september/ october 2010
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DOCTORS life + leisure
september/october 2010
contents
september/october 2010
Editor and Art Director Barb Sligl Editorial Assistant Adam Flint
Contributors Dr. Dara Behroozi Dr. Susan Biali Dr. George Burden Dr. Holly Fong Dr. Art Hister Dr. Marlene Hunter Tim Johnson Dr. Chris Pengilly Dr. Neil Pollock Manfred Purtzki Kevin Revolinski Dr. Kelly Silverthorn Cherie Thiessen Corey Van’t Haaff Cover photo Elena Elisseeva
10 30
Senior Account Executive Monique Mori Account Executive Teri Richardson Sales, Classifieds and Advertising In Print Circulation Office 710 – 938 Howe St. Vancouver, BC V6Z 1N9 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com
FEATURES
10 make it Muskoka Escape to Ontario’s cottage country 30 Patagonia Take a cruise to the end of the world
Associate Publisher Linh T. Huynh
Production Manager Ninh Hoang
CME Development Adam Flint
Founding Publisher Denise Heaton
clockwise from top left: courtesy The rosseau; kevin revolinski; Elena Elisseeva
Just For Canadian Doctorsis published 6 times a year by In Print Publications and distributed to Canadian physicians. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications. In Print Publications 710 – 938 Howe St. Vancouver, BC V6Z 1N9 Canada
COLUMNS
DEPARTMENTS
14 doctor on a soapbox
5 September/October mix
Taking care of your health
15 living well 5 ways to boost your happiness
26 employment opportunities
26 classifieds
The last decade
18 techworks
37 sudoku
Slick stethoscope
38 small talk with Dr. Tram T. Nguyen
34 the wine doctor Israel wines
35 the food doctor
Printed in Canada.
cover photo:
Slow-cooked salmon
36 the wealthy doctor
miss an issue? check out our website!
19 CME calendar
17 motoring
www.justforcanadiandoctors.com
16 prescribing R & R
Sharing office expenses
Just hours from Toronto’s concrete-scape is Muskoka’s autumn landscape. Escape lakeside north of the city and discover autumn’s vivid colours.
September/October 2010 Just For Canadian Doctors
3
from the editor
Use your head to protect your skin.
Physicians know a thing or two about sun protection. That’s why we know you and your patients will appreciate that all Tilley Hats are certified UPF 50+ and most Tilley Travel Clothing is sun protective too. For information on our Physician Hat Program email sylviap@tilley.com.
Toronto • Montreal • Vancouver For a local retail store or mail order: 1-800-363-8737 www.Tilley.com
refresh rejuvenate
T
he heat of summer has faded, the air is crisp with the scent of fallen leaves, and everything seems to be slowing down…the perfect season for some downtime by the lake, at sea or at the spa… Escape to the spiritual sanctuary of New Mexico’s high desert. The spa experience here is sweet (page 5 – 6). Refresh and rejuvenate amidst stunning scenery. Another kind of spectacular is found much farther south in Patagonia (page 30). The sweeping arid vistas in shades of rich, fall-like colour change to the cool palette of icy ocean and glacier-clad mountains. An even farther trek: the Aussie outback (page 7)., which is made accessible via the Great Southern Rail’s Indian Pacific train. It’s a 65-hour journey through more gorgeous scenery, punctuated by gourmet food. Much closer to home is Ontario’s beloved cottage country (page 10). Think toasty campfire, rustling dry red-and-yellow leaves, frosty forest, the call of the loon… it’s quintessential Canadiana and a Group of Seven painting come to life. Stay at one of Muskoka country’s luxurious lodges for the high-end version of roughing it. Or stay put and travel through a glass of wine from Israel (page 34). Pair with some slow-cooked salmon (page 35), and take some time to pay attention to you—a healthier, happier you is in order this fall (page 15). “Fatten up” a little before fall fades and winter’s hibernation is here… See page 16 for the third finalist in our R & R writing contest. Dr. Jean Hlady shares her adventure in Bhutan. Share your own adventure or leisure activity with Just For Canadian Doctors’ readers, whether at home or afar. Send a 700-word story and we may publish it in our “Prescribing R & R” column. Published submissions have a chance to win an all-expenses-paid trip with Quark Expeditions (details at justforcanadiandoctors.com). We’ll continue to run the best stories in 2010. Barb Sligl, BA, MPub feedback@InPrintPublications.com
mix
what/when/where > september/october
style | food | shows | festivals | places | getaways | gear…
spa it! in New Mexico
getaway
clockwise from top right: ojo caliente; b. sligl (3)
clockwise from top left Christianna Uehlein, the
chocolatier at Body of SanteFe; Theironspringpool at OjoCaliente; Christianna’s cookingclass creations— handmaderaworganicchocolatetruffles sweetened withagavenectar; luxecasita at El MonteSagrado.
Ten Thousand Waves Ten Thousand Waves is like a Japanese onsen—in the high desert of New Mexico. This spa resort, tucked onto 26 acres of mountainside just outside Santa Fe, includes a big and beautiful day spa where you can soak with regulars, and perhaps spot a celebrity (stay zen!). Or indulge in isolation within the gorgeous mix of traditional Japanese design elements and modern concrete, tile, and steel in a Shoji Private Bath. After the sauna, hot tub and cold plunge pool, take it even further with a signature treatment like the Yasuragi (“comfort”) for total relaxation. tenthousandwaves.com Body of Sante Fe In the heart of Santa Fe is this multi-faceted day spa—sample farm-to-table superfoods and “scrumptious” bio-dynamic wines at the café, learn how to create organic chocolate truffles, shop eco and sustainable fashion and homeware, catch a Kundalini yoga or Nia (mix of martial arts and dance) class, and top it all off with a full-body massage. A sign upon entering: “love your body, love your earth.” This restaurant-cum-cooking school-cum-store-cumyoga studio-cum-spa is a local hot spot…one regular: Santa Fe resident and yoga guru Ali McGraw. bodyofsantafe.com El Monte Sagrado Taos, an hour north of Santa Fe, offers more celebrity spotting (Julia Roberts has a ranch here) with a more rustic vibe…except at El Monte Sagrado. This adobe style resort is a swish getaway (and a great place for CME events)—there’s a varied and extensive art collection displayed throughout the property and the >> September/October 2010 Just For Canadian Doctors
5
mix
september/october
spa it >> tranquil grounds include a sacred circle of trees revered by the pueblo people. And there’s the spa. Meander along the path past [more] villa guest suites to this haven of exquisite treatments…then test out the sauna in a charming outdoor hut. elmontesagrado.com Ojo Caliente Away from civilization, about midway between Santa Fe and Taos, are historic hot springs long used by pueblo people for their healing waters. Named Ojo Caliente, “hot eye,” by the Spanish in the 1500s, the site has been a day-use spa for 140 years. Iron- and lithium-rich water bubbles up into pools surrounded by red-tinged cliffs under the azure sky of the high desert. It’s hard-core relaxation in what seems like the middle of nowhere. And it is. This is Georgia O’Keefe country, where you might share the scenery with a striking but timid tarantula sunning himself nearby…or perhaps an equally striking Charlize Theron, who stayed here while on a Vogue photo shoot…Stay for dinner (there’s a “Dip & Dine” package) then settle into a cliffside suite, start up a fire, fill the private outdoor tub and gaze at the net of stars above. ojocalientesprings.com —B. Sligl
getaway
For more on New Mexico go to newmexico.org.
style
kick it !
