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Posts Tagged "Task"

3Apr

National chronic pain task force a first step: federal health minister

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‘People with chronic pain are often underemployed or unemployed because they simply cannot work and not all of us have extended health benefits and even health benefits run out,’ says Andrew Koster.


‘People with chronic pain are often underemployed or unemployed because they simply cannot work and not all of us have extended health benefits and even health benefits run out,’ says Andrew Koster.


CHAD HIPOLITO / CANADIAN PRESS files

The federal health minister is forming a national task force to provide input on how to better prevent, treat and manage chronic pain, which affects one in five Canadians and is often addressed with opioids.

Ginette Petitpas Taylor said in an interview Wednesday the task force will provide information on barriers that may prevent people suffering with persistent pain from receiving the treatment they need.

“This is the first step in addressing the issue of chronic pain in this country,” she said, adding the eight members will consult with governments and advocacy groups around the country and provide an initial report in June, followed by two more over the next couple of years.

Petitpas Taylor made the announcement in Toronto at the 40th annual scientific meeting of the Canadian Pain Society, which has long called for a national pain strategy, especially as the opioid crisis has exacerbated the stigma around prescribing and use of the pain killers.

She said she committed to exploring the creation of a national pain task force after a discussion with patients, clinicians and researchers at a symposium in Toronto last year, when she heard people living with pain often feel their condition is misunderstood and services are inconsistent.

“We have to recognize that Canada’s a big country and we certainly know there’s inconsistent services in provinces and territories so I have to really have a good understanding of what’s available and what’s happening out there,” Petitpas Taylor said.


Ginette Petitpas Taylor, Minister of Health, stands during Question Period in the House of Commons on Parliament Hill in Ottawa on Thursday, Sept. 21, 2017.

Sean Kilpatrick /

The Canadian Press

Advocates for pain patients presented the former Conservative government with a plan in 2012, but Petitpas Taylor said it’s too early to say whether such a plan will be introduced.

Andrew Koster, who suffers from debilitating lower back and knee pain from a type of arthritis called ankylosing spondylitis, said he’s concerned the task force’s work will go nowhere if there’s a change in government in October.

“I’m looking for signs from the government that they’re taking this seriously and it’s not just something to state during an election campaign,” he said. “There has to be definite action.”

Koster, who will have surgery on his left knee next month following an operation on the other one last year, said he can no longer afford to pay $100 a week for acupuncture to deal with daily pain after he voluntarily reduced his opioids over concerns about any long-term consequences.

“People with chronic pain are often underemployed or unemployed because they simply cannot work and not all of us have extended health benefits and even health benefits run out,” he said from Victoria.

He said it’s crucial for the task force to identify non-drug costs for patients and provinces for services such as physiotherapy, occupational therapy and acupuncture as part of any strategy it may come up with in its final report.

Andrew Koster, who suffers from debilitating lower back and knee pain from a type of arthritis called ankylosing spondylitis, pictured at his home in Victoria in 2018.


Andrew Koster, who suffers from debilitating lower back and knee pain from a type of arthritis called ankylosing spondylitis, pictured at his home in Victoria in 2018.

CHAD HIPOLITO /

CANADIAN PRESS files

Serena Patterson, a 60-year-old psychologist in Comox, has lived with pain associated with fibromyalgia for over half her life and also developed migraines that prevented her from continuing her teaching job at a college.

She said a three-year task force seems excessive, especially because advocacy groups have enough information on health-care gaps and patients wait too long to see specialists.

“I think we know that people are dying in an opioid epidemic and chronic pain patients are high on that list,” Patterson said.

“I would hope that this three years would be building, not more research. What needs to be built is a network of multidisciplinary team programs that are accessible, that are in rural areas as well as urban areas, that provide not only medical support but psychological as well as social support to help people be full participants in their life and in their community.”

Dr. Norman Buckley, scientific director of the Michael G. DeGroote Institute for Pain Research and Care at McMaster University in Hamilton, said hundreds of organizations, patients, clinicians and researchers came together in providing the federal government with the strategy in 2012. There was no action at the time but he said the opioid epidemic has now made that unavoidable.

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20Feb

Task force set up to tackle sexual harassment at UBC medical school

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UBC medical students are being sexually harassed more often than students in other Canadian medical schools, according to a new report.

An internal memo written by Dr. Andrea Townson, acting co-head of the UBC department of medicine, and sent to medical faculty at the University of British Columbia, refers to the “deeply concerning” results from a 2018 questionnaire of students who graduated from the 17 medical schools across Canada. Sexual remarks, uninvited touching and sexual assault are examples of harassment.

• Twelve per cent of students at UBC reported unwanted sexual advances and touching by faculty, fellow students, health professionals or patients, compared to a national average of 6.5 per cent.

• Thirty-three per cent of students at UBC said they were subjected to offensive sexist remarks, compared to the national average of 25 per cent.

• A third of UBC medical students also said they were subjected to racially offensive remarks, compared to the Canadian average of 12 per cent.

“We aren’t unique or isolated with these concerns but we are obviously not happy to see these high reported rates so it’s launched a number of different initiatives,” said Dr. Deborah Money, executive vice dean of the UBC medical school.

UBC results from the annual report have been “steady” over the past number of years, according to Money.

Money is chairing a dean’s task force meant to find ways to change the culture and environment at the medical school and to prevent mistreatment and harassment at the more than 80 training sites where UBC medical students learn, such as hospitals and clinics.

“Part of our work has to focus on learning from others, so we know what best practices look like.”

Sixty per cent of UBC medical graduates said they had been publicly humiliated. This may include being asked a question by a professor in a group setting, not knowing the answer and feeling shame about it because of, for example, how the instructor reacted.

This raises the question of whether students are becoming more sensitive to these kinds of learning tools.

“That’s a tough question. It’s an old style of teaching and how it’s done or how it’s perceived may be different in each scenario. We have actually made a video that tries to distinguish between being challenged academically and being bullied or called out so much that people feel humiliated,” she said.

Money said staff have collected data on the reported incidents of public humiliation, racially or sexually offensive remarks and unwanted sexual advances experienced by students.

Townson told clinical faculty members in the memo obtained by Postmedia that if they are concerned they’ve made a comment that might have been misinterpreted and want “a safe place to debrief” they should come and speak to her.

She said in the memo that “addressing student mistreatment” is a priority and students need a clear mechanism for reporting concerns. UBC has several satellite sites — Vancouver, Victoria, Kelowna and Prince George — where undergraduate students learn and Townson said in her memo that the disturbing reports are “not isolated to a single site or a single rotation.”

Money said there are about 700 professors in the medical school and about 7,000 clinical instructors. When students complain about a particular instructor or fellow student, an investigation is launched to determine whether coaching or discipline is required. Money said she couldn’t say how often that occurs but said expulsion is “rare and extreme.”

The survey of medical school graduates in Canada covers a broad range of topics about the quality of education and student experience and has been conducted annually by the Association of Faculties of Medicine of Canada since 2015.

UBC is the fifth largest medical school in North America with 288 students admitted each year, and 4,500 students doing residencies and other postgraduate work.

At the same time as UBC is grappling with the mistreatment issue, the Lancet has published the results of an alarming survey showing that sexual harassment — by patients, teachers and peers of medical students — is common in Canada.

The study by researchers in Ontario and Alberta shows that despite policies and complaint mechanisms intended to promote respectful conduct and to prevent harassment, students are subjected to everything from sexist remarks to rape. A total of 807 incidents were reported by 188 respondents to the 2016 anonymous survey. The harassment occurred in clinics, medical schools and social settings; patients requested medical students touch their sexual organs and they groped doctors. One student said she was raped by a fellow student. Faculty members were implicated in about 20 per cent of the incidents that were predominately experienced by female students. Men were the most frequent perpetrators.

The authors say that faculty, peers and victims come to almost normalize sexual harassment. Students try their best to ignore it while at the same time finding it “confusing, upsetting and embarrassing.”

Many don’t report it because staying silent is seen as “less risky than confrontation or official reporting.”

Dr. Susan Phillips, a professor at Queen’s University and co-author of the Lancet study, said it is clear that women who are practising doctors or studying to become doctors are not immune to harassment and sexual assault.

“This is a societal problem. And we have to find ways to decrease the incidence,” said Phillips, who several years ago published a study in the New England Journal of Medicine showing that 78 per cent of female doctors had been harassed by inappropriate comments or conduct by patients.

“Medical schools can’t fix societal problems but they can do more to legitimize student concerns. That means if they hear about a patient or faculty member making inappropriate comments, they don’t let it go. There has to be zero tolerance and in the case of faculty members, it has to be enforced.”

One limitation of the Lancet study is that few medical students completed the survey. There are about 11,600 medical students across Canada and just under 300 completed the consent form to submit answers to the anonymous survey.

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Twitter:@MedicineMatters




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