White Coat, Black Art

Quebec family doctors have struck a tentative agreement with the province, but Dr. Marina Lagodich has made up her mind. When the CAQ government rushed through their healthcare overhaul, Bill 2, in late October, it was the last straw. December 17 will be her last day practicing as a Quebec doctor. Across the province, doctors have criticized the bill, saying it encourages “fast food medicine.” Health policy expert Steven Lewis says although the Quebec government’s means are extreme, it’s hard to argue with its aims: to solve the “disgraceful” primary care crisis.

Ottawa family physician Dr. Nili Kaplan-Myrth faced a long wait for surgery after post-menopausal bleeding, and has seen her patients endure the same. Dr. Nick Leyland, president-elect of the Society of Obstetricians and Gynecologists of Canada, explains that gynecologists have limited operating room access, fewer perform surgery, and ovaries are valued less than testicles in the surgery hierarchy. Also: what’s being done to improve care for women nationwide.

Miles Randell, an advanced care paramedic, is trying to do something different for frontline health-care workers who need a supportive work environment. He says years of working as a paramedic in Vancouver led to post-traumatic stress that left him unemployable. And that the help he needed wasn’t there. So he created TEAAM (Technical Evacuation Advanced Aero Medical), a non-profit that deploys helicopters to provide advanced life support in some of the most rugged locations in B.C.’s wilderness. But TEAAM is also a workplace where health-care workers are encouraged to regularly check in and talk about work stress after a call.

Dr. Paxton Bach has spent years trying to help people navigate a broken system. Inconsistent approaches to withdrawal management, long wait times for detox and recovery programs and a system that struggles to address the social determinants of health have caused too many of his patients to fall through the cracks. So he and a team at St. Paul’s Hospital in downtown Vancouver are trailblazing a new model of care that’s set to roll out across B.C. It’s called Road to Recovery, and it’s helping doctors like Bach answer the question: How can I keep you alive until tomorrow?

Like many of Canada’s rural and remote communities, Mackenzie, B.C.’s hospital struggles to staff the ER. But once a week, a doctor hundreds of kilometres away fills in virtually. Many provinces like B.C. are using virtual care in ERs in an attempt to keep the doors open. But critics are concerned about patient safety and the need to balance virtual with in-person care.

When care at a hospital or clinic falls short for you or a loved one, how do you raise concerns that get results? We asked listeners for stories about making complaints in health care and were flooded with them. Dr. Rob Robson, an ER physician, patient safety expert, and health-care mediator, helps us unpack what works and what doesn’t when you want your voice to be heard.

Until recently, Jeremy Auger’s diabetes was unstable. Then he met endocrinologist Dr. David Campbell and the team with the diabetes mobile clinic in Calgary. The roving clinic brings care directly to people who are homeless or have low incomes. For patients like Jeremy, it’s a lifeline that helps prevent devastating complications.

Obesity has more than tripled in Canada since 1981. In their new book “Food Intelligence,” Canadian co-authors Julia Belluz and Kevin Hall - an award-winning health and science journalist, and a prominent researcher on metabolism in the U.S. - argue that it’s not because of a collective loss of willpower. Instead, they say the foods we buy and eat have become more calorie-dense, delicious and addictive over the last 40 years.

More with Kevin Hall! Until recently, Hall was the U.S. National Institutes of Health’s key researcher on the connection between ultra-processed foods and obesity. He took an early retirement due to increasing censorship of his work. He talks about his groundbreaking study with former “The Biggest Loser” contestants, the link between Big Tobacco and Big Food, and why Canadian scientist expats like him may soon be looking to return home.

When his wife died of endometrial cancer, Charles Kinch refused to accept that the care she received was the best she could get. His complaint, at first dismissed, has now sparked major changes in how cancer patients in British Columbia are treated and supported.

Like many Canadian small towns, Carberry, MB had become a healthcare desert. In 2023, the small ER closed and the last doctor left. Carberry embarked on the fight of its life to get healthcare back. Just days before the first of two new MDs starts work, Dr. Brian Goldman visits Carberry to learn about the Herculean efforts it takes for one town to reinstate healthcare, and make sure they don't lose it again.

For three decades, Dr. Brian Day has been at the centre of the debate around private health care in Canada. Despite losing his court battle to bring it to B.C., Day still wants to see more private, for-profit clinics. The orthopedic surgeon and owner of Vancouver's Cambie Surgery Centre says competition from the private sector could push the public system to deliver faster and better care.

Ottawa’s Montfort hospital sees twice the number of patients for mental health emergencies as the Ontario average. And as this number increased in recent years, the everyday environment of the ER waiting room – chaotic, loud and overstimulating – became an ever larger trigger, causing distressed patients to flee or harm themselves or others. In the new Mental Health Emergency Zone right off the main ER, everything has been designed for de-escalation, and staff and patients are seeing dramatic results.

Gurleen Kaur Chahal is one of the inaugural students at Toronto Metropolitan University’s new Peel Region medical school, designed to serve the area’s diverse population. She's determined to be part of the solution for the kinds of struggles her multigenerational Punjabi household has faced accessing care.

After a seemingly innocuous question about pi, Allan Brooks tumbled down a ChatGPT rabbit hole. Three weeks later, he emerged, after spending 300 hours in a spiralling 7,000-prompt exchange with the chatbot. Dr. Keith Sakata, the psychiatrist whose viral thread on X breaks down the phenomenon known as “AI psychosis,” says the built-in sycophancy of large language models like ChatGPT needs to change before more harm is done.

How much would you be willing (and able) to pay to get your knee or hip replaced? Calgarian Linda Slater's knee pain became unbearable during her two-year wait to see an orthopedic surgeon. She drained her retirement savings to pay $30,000 for a new knee at a private Toronto clinic. Dr. Rick Zarnett, an orthopedic surgeon who works out of both a private clinic and public hospital, says the system needs to improve so patients can get surgery sooner.

Companies are spending big bucks advertising weight-loss drugs like Rybelsus, seeing huge potential in capitalizing on the popularity of Ozempic. But in Canada, so-called "reminder ads" can give only the name of the medication, not what it's for, telling people to ask their doctor for details. Ad man Terry O’Reilly says it can result in bad ads that turn people off, and pharmaceutical policy expert Barbara Mintzes says reminder ads can lead to overtreatment and high costs, doing more harm than good.

As a rapper, Bishop Brigante was no stranger to on-stage battles. We met up with the then-45-year-old when he was battling Stage 4 colon cancer, which he said was caught too late. Bishop wanted Canadians to have easier access to colonoscopies and said advocacy had given him newfound purpose.

Many women report difficulties with orgasms, low libido or pain around intercourse. And given that many have never even learned much about their genitals, they don’t always know where to get help. A cadre of Canadian doctors specializing in women’s sexual health is trying to change that. They’re helping patients boost pleasure, while empowering them to get to know their sexual anatomy.

Attracting a family doctor to work in a community is challenging, with fewer physicians choosing family medicine. That's why Cheryl Gnyp, the recruiter for Castlegar, B.C., needs to stand out. She uses the board game Operation and specialized coffee as part of her 10-minute sales pitch to potential recruits at conferences. It can take years before a doctor starts working in the community, but she’s in it for the long haul.