Strut your stuff in the TOMS wedge. The fun and flattering shoe hits all the high trend notes while also delivering on another level: a charitable cause. Buy a pair and a child in need in the developing world gets his or her own pair of TOMS to run around in. It’s the best of both worlds: fashion and philanthropy. Pick one of the fresh fall colours (like cranberry, below, ash or midnight blue) and start walking… —B.S. toms.com
6
Just For Canadian Doctors September/October 2010
got one yet?
gear/
gadget
Another must-have from Apple? The iPad has been called revolutionary, a game-changing device that does it all—browse the web, read and send email, organize and store photos, watch videos, listen to music, play games, read e-books, use those apps… with a few finger strokes on Apple®’s MultiTouch™ display. And all this comes in a sleek package that’s just 1.5 pounds and a half-inch thick, bringing new meaning to the term “travelling light.” Add some key apps— ”Currency” for easy conversions on the road, a Frommer’s guide for your destination of choice, “TravelTracker” to store and update all your travel info—and you’re set to jet. —B.S. apple.ca
top left: courtesy Ojo Caliente
Hot-stone massageat OjoCalientein NewMexico
rough it…barely
september/october
doctors in the
mix
from top: cherie thiessen; courtesy Great Southern Railway; cherie thiessen
outback
I’m in the Aussie outback get- ghost town of Cook, 3, one of away population the most isolated places on earth: no roads, 1100 km from Adelaide and 1500 km from Perth. A sign is all that remains where once stood the Bishop Kirby Memorial Hospital. “The flying medical service provided a backup service and in later years the Royal Flying Doctor Service fulfilled this role until Cook ‘closed’ in 1998,” the plaque reads. The hospital had an operating theatre, two wards, and quarters for the hardy staff, who had to withstand a paucity of water and a surplus of dust storms and flies. The flies are back today and the heat somewhat fierce, but that’s OK, we can turn on the air conditioning in our sleeper. Great Southern Rail’s Indian Pacific train takes on fuel here, the halfway point across the continent’s expansive girth, from Perth to Melbourne, from one ocean to another. The journey may be 65 hours, but it passes too quickly. Meals are gourmet, sleepers are comfortable, cabin stewards exemplary, and fellow travelers, mainly Aussies on this trip, curious and chatty. We choose sea trout with hollandaise sauce and asparagus for our first lunch, accompanied by an excellent Verdehlo that tickles our throats way too seductively. Outside the windows, the scenery unfolds expansively, rose and white gala birds explode from trees, kangaroos startle, and camels stop munching to stare us down. What are they doing here? The audio programme in our sleeper soon provides the answer. In the 1860s, about 10,000 were brought from Arabia to transport goods across this arid landscape. Once the railway came through, the camels were made redundant, and went walkabout. There are now around 500,000. From the verdant Avon Valley near Perth, the scenery fades into endless wheat fields, and then to
mallee scrub, a type of dwarf eucalpyt only found down under, according to our luncheon companion, a retired army man. At midnight we reach Kalgoorlie, taking a “whistle stop” tour that sweeps us into the windy night to stare down into its immense Super Pit, 3.6 km long and 512 metres deep. Operating 24/7, the gold mine has been described as the richest square mile on earth. Thirty thousand people live in the surrounding town. The next day we awake to endless flat rust limestone, the Nullabor Plain, anticipating our arrival at Cook. Once a school, post office, stores, hotel, tiny jail and the hospital serviced this town in the middle of nowhere. That’s now reduced to the miniscule lockup, and a huddle of buildings. Back aboard and riding the rails, we notice that the scenery is changing again, becoming lush and hilly as we approach Adelaide and its famous Riesling Trail. We’re taking a day off here to cycle and sip some of the offerings along the trail, reboarding for Melbourne tomorrow. After all, there’s no hurry, and no worries. —Cherie Thiessen more info The official Australia tourism website: australia. com • Great Southern Rail: greatsouthernrail.com.au while in perth Don’t miss an opportunity to stay in the exquisite Richardson Hotel. Featuring vibrant art, spacious luxurious suites, gracious personal service and incredible dining. If you’re too tired to visit the dining room, just open your fridge and freezer. Some of the chef ’s entrees, with accompanying wines, are bound to tempt you. therichardson.com.au while in adelaide Set up a Clare Valley Reisling tour with walkabout tours. (What guide Jeff Easley doesn’t know about wines couldn’t even fill a wine glass.) touraboutadelaide.com.au
September/October 2010 Just For Canadian Doctors
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ADVERTISING FEATURE >>
Leading doctors have discovered the perfect prescription for luxury living — right in the heart of downtown Toronto at Bay and Adelaide.
doctors know best
Trump International Hotel & Tower Toronto: today’s prescription for luxury living
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home away from home
Dr. Ram came to Canada 10 years ago to study medicine and build a practice. “I’ve lived in condominiums ever since I left Malaysia because they suit my lifestyle,” says Dr. Ram. “I’m not ready for the picket fence yet. With the kind of work that I do, I need to have a place that’s convenient and accessible to the things that I like to do and the Trump Tower is all that.” Dr. Soloway grew up in New York and took his medical training in Philadelphia, specializing in medical orthopaedics. He sees as many as 500 patients per week in his New Jersey clinic and he loves to visit Toronto. He finds it a lot like major cities in the United States, only smaller, safer and cleaner. “My favourite part about Toronto is I see it as a major metropolitan city, but because it’s a little bit smaller, it has a more ‘home-like’ feeling and the streets are clean. It features major sports just as if it is any US city on a large, world-class scale,” says Soloway. Donald Trump (left) and Dr. Stephen Soloway are equally enthusiastic about Trump International Hotel & Tower Toronto.
The exclusive Trump® lifestyle includes a 31st floor residents-only Sky Lobby featuring an 800-sq. ft. outdoor enclosed terrace with sweeping views of the city below. A dedicated residential concierge is also on hand to tend to all your everyday needs.
indulge in the centre of excellence surrounding you
Toronto’s downtown real estate market offers many advantages to urban professionals who want to stay close to business centres and key professional and cultural institutions. Says Ram, “The city is still priced very well and it offers so much, easily as much as Chicago, London or Paris. Also, Toronto is a very safe environment. The education is top-notch. The people are friendly. The list goes on, but in my mind it’s an ideal society.” As a world leading centre for medical research and innovation, Toronto houses North America’s fourth largest medical community, including 100 hospitals and research institutions, nine teaching hospitals and more than 30 specialized institutions. It has a thriving medical and biotech community, and is a home for providers of pharmaceutical products, medical devices and technology, diagnostic labs, health care services, IT systems and hospital supplies. Of all the buildings in the city of Toronto, Dr. Ram chose Trump International Hotel & Tower because it is close to the hospital and convention centres and because he recognized the exceptional quality of the Toronto Trump property. “There are a couple of reasons why I frequent Toronto. One is for the social life. Fantastic restaurants, nightlife, and culture that’s easily accessible,” says Ram. “But more importantly, I come here for my work. The hospitals, physicians and even the conferences held in Toronto are top-notch and world-renowned.”
Soloway loves the convenience of Trump Toronto. “Convenience is the ability for you to arrange your life so it’s as easy as possible with as few bumps in the road. If you can set that up for yourself, you have convenience.” He also loves the excellence. “Trump is the newest. He offers the best product.”
luxury and exclusivity are what trump does best
Dr. Soloway is such a fan of the Trump brand that over the years, he has purchased 33 Trump properties in a variety of cities, including Chicago, New York and now Toronto. “For me, the Trump experience has allowed me luxury, security and a convenient lifestyle.” Dr. Ram, who bought a 600 square foot suite, recently visited the model suite and described it as “600 square feet of pure luxury.” He is so smitten with Trump Toronto that he is considering buying a penthouse suite as well. “The Trump brand, to me, embodies style, elegance and exclusivity. I do not believe that there is such a building or project in Toronto today that embodies that spirit. I am proud to be partaking in something that Toronto is going to be very proud of.” Trump International Hotel & Tower Toronto luxury hotel condominiums are priced from $900,000; private residences are priced from $2.1-million (CAD). Sales are by appointment only. The sales office is located at 120 Adelaide Street West, Suite 110; telephone number is 416-214-2800 or toll-free at 1-866-91-TRUMP. Visit the web site at trumptoronto.ca/candocs
COURTESY TRUMP INTERNATIONAL HOTEL & TOWER TORONTO®
anadian doctor Ganesh Ram and American doctor Stephen Soloway both recently purchased suites in one of Toronto’s most exclusive real estate properties, the 60-storey Trump International Hotel & Tower Toronto®. Malaysian-born Ram, who practices medicine in London, Ontario and New York-born Soloway, who runs a busy clinic in New Jersey, have chosen Toronto’s Trump Tower as their home base in Canada’s largest city. With Toronto’s real estate market continually growing and construction of the Tower on schedule to open in 2011, the doctors are delighted with the luxury lifestyle and convenience that the Trump Tower promises them.
IN THE O.R., PEOPLE’S LIVES ARE IN MY HANDS. AT HOME, I PREFER TO LET OTHERS TAKE CARE OF ME. TA K E M E T O T R U M P ® Welcome to your life at Trump International Hotel & Tower®, Toronto’s new premier address. Home to the most exclusive luxury residences in one of the most vibrant cities in the world. A place where most could only dream of living. And where you can call home. Here, the world’s finest five-star amenities are on call for you night and day. Providing attention without intrusion, service without boundaries. Just the way you want it, just for you. Welcome home.
F O R M O R E I N F O R M AT I O N , C O N TA C T T H E S A L E S O F F I C E AT 4 1 6 . 2 1 4 . 2 8 0 0 O R V I S I T T A K E M E T O T R U M P. C A
TRUMP INTERNATIONAL HOTEL & TOWER TORONTO ® IS NOT OWNED, DEVELOPED OR SOLD BY DONALD J. TRUMP, THE TRUMP ORGANIZATION®, OR ANY OF ITS AFFILIATES. TALON INTERNATIONAL DEVELOPMENT INC., THE OWNER AND DEVELOPER OF THE PROPERTY, USES THE TRUMP NAME UNDER LICENSE FROM TRUMP MARKS TORONTO LLC, WHICH LICENSE MAY BE TERMINATED OR REVOKED ACCORDING TO ITS TERMS.
travel at home Algonquin Park. > The Rosseau. > Evening campfire at The Rosseau. > Algonquin Park. > The Briars. > Highway through Algonquin Park. opposite page Yoga lakeside at The Rosseau.
clockwise from top left: MacDougall; The Rosseau (2); Scott; Flock; Butterill
clockwise from top left
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Just For Canadian Doctors September/October 2010
travel at home
a place on the lake No cottage? No problem! Get your fix at these three cottage country resorts within driving distance from Toronto… story
by Tim Johnson
courtesy The rosseau
A
utumn in Ontario’s cottage country is a wonderful thing— lakes, hills and charming little towns, all festooned in the wonderfully vivid reds, browns and yellows of fall. And from Algonquin Park to Lake Simcoe to Muskoka, all that beauty is within a fairly easy drive from Toronto. But those who find themselves without the keys to a cottage face a dilemma. How does one experience all that wild and wonderful splendour without facing down the prospect of sleeping in a tent (or the awkwardness of dropping not-too-subtle hints in the presence of friends who do have a place on the lake)? There’s a great alternative—the cottage country resort. Here are three great options, all of which offer comfort, activities and even luxury amenities, right in the heart of the action. >>
September/October 2010 Just For Canadian Doctors
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travel at home
Killarney Lodge Algonquin Provincial Park
Encompassing an astounding 7,600 square kilometers of hardcore wilderness, Ontario’s legendary Algonquin Park is a magnet for intrepid adventurers and avid campers. But you can leave the Coleman stove at home and instead book a room at Killarney Lodge, a resort which sits on a tiny spit of land surrounded on three sides by the beautiful Lake of Two Rivers, just off the only road (Highway 60) through the park. Killarney’s
cabins are designed for maximum comfort (from the spa-quality soaps and creams in the bathrooms to the sheets on the beds, which match the thread counts provided by five star hotels) and minimal disruption (there are no televisions, phones or radios— just windows looking out to the lake). The cabins are all knotty pine inside and log cabin construction, and that aesthetic extends to the main lodge, where guests hunker down for some fine country dining next to the lodge’s roaring fireplace, which vigilantly fends off the chill of cool autumn nights. Rates include three meals a day, and you can either opt to buy your wine there or bring your own (there’s no corkage)—they’ll
The Briars Jackson’s Point
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even keep it cool for you during your stay. Many come to Killarney for the paddling. All of the guest cabins are on the waterfront and face the lake; most feature their own dock, and all include their own canoe. There are no motorboats or jetskis permitted within the park limits, so you can paddle in quiet solitude. But if you’re more of a summer-weather canoeist or kayaker, Killarney still has plenty to offer. Algonquin’s autumn tapestry—straight out of a Tom Thomson painting—is well enjoyed on a mountain bike or on foot, and a number of nearby hiking trails, from Booth’s Rock to Centennial Ridges, lead up to amazing views of the seasonal colour. Or you can simply take the opportunity to relax and sip a cup of coffee on the dock.
Just For Canadian Doctors September/October 2010
Just a breezy 60 minutes north of Toronto, vacationers have been beating a path to the beautifully manicured ground of the Briars for many decades, seeking recreation and relaxation on the south shores of Lake Simcoe. In many ways, the Briars feels like a throwback—in a good way. A bastion of 19th century civility and charm, the resort’s first buildings—all of which still stand—were built way back in 1880 by Dr. Frank Sibbald, the grandfather of the current owner. Dr. Sibbald was trained in Edinburgh and spent much of his career as a surgeon with the Royal Navy in Shanghai, and he integrated his experiences overseas into the design of the buildings and grounds, from the octagonal Peacock House, which echoes what he saw in China, to the hedgerows and stables straight out of the Scottish countryside. There’s an on-staff historian who takes guests on tours, and boat cruises on the Lady Simcoe provide interesting background facts and marvelous views. But the Briars certainly isn’t stuck in the past. The original Cottage Regency manor house has been carefully renovated and preserved, and new wings have grown out in every direction, like limbs from a tree trunk. A number of amenities have been added, including a gym, indoor solarium pool and whirlpool, full-service spa, billiards room and pub, plus an iconic tower that looks straight out of a fairy tale (all guests are welcome to go up there to take in a lovely view of the grounds and the lake). Room rates generally include meals, and the delicious fare offered in the dining room features many fresh and local ingredients, including vegetables from the on-site chef’s garden, which in the fall brings forth yellow and orange carrots, heirloom tomatoes, baby squash and potatoes. And you will have plenty of opportunities to work off any extra pounds outside on the 18-hole Scottish woodlands golf course, on the
kilometers of trails on the property (bikes are loaned for no charge), or out on the lake in a canoe or kayak.
The Rosseau Muskoka, Minett This JW Marriott resort—Canada’s first—is the epitome of cottage country chichi. Located on one of Muskoka’s most beautiful—and expensive—lakes (places on the water routinely sell for millions) The Rosseau features organic cuisine, designer interiors and even valet parking. All rooms include their own fireplace, and the resort offers five different dining options, including Teca, an Italian restaurant with an openconcept kitchen that was named one of the top ten new restaurants in Canada in 2009. There’s also a yoga and pilates studio, an indoor-outdoor pool, a 13,000 square foot spa with eleven treatment rooms and indoor hot tubs overlooking the lake, plus a championship golf course across the road. But all of this luxury doesn’t mean that The Rosseau is detached from its surroundings. The resort offers stunning views of the area from its perch high atop a bluff, and employs a staff naturalist who leads guided hikes. Guests can also take advantage of their private beach, mountain biking, canoeing, kayaking, bird watching and sailing. On weekends local artisans swing by to offer workshops, and families are welcome to make s’mores around the bonfire or to take part in their autumn nights astronomy tour. And The Rosseau offers a full menu of seasonally-focused special events. This fall’s offerings will include a Thanksgiving feast, a Halloween pumpkin carving session, and a day of foraging for wild mushrooms led by the staff naturalist and a mycologist (i.e. a fungus expert), followed by a mushroom-inspired cooking class taught by the resort’s chefs.
if you go
+
Killarney Lodge Driving distance from Toronto: 3 hours Rates start at: $229 per person for a one bedroom cottage, three meals and a canoe killarneylodge. com; 1-866-473-5551
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September/October 2010 Just For Canadian Doctors
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d o c t o r o n a s o a p b o x D r . c h r i s p e n g i l ly Dr. Chris Pengilly isJust For Canadian Doctors’ current affairs columnist. Please send your comments to him at doconabox@telus.net.
physician health Maintain your health amidst the stress of modern medical practice
P
hysicians, almost by definition, take care of many aspects of patients’ health every day. Most of them do a good job. I wonder, however, whether they are so good at looking after their own health. I think the profession is moving in the right direction, but has a long way to go. Every generation of physicians considers that the next upcoming generation is spoiled or pampered. I knew when the relationship within the practice in the UK where I was an ‘assistant’ had broken down irreparably when the senior partner was relating how he had regularly been on call when he was an assistant for four straight weeks, and my request for a weekend off was denied. He was upset when I reposted that they used to shove little boys up
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Medicine has always been a stressful chimneys to sweep them, and that was not right either. It was not long before I was on occupation. I do not know that it is more stressful now than 50 Air Canada heading for Manitoba (to what he deyears ago though the scribed as “huh—a string stresses are different and change with time. It of towns strung along a railway line”). must have been difficult seeing patients with So it is with mixed so many conditions emotions that I hear anecdotes of medical that could not then be treated. students leaving sharp I can remember on the quitting hours declining an invitation making house calls in remote rural UK and from the consultant to see a particularly interestreturning home —Sir William Osler upon having to go straight ing case. I think they have out again since there it right—but this is a hard learning curve for me. was no way to be contacted concerning the new incoming call. I could never even imagine a cell phone, or an automatic transmission car with GPS. I think the major stress of modern medical practice comes from the lethal combination of total responsibility but without control. It is a frustration that physicians face every day when they know the patient requires surgery but cannot get operating room time, needs an endoscopy without procedure time, or know the optimum medication for the patient but find that funding is refused or there is a manufacturer’s shortage. There are other sources of stress as attributable to the mixed blessing of progress of medical science. Diagnosis of many conditions is now much easier thanks to the CT scan, ultrasound, echocardiogram and MRIs. The problem being that pathology is often inadvertently found in frail, invalid or elderly patients and the decision to treat or not to treat has to be made. Often this causes unreasonable pressure from families to treat what may well be best left alone. Many of the stresses physicians bring on themselves. The days of the affluent physician are over. Socialized medicine has seen to that. So to expect to live as affluently as our dental or lawyer colleagues is unrealistic. Physicians will still maintain their independence and stick to fee-for-service payments like Linus and his blanket. So how can physicians maintain > >
Just For Canadian Doctors September/October 2010
“A physician who treats himself has a fool for a patient.”
living well Dr. susan biali Susan Biali is a practicing GP, media wellness expert, international speaker, flamenco dancer and author of Live a Life You Love: 7 Steps to a Healthier, Happier, More Passionate You. susanbiali.com
healthier and happier 5 drug-free ways to boost a depressed mood
S
ome of you may be familiar with my story: I used to suffer from clinical depression, reaching my lowest point 10 years ago during the second year of my Emergency Medicine residency. After reaching the point of no return and almost taking my own life, I realized that I needed to make some drastic changes. Some of these included taking up dancing in my late 20s (I now perform flamenco professionally), embarking on a career as a writer, and even commuting from Mexico for a few years. With time, all aspects of my life improved so much that I began analyzing how and why things got so much better, and translated my observations into a book, which came out this year: Live a Life You Love: 7 Steps to a Healthier, Happier, More Passionate You. With the release of the book came a media tour of the US, and I was surprised
doctor on a soapbox continued from page 14
> > their health? Fortunately the subject is becoming more and more prominent under the auspices of the Canadian Medical Association. The end result is that there is a series of provincial chapters of Physicians Health Programmes. Contact information for these can be found at cma.ca/provincialphysicianhealthprograms. These programs offer confidential, prompt and free help for physicians in any form of physical or mental distress. I suggest, however, that we should try to intervene before the distress reaches a level where help is needed. This could be achieved by insisting that every physician has his own family physician who should be consulted with an office visit at least once a year. This may sound like yet one more regulation in our already over regulated life, but physicians are notorious for neglecting their own health. “A physician who treats himself has a fool for a patient.”—Sir William Osler
to find that the topic that the media and public were most interested in was how to improve your mood and mental health through non-pharmaceutical methods. Here are five of the most effective, easy ways I have discovered, which I use regularly to protect and boost my mental health (and that of my patients):
shown that a Mediterranean diet pattern protects people from depression. Experts speculate that this way of eating—rich in fish, olive oil, fruits and vegetables, legumes and whole grains— provides B-vitamins, omega-3 fatty acids, and anti-inflammatory fibre that protect and heal the brain. Junk foods have the opposite effect: the glycemic highs and lows associated with sweet sugary foods and the inflammation caused by trans-fatrich processed foods can mean trouble for an already troubled brain.
Some of the most effective things in life are the simplest
1. Ask what’s really behind your mood In my case, I was in a career that wasn’t suited to my personality, was sleep-deprived and extremely stressed, and my life was myopically focused on medicine and nothing but—a recipe for disaster. I also had negative thought patterns and ways of interpreting life events that I have since changed. Journaling helped, and so did counselling and group work. Studies show that psychological treatments such as cognitive therapy can be as effective as antidepressants, and are more effective at preventing relapse. 2. Get moving A study published in the 1999 Archives of Internal Medicine reported that a brisk 30-minute walk three times a week may be just as effective in relieving symptoms of major depression as prescription medications. Another study from researchers at the University of Vermont showed that just 20 minutes of moderate exercise in the morning translated into a sustained elevated mood for an average of 12 hours post-exercise. If I’m feeling down in the dumps, all I usually need to do is respond to my dog’s perpetually pleading eyes and take him (or rather, he takes me) for an energetic walk around the neighbourhood. I almost always bounce back in through the door, full of energy and feeling immensely better. 3. Eat the right foods You’ve probably heard of the benefits of the omega-3 fatty acids for mood and brain health, and multiple studies have also
4. Create opportunities to laugh Many of us who experience low moods or depression can rightfully blame it on stress. A good laugh decreases the release of the stress hormones adrenaline and cortisol, and may even turn on your fountain of youth by promoting growth hormone release. I’ve found it immensely helpful to lighten up in general (seizing any opportunity to act silly), spend time with people who make me smile, and watch funny movies and television shows whenever I can. 5. Listen to music that you love Some of the most effective things in life are the simplest. Music can reduce stress and has even been shown to lower systolic blood pressure. Studies which examine the effects of music therapy on depressed patients have found that music can improve a low mood, increase self-esteem, and even reverse depression. The type of music you listen to is important: choose something upbeat that you enjoy, rather than a melancholy sad love song. It’s amazing what one great song can do for your day (especially if you’re alone at home and can sing out loud and dance without anybody catching you!).
September/October 2010 Just For Canadian Doctors
15
*
prescribing r & R Share your own adventure or leisure activity with Just For Canadian Doctors’ readers for a chance to win an all-expenses-paid trip with Quark Expeditions. See details at justforcanadiandoctors.com/contest.html. We’ll continue to run the best stories in 2010. Send your submission to feedback@inprintpublications.com.
magical kingdom
by Dr. Jean Hlady
A physician experiences a land of gross national happiness ing people about contraception and teenage pregnancy. When I found out about the major doctor shortage in the country—only 100 doctors for 700,000 people—I did not anticipate firsthand experience of the Bhutanese medical system…but after our first night in Paro (and a dinner of the famous national dish of cheese and chilies) my friend became violently ill. The next day, after travelling on a twisty road to Thimpu with two guides (who tried to settle her stomach with pieces of apple), she was showing signs of shock and we had no choice but to go to hospital. With trepidation we approached the Emergency Department in Thimpu. It was extremely basic—10 – 12 beds and no facilities to speak of. Relatives brought blankets and food for sick family members. But I was struck by how calm everybody was. No one was loud or demanding. Everyone seemed to accept fate. And I got a laugh (at times like this, a sense of humour helps) out of a sign in the hospital: “Visitors will not be entertained in the Emergency Department.” One nurse basically ran the Emergency Department on her own. She made a quick diagnosis (gastroenteritis with dehydration) without the aid of any tests and started an IV slickly on the first attempt. A doctor eventually appeared and told my friend that she wouldn’t die but kept asking if she had any chest pain. Throughout all of this the two guides stayed with us helping in any way they could. By the end of the afternoon my friend was given three Ziploc bags of medicine. There were no labels, only circles indicating what time of day the meds should be
taken (many people here are illiterate). All of the treatment (IV, medical and nursing care, medication) was free. Throughout this ordeal everyone was wonderful to both of us. I have never had such attention from guides. We left our tour for a few days, during which I saw a different side of the country than as a tourist—a high school volleyball game, marijuana plants growing wild on the roadside and an archery match (archery is the national sport and the Bhutanese hope to win an Olympic medal one day). When we rejoined the tour, we took part in the Thimpu tsechu, an annual religious festival. Masked and beautifully costumed dancers perform lively pantomimes of Buddhist mythology accompanied by cymbals and drums. It’s also an opportunity for rural people to socialize and dress up in their finery and, for us, a highlight of the trip. We left the festival to see more of the countryside, travelling up a high mountain pass to the Haa Valley and climbing what seemed like a mile up the side of a mountain to the famous precarious Tiger’s Nest Monastery (I made it all the way!). Looking back, I am still struck by the incredible beauty of the country, its charming culture and unique architecture. But what I remember most is the kindness of the people. And, yes, I believe most of them are happy. It is amazing and heartening to see how this tiny kingdom has retained its identity being bordered by two super powers—China on one side and India on the other. As I flew back out of Bhutan I was genuinely sorry to leave this wonderful country and its people behind.
Dr. Jean Hlady is a pediatrician at BC Children’s Hospital in Vancouver, BC. . Hung Chung Chih
contest finalist!
W
e boarded the Druk Air flight from Kathmandu in Nepal to Paro in Bhutan with no idea what adventure lay before us. After catching a glimpse of Mount Everest and the Himalayas we landed in the terraced, lush green Paro Valley. Disembarking, we seemed to step back in time. Quaint Bhutanese homes with brightly painted window frames, all strikingly similar, dot the countryside. It’s a rural society with one main road that crosses the country and no traffic lights…when a traffic light was installed in Thimpu (the capital) it caused so many accidents that it was removed. And it’s illegal in Bhutan to honk your car horn. The Bhutanese have managed to preserve their ancient traditions and culture. Most people continue to wear the national costume and are devout Buddhists. Prayer flags flutter on the hillsides, along with chortens (commemorative monuments) and monasteries known as dzongs, beautifully decorated with colourful murals and prayer wheels. The country is peaceful and the philosophy is one of Gross National Happiness. They describe the four pillars of happiness—a stable government, peace, religious freedom and the right to own land. The Bhutanese people also have great respect for their Royal family. We arrived in Bhutan just as a major earthquake strick in the east, killing about 12 people. The King travelled many hours by road to be with the quake victims (there are no planes or helicopters for the Royal family’s use). And the Queen is involved in many social initiatives; she’s been known to walk eight hours from village to village, educat-
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Just For Canadian Doctors September/October 2010
motoring
D r . k e l ly s i l v e r t h o r n
Dr. Kelly Silverthorn is a radiologist and Just For Canadian Doctors’ automotive writer.
2000 Acura MDX
the last decade 2000 – 2009: evolutionary or transformational?
W
e’re into the last quarter of 2010 now. Did the dawn of our new decade unfold unnoticed? What a contrast to the hubbub of the new Millennium in 2000! My reflection upon the last decade is first to the hallmark historical moments…9/11 and An Inconvenient Truth. Next I contemplate how a decade transforms children, and abets the incremental decline of middle age. Before long, I also think about how the automobile has changed since 2000. As circumstance would have it, my wife took delivery of her second Acura MDX (mid-size SUV), nearly a decade after her first. Through the prism of our new Acura the intervening decade looked decidedly evolutionary. Our new MDX is slightly larger and heavier. With its larger engine, it’s both quicker and faster, with similar fuel economy. The transmission has an extra gear, and the wheel diameters an extra inch. This new SUV comes with more electronic features, and more safety features, including more airbags. Engineering developments through the decade have given the consumer more of everything. On a constant dollar basis the new MDX and other models today cost consumers ~13% less than in 2000. In Canada, sales of new light trucks slowly inched forward from 45% of market share in 2000 to 49% in 2009. All sounding incremental so far? Drill a little deeper and the decade’s trends look more transformational. Buckle up, here goes!
crossovers: The mix within light trucks saw big shifts. “Crossovers” (car mechanical underpinnings with SUV-like ride heights), quadrupled their market share to 21% of new vehicle sales, while minivans and truck-based SUVs market share shrank commensurately.
downsizing: Whether light trucks or cars, Canadians bought more from the smallest sized categories—up from 35% in 2000 to 51% in 2009. Intermediate-sized vehicle market share felt all of this loss. Full-sized/ luxury/sports vehicles market share stayed steady at 10 – 11% in Canada, versus a steady 18 – 20% market share in the US.
ditching Detroit: In 2000, 66% of our new purchased vehicles were made by Detroit’s Big Three, which had shrunk by a full third
to 44% by 2009. Given that huge decline, not surprisingly, GM and Chrysler were at the bailout trough as the decade closed. This sad saga is far from over.
Asians eat Detroit’s lunch: As we’ve all heard, Toyota overtook GM as the world leader in unit sales late in the decade. Japanese nameplates increased Canadian new vehicle market share from 25% in 2000 to 38% in 2010. Korea’s “K2” (Hyundai and captive brand Kia) had a proportionately even bigger surge from 4 to 10%.
2010 Acura MDX
European fortune cookies: The Europeans also increased Canadian new vehicle market share from 5 to 8%, though their mixed fortunes are interesting. With GM’s troubles, Volkswagen is arguably now as high as #2 in sales worldwide, but in Canada VW is a distant 9th and falling. Saab is on life support. Opel (GM Europe) is in custody court. Volvo, Jaguar, and Land Rover brands eventually found new South East Asian owners. So then, what European brands did make gains in Canada? That would be the new (captive) small car brands MINI and Smart, as well as blue chips BMW, Mercedes and Audi. Fiat returned to North America as Obama’s anointed Chrysler savior. leasing languishes: Vehicle purchase financing (a.k.a. leasing) by the car companies themselves began the decade in the 25 – 30% of new units range, peaked at 45%, and plummeted as the decade closed to just 7%. Bank loans to finance new car purchases ebbed and flowed in mirror image, rebounded to 77% of transactions in 2009. Cash purchases began the decade at 19% and ended the decade at 16%.
black is back: Worldwide the three most popular car colours are silver, white and black. Black is the runaway favourite in Europe at 27% of new car sales, where the yuppies all seem to drive black Audi A6 TDI Avants. The rest of the world is following
Europe with black gaining in popularity, and silver and white falling. (Indeed, our new MDX is black, and the outgoing one silver.)
Value Village visions: As new vehicles have gotten progressively better and cheaper, so have used cars. Compared to ~700,000 new light vehicles bought in Canada in 2009, Canadians bought 2,800,000 used cars in 2009, up from 2,000,000 used cars purchased in 2000. Used-car-only dealers also improved their look and their market penetration. Many of the Canadian new car dealers shuttered by Detroit’s Big Three late in the decade will be reborn as used car superstores, continuing this trend.
China’s Quiet Revolution: China’s new light vehicle sales rose from less than a million in 2000 to more than ~13 million in 2009, and to be the largest market in the world. The US domestic market peaked at ~17 million new units sold annually middecade and skidded to just ~10 million in 2009. In 2009, ~75% of Chinese new car buyers had never purchased a car before, versus just 1% in the US. If my wife were to buy another Acura MDX in 2019 I expect it will have evolved to offer more of everything than our 2009 at the price of fewer constants. Yet, by 2019 China and India will have transformed the world’s automotive marketplace. The fashions, tastes, and needs of Asian consumers will progressively dictate what the rest of the world builds and buys.
September/October 2010 Just For Canadian Doctors
17
techworks
C o r e y Va n ’ t H a a f f Corey Van’t Haaff is Just For Canadian Doctors’ technology columnist and the owner of Cohiba Communications. She can be reached at medicalnews@ cohibacommunications.com and welcomes ideas for future columns.
hear the beat 3M Canada’s Littmann Electronic Stethoscope
I
n 1973, violinist David Harrington formed the now-renowned Kronos Quartet. It grew from his childhood love of hearing the violin being played. It grew, too, from his fascination with listening to his grandmother tell stories of great violinists from the early 20th century. By age nine, Harrington found himself playing the violin, and he has been at it ever since. The Kronos Quartet has collaborated widely with performers and composers as disparate as ying and yang, performed thousands of concerts worldwide, and released some 45 recordings of works for string quartet. Harrington once described a project by saying, “We wanted to go from the most intimate sound to the largest, in the space of a heartbeat.” 3M had a similar idea. For the past two decades, there have been a number of electronic stethoscopes on the market but they just never caught on. The sound quality was mediocre and some amplified ambient room noise at the same level as the heartbeat. Doctors couldn’t adequately isolate the sound they wanted to hear, which was probably a good thing, since the early electronic stethoscopes’ sound didn’t always resemble the heart sounds doctors were trained on. “Those electronic stethoscopes didn’t sound exactly like mechanical stethoscopes,” says Jackie Allan, Marketing Supervisor, 3M Canada’s Healthcare Division. “If they were left on, the power would drain and doctors didn’t like turning them on and off 20-to-30 times a day.” 3M’s Littmann Electronic Stethoscope Model 3200 is a state-of-the-art electronic stethoscope. The previous model (3000) with ambient noise reduction technology has held the number one position worldwide for electronic stethoscopes. “This—the 3200—is a step beyond,” she says. The Littmann 3200 is enabled with Bluetooth wireless technology, on-board recording, and ambient noise reduction. In fact, she says, it eliminates an average of 85 per cent of distracting ambient noise. There
18
are eight levels of sound, offering up to 24X sound amplification. It reduces frictional noise, created by moving the stethoscope on the body. The scope comes packaged with a Bluetooth dongle, like a USB flash drive but with a Bluetooth signal. It pairs the stethoscope with the physician’s computer. “The new Littmann 3200 Stethoscope has onboard recording capability, so clinicians can record sounds for playback later or, with the stethoscope’s Bluetooth wireless feature, they can send sounds realtime to their laptops,” says Allan. “If a physician visits a patient at home, they use the on-board recording to store the heartbeat and then transmit it to their computer back at the office. In the office, the physician has the ability to view heart and other body sounds on a computer in real-time while the stethoscope is still on the patient.” The Zargis StethAssist software included generates a phonocardiogram, a visualization of the sounds. Physicians can see a graph of the heartbeat — email it to a cardiologist or colleague for a second opinion or just store it for later review. Optional software includes the Cardioscan Heart Sound Detection Software from Zargis Medical, which helps the physician analyze cardiac sounds for heart murmurs, and decide if a referral to a cardiologist is necessary. The bigger picture, she says, is because it is Bluetooth-enabled, the stethoscope opens the door to future software development. The Littmann 3200 shows huge promise for telemedicine applications. Physicians or nurses practicing where no cardiologist is available can email the heartbeat to the cardiologist or, in the very near future, even have him or her listen in real-time while the patient is in a remote location. Battery life is a lesser issue as the Littmann 3200 goes into sleep mode after three minutes of non-use, saving batteries and saving physicians from turning it on and off; something they need do only once in
Just For Canadian Doctors September/October 2010
the morning. It even looks the same. There’s nothing wrong with the design of a traditional stethoscope so why change it? It still has two ear pieces and one chest piece, but the technology has revolutionized its functionality, including a frequency button and volume control. And because it’s wireless, there’s nothing to impede a physician’s movement around the patient. The technology allows doctors to catch sounds they may have otherwise missed with a mechanical stethoscope. “It gives better sensitivity and more confidence in decision-making,” says Allan. “Physicians can catch someone who may not have been referred, or stop needless referrals. They save time, reduce unnecessary tests. Patients also like that the physician is recording their heartbeats for comparison.” It’s designed to work with patients of all ages and sizes, an important consideration with the growing obesity epidemic. Powered by a single double AA battery, the Littmann 3200 allows doctors to hear potential heart problems. “If they don’t hear it,” says Allan, “they don’t know they’re missing it. The Littmann 3200 completely redefines what a stethoscope is capable of.”
toronto / dresden / baltimore / rome / riyadh … | c a l e n d a r
cme
A n intern ation a l guide to continuing Medical Education
fall 2010 + beyond
toronto Toronto skyline
chocolate elixir at Soma
the Distillery District
Art Gallery of Ontario
Royal Ontario Museum
gourmet fare at Canoe
Queen St. West
clockwise from top left: otmp (2); www.torontowide.com; jo-anne mcarthur; tourism toronto; emily sheff; soma chocolatemaker
cosmopolitan toronto: a city with plenty on its plate (CME events in toronto are highlighted in blue)
T
oronto stems from the Huron word, toronton, that means “meeting place,” and, as Canada’s biggest metropolis, it’s that and more. So, yes, meet here— there are limitless options in accommodations, entertainment, dining, shopping—and then go out on the town, explore the world-class museums and galleries and walk the diverse neighbourhoods—Little Italy, Little Portugal, the Gay Village, the Annex, Koreatown, Chinatown, Kensington, Cabbagetown, the Distillery, Yorkville, West Queen West, India Bazaar, Greektown…there’s a microcosm of just about anywhere right here in Toronto. [stay] One of the city’s most historic and recognizable hotels is the Fairmont Royal York, the place to stay since 1929. Today there are plenty of super-swish and luxe boutique hotels that have garnered fresh attention with sleek style, but this grand dame remains a stalwart, especially for CME events. With capacity for up to 1,670 guests and a choice of 32 meeting and function rooms, a gourmet restaurant (EPIC), catering, and just about anything else you need, it’s an easy choice. fairmont.com/royalyork [dine] Venture out to sample Toronto’s fabulous food scene. One high (literally)
is Canoe, atop the TD Bank Tower. It’s a hot spot—for the cityscape, the people watching, and, of course, the food. Nosh on dishes like Seared La Ferme Foie Gras, Wellington County Beef Tenderloin, and Borage Honey & Pine Nut Tart…far above the glittering downtown. oliverbonacini.com/canoe.aspx For a more informal bite and some conscientious fast food, grab a hotdog at Buddha Dog (buddhafoodha.com) or sip an “elixir” of Mayan hot chocolate at Soma Chocolatemaker (somachocolate.com). [museum hop] For some serious awe factor, visit two of Toronto’s recently refurbed cultural meccas. First, check out the Ontario Gallery of Art, overhauled by Frank Gehry to stunning effect. Inside, of course, is a world-class collection of art, including an impressive display of Canada’s Group of Seven. ago.net Then there’s the Royal Ontario Museum, also upgraded with a love-it-orhate-it ultra-modern Michael Lee Chin Crystal extension that protrudes from the original 19th-century original museum structure (love it!). The glass-and-steel protrusions, named one of the seven architectural wonders of the world by Condé Nast Traveler, will, at the very least, inspire plenty of
discussion… rom.on.ca [neighbourhood hop] With more than 100 cultures, Toronto has tasty world cuisine and a vibrant vibe—something is always going on. Stroll down Queen Street West, with its hip galleries and coffee shops. Experience a karaoke bar in Koreatown. Grab a pint in the historic Distillery District, North America’s largest and best-preserved collection of Victorian industrial architecture. Or check out the Annex, where bohemia and academe meet in the lively community surrounding the University of Toronto, next to chic Bloor-Yorkville. On Yorkville’s “Mink Mile” find designer threads (Prada, Gucci, Chanel…) or sit back in a café and celebrity watch during the Toronto International Film Festival in September (this year, its 35th, look for Eastwood, Damon, Redford, De Niro, Kidman…to name a few). tiff.net [shop] Any of Toronto’s neighbourhoods offer unique finds and shops. But for a full-on fashion fix, there’s Holts. Holt Renfrew, the flagship of Canada’s haute couture department store, is fittingly set in the heart of tony Yorkville. Window shopping allowed… holtrenfrew.com —B. Sligl For more info: seetorontonow.com
September/October 2010 Just For Canadian Doctors
19
Biochemistry
Anesthesiology
Alternative Medicine
Aesthetic Medicinee
c mcmee when calendar where
For:
topic
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Sep 25-27
Vancouver British Columbia
Introductory Course To Botox & Cosmetic Fillers, And Advance Course In Non-Surgical Facelifts
The Physician Skincare and Training Centre
877-754-6782 See Ad Page 22
ptcenter.org
Oct 27-30
Bangkok Thailand
10th International Rhinoplasty & Cosmetic Facial Surgery Workshop
Indian Society of Facial Reconstructive Surgery
011-91-731249-6038
cosmeticrhinoplastyindia.com
Nov 04-07
Barcelona Spain
1st World Congress On Controversies In Plastic Surgery & Dermatology
ComtecMed
011-972-3-5666166
comtecmed. com
Nov 13-14
Vancouver British Columbia
Introductory Course To Botox & Cosmetic Fillers
The Physician Skincare and Training Centre
877-754-6782 See Ad Page 22
ptcenter.org
Mar 09-11 2011
Miami Florida
28th Annual Miami Breast Cancer Conference
Physicians’ Education Resource
888-949-0045
cancerlearning. com
Oct 17-22
Kauai Hawaii
9th Annual Destination Health: Renewing Mind, Body And Soul
Scripps Conference Services & CME
858-652-5400
scripps.org
Apr 14-17 2011
Istanbul Turkey
TARTEN 2011 (Transatlantic Reproductive Technologies Network)
011-90-312440-5011
tarten2011.org
Oct 31Nov 04
Scottsdale Arizona
Scottsdale Anesthesia Conference 2010
holidayseminars.com
877-859-0550
holidayseminars. com
Nov 01-05
Kailua-Kona Hawaii
2010 Fall Hawaiian Seminar Of California Society Of Anesthesiologists
California Society of Anesthesiologists
800-345-3691
csahq.org
Dec 08
London England
5th Emergency And Critical Care ECHO Course
Infomed Research & Training Limited
011-44-208123-0021
infomedltd. co.uk
Dec 11-15
Philadelphia Pennsylvania
50th Annual Meeting Of American Society For Cell Biology
American Society for Cell Biology
301-347-9300
ascb.org
Mar 09-13 2011
Barcelona Spain
10th International Conference On Alzheimer’s & Parkinson’s Diseases
Kenes International
011-41-22-9080488
kenes.com
May 07-13 2011
Quebec Montreal
19th Scientific Meeting And Exhibition Of The International Society For Magnetic Resonance In Medicine
International Society For Magnetic Resonance In Medicine
510-841-1899
ismrm.org
Oct 11-17
Nassau Bahamas
NEI Conference Series - Sleep Apnea: Diagnosis, Treatments and Impact on Cardiovascular Disease
National Education Institute
866-685-6860 See Ad Page 21
neiconferences. com
Oct 13-15
La Jolla California
21st Annual Coronary Interventions
Scripps Conference Services & CME
858-652-5400
scripps.org
Dec 03
Rome Italy
AIM Rome
011-39-06-330531
aimgroup.eu
888-647-7327 See Ad Page 20
seacourses. com
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Just For Canadian Doctors
September/October 2010
Great CME during the day. Paired with culinary & wine adventures in the evening and onshore.
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Emergency Medicine
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cme
calendar
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Nov 06-09
Prague Czech Republic
13th Annual European Congress Of International Society For Pharmacoeconomics & Outcomes Research
International Society for Pharmacoeconomics & Outcomes Research
800-992-0643
ispor.org
Dec 02
Quebec City Quebec
Journee Clinique De Pharmacologie
U. Laval
418-656-5958
ulaval.ca
Feb 03-04 2011
London England
6th International Pharmacoeconomic Conference On Alzheimer’s Disease
Alzheimer’s Drug Discovery Foundation
212-935-2402
alzdiscovery.org
Sep 24-26
Santa Barbara California
2010 Calderm Annual Meeting
California Society of Dermatology & Dermatologic Surgery
916-498-1712
calderm.org
Nov 26-27
Halifax Nova Scotia
Living Well With Scleroderma - 11th Annual Conference and AGM
Scleroderma Society of Canada
902-423-3942
scleroderma.ca
Dec 09-12
Dresden Germany
Cosmoderm 16: International Aesthetic Dermatology Congress Of European Society For Cosmetic & Aesthetic Dermatology
Conventus Congressmanagement
011-49-36-4135330
cosmoderm2010.de
Feb 04-08 2011
New Orleans Louisiana
69th Annual Meeting Of The American Academy Of Dermatology.
American Academy of
847-330-0230
aad.org
Oct 20-23
Edmonton Alberta
13th Annual CDA/CSEM Professional Conference and Annual Meetings
Canadian Diabetes Association
800-226-8464 ext. 7077 See Ad Page 23
diabetes.ca/ conference
Nov 04-06
Los Angeles California
8th Annual World Congress On Insulin Resistance, Diabetes & Cardiovascular Disease
Metabolic Endocrine Education Foundation
818-342-1889
insulinresistance.us
Mar 04 2011
Sacramento California
37th Annual UC Davis Diabetes Symposium
UC Davis Health System
916-734-5390
ucdavis.edu
Oct 07-08
Baltimore Maryland
Practical Emergency Airway Management
Jefferson Medical College
888-533-3263
jefferson.edu
Nov 04-05
Baltimore Maryland
Practical Emergency Airway Management
Jefferson Medical College
888-533-3263
jefferson.edu
Nov 19-21
Las Vegas Nevada
Difficult Airway Course
Airway Management Education Center
866-924-7929
theairwaysite. com
Dec 08
Montreal Quebec
Onboard Medical Emergencies
Onboard Medical Emergencies
See website
OnboardME. com
Dec 13-17
Sarasota Florida
Primary Care: Improving Your Outcomes Through Diagnosis And Treatment
Hamad Medical Corporation
011-974-4397398
qatarhealth.info
Jan 13-15 2011
Bonita Springs Florida
2011 Annual Meeting Of National Association Of Emergency Medical Services Physicians
National Association of Emergency Medical Services Physicians
800-228-3677
naemsp.org
Jan 31Feb 02 2011
SilverStar British Columbia
BEEM (Best Evidence in Emergency Medicine) Course
McMaster University
905-521-2100
beemsite.com
new CME list fromDermatology Adam
Learn Virtually anytime - anywhere access your Cme worldwide travel & Learn Format Connect with us 24/7. toll-Free:1-866-685-6860 www.neiconferences.com 7X2.5_canadian_family_physicians1 1
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September/October 2010 Just For Canadian Doctors
Infectious Diseases
Immunology & Allergy
Genetics
General & Family Medicine
Endocrinology
calendar c mcmee when where
22
topic
sponsor
contact
website
Harvard Medical School
617-384-8600
hms.harvard. edu
14th Asia-Oceania Congress Of Endocrinology
Console Communications
011-60-3-21620566
pinghealthcare. com
Sarasota Florida
Geriatrics: A Primary Care Approach To The Aging Population
American Medical Seminars, Inc.
941-388-1766
ams4cme.com
Oct 4-10
Whistler BC
NEI Conference Series - Ethics and Health Care Professionals
National Education Institute
866-685-6860 See Ad Page 21
neiconferences. com
Oct 12-23
Tahiti
Pain Management Update 2010
CME At Sea
888-523-3732
cmeatsea.org
Nov 26Dec 06
Eastern Caribbean Cruise
Sexual Health Medicine
Sea Courses Cruises
888-647-7327 See Ad Page 20
seacourses. com
Dec 03-04
San Francisco California
5th Annual Primary Care Sports Medicine: ABCs Of Musculoskeletal Care
University of California, San Francisco
415-476-4251
cme.ucsf.edu
Jan 26-29 2011
Rome Italy
2011 International Conference On Health Informatics
351-265-100033
insticc.org
Feb 13-27 2011
Australia New Zealand Cruise
12th Annual Update in Gastroenterology - 2011
Continuing Education, Inc./University at Sea
800-422-0711 See Ad Page 39
continuingeducation.net
May 1014 2011
Toronto Ontario
1st International Conference on Faculty Development in the Health Sciences
CEPD, University of Toronto
888-512-8173
cepd.utoronto. ca
Oct 01
Welwyn England
Non-Coding RNA’s In Development
European Scientific Conferences
enquiries@ euroscicon.com
euroscicon.com
Dec 07-08
Riyadh Saudi Arabia
Treatment Modalities For Genetic Diseases: From Diet To Gene Therapy
King Faisal Specialist Hospital
011-966-1-4424988
bportal.kfshrc. edu.sa
Nov 04-07
Victoria British Columbia
2010 Canadian Society Of Allergy And Clinical Immunology Annual Scientific Meeting
Canadian Society Of Allergy And Clinical Immunology
613-730-6272
csaci.ca
Jan 27-29 2011
Berlin Germany
1st International Conference On Current & Future Vaccination In Adults
ComtecMed
011-972-3-5666166
comtecmed. com
Nov 01-19
Ifakara Tanzania
Health District Management: Priority Setting, Planning And Programme Design
Swiss Tropical and Public Health Institute
41-61-28482-34
swisstph.ch
Apr 07-10 2011
Montreal Quebec
AMMI Canada - CACMID Annual Conference
AMMI Canada and CACMID
613-260-3233
ammi.ca
Apr 09-16 2011
Caribbean Cruise
2011 Infectious Disease Review
Continuing Education, Inc./University at Sea
800-422-0711 See Ad Page 39
continuingeducation.net
Nov 05-07
Boston Massachusetts
Surgery Of The Thyroid & Parathyroid Glands
Dec 02-05
Kuala Lumpur Malaysia
Jan 31Feb 04 2011
new CME list from INSTICC Adam
Just For Canadian Doctors
September/October 2010
Oncology & Palliative Care
Nutrition
Neurology
Nephrology
Legal Ethics
Internal Medicine
cme
calendar
cme
when
where
topic
sponsor
contact
website
Oct 21-24
Sedona Arizona
Mayo Clinic 13th Annual Internal Medicine Update
Mayo School
480-301-4580
mayo.edu
Nov 06-10
Toronto Ontario
2010 Critical Care Canada Forum
Bayley Group
888-527-3434
criticalcarecanada.com
Nov 19-20
New York New York
15th Annual Perspectives In Thoracic Oncology
Imedex
678-242-0906
imedex.com
Oct 18-20
Tucson Arizona
Forensic Review Course Of American Academy Of Psychiatry & The Law
AAPL
800-331-1389
aapl.org
Feb 20-21 2011
Ximer Arpora India
2nd International Conference On Medical Negligence And Litigation In Medical Practice
Indian Association of Medico-Legal Experts
011-91-989109-8542
iamleconf.in
Oct 20-23
Boston Massachusetts
2010 Cardiometabolic Health Congress
Cardiometabolic Health
877-571-4700
cardiometabolichealth.org
Nov 16-21
Denver Colorado
Renal Week 2010
American Society of Nephrology
202-416-0675
asn-online.org
Feb 17-20 2011
Bangkok Thailand
21st Conference Of The Asian Pacific Association For The Study Of The Liver
Kenes Asia
011-65-62924706
apasl2011bangkok.org
Dec 03-07
San Antonio Texas
2010 American Epilepsy Society’s Annual Meeting
703-960-1213
aesnet.org
Dec 07-08
St. Andrews England
Endoscopic Spine Surgery
Aesculap Academy
011-49-746195-2001
aesculap-academy.com
Oct 21-22
Washington District of Columbia
2010 American Institute For Cancer Research Conference On Food, Nutrition, Physical Activity & Cancer
American Institute for Cancer Research
202-328-7744
aicr.org
Nov 04-05
San Francisco California
10th Annual Nutrition & Wellness In Health & Disease
Mayo School
800-323-2688
mayo.edu
Nov 30Dec 30
Riyadh Saudi Arabia
Primary Care: Improving Your Outcomes Through Diagnosis and Treatment
King Faisal Specialist Hospital
011-966-1-464
ams4cme.com
Oct 04-07
Rome Italy
52nd Annual Meeting Of The Italian Cancer Society
AIM Group
011-39-06-330531
aimgroup.eu
Oct 22-23
Cairo Egypt
Middle East-North Africa Oncