. Wood clarifies the hurdles faced in identifying and treating AUD, highlighting the shortfall in healthcare provider education and resources. He underscores the importance of routine screening for alcohol use by physicians and offers invaluable tips to improve recognition of this pervasive disorder.


Dr. Wood outlines the recommended pharmacotherapies as stipulated in the guideline. He points out the frequency with which ineffective, or even harmful, treatments are prescribed for mood symptoms related to AUD and calls on physicians to follow evidence-based approaches.


Dr. Wood concludes by emphasizing the necessity of constructing a comprehensive system to tackle alcohol use disorder head-on in Canada, fostering a thorough understanding of this widespread health challenge among the medical community.



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 Twitter @BlairBigham and @Drmojolaomole

Twitter (in English): @CMAJ
Twitter (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

In this episode, Dr. Blair Bigham and Dr. Mojola Omole speak with two co-authors of a new guideline published in CMAJ entitled "Preventive care recommendations to promote health equity".
Dr. Nav Persaud and Dr. Aisha Lofters explain the importance of embedding health equity into healthcare and discuss specific ways public policy and individual primary care physicians can work together to promote equity in their practices. The conversation highlighted some key recommendations such as:
Begin outreach at the age of 45 instead of at the age of 50 for colon cancer screening. This recommendation is based on the recognition that younger ages of diagnosis are being observed, particularly among people who are disadvantaged. The goal is to eliminate barriers for individuals ready to start screening and prioritize health equity during implementation.Offering publicly funded HPV self-testing for cervical cancer screening, especially for disadvantaged individuals who may face barriers to traditional screening methods.Implementing depression screening and offering online counseling programs or cognitive behavioral therapy for patients who screen positive.Providing resources for families experiencing poverty, such as a one-page sheet detailing available support.Prioritizing care for specific populations based on inequities in health outcomes, such as prioritizing cardiovascular disease screening in women due to discrimination and sexism within the healthcare system.Overall, Drs. Persaud and Lofters advocate for a shift towards recognizing that inequities in health outcomes exist and that primary care physicians need to embed equity into their healthcare practices.



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 Twitter @BlairBigham and @Drmojolaomole

Twitter (in English): @CMAJ
Twitter (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

In this episode, Drs. Blair Bigham and Mojola Omole speak with two leading experts: Dr. Samira Jeimy, an allergist, and Dr. Isaac Bogoch, a specialist in infectious diseases, about the increasing prevalence of allergies and infections in Canada attributed to insects.


Dr. Jeimy authored the article in the CMAJ titled “Five things to know about… tick-borne red meat allergy (α-gal syndrome)”. Dr. Jeimy describes how tick bites introduce a carbohydrate, alpha-gal, leading the human body to manifest allergic reactions to red meat. She underscores the diagnostic challenges associated with this allergy due to its delayed reactions and the spectrum of symptoms, which can range from mild to critical.


Dr. Bogoch shifts the focus to the expanding footprint of tick and other insect-borne diseases in Canada, such as Lyme disease, anaplasmosis, and babesiosis. He attributes this surge to the climatic shift towards warmer temperatures and abbreviated winters. He emphasizes the indispensability of preventive measures, including vigilant tick checks, use of repellents, and donning protective clothing.


Both experts stress the urgency of heightened education, rigorous surveillance, and enhanced testing methodologies. As ticks and insects advance further north, physicians need to be alert to this emerging health challenge.



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 Twitter @BlairBigham and @Drmojolaomole

Twitter (in English): @CMAJ
Twitter (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

Canada’s emergency departments are in crisis: hospital occupancy rates exceed 90% for many days in a row, and many Canadian hospitals have been exceeding 100% occupancy for months on end. As a result, quality of care has decreased, staff retention has become problematic and overcrowding of emergency departments, a symptom of the problem, is assured.
On this episode, Drs. Omole and Bigham speak with Dr. Catherine Varner, an emergency physician in Toronto, deputy editor of CMAJ, and author of two editorials in the journal detailing the state of Canada’s emergency departments, the causes of the crisis and possible solutions. Joining the conversation is Dr. David Petrie, an emergency physician in Halifax and co-chair of the Canadian Association of Emergency Physicians’ EM:POWER Task Force on the Future of Emergency Care who explores what a whole system approach to resolving this pressing issue might look like.

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 Twitter @BlairBigham and @Drmojolaomole

Twitter (in English): @CMAJ
Twitter (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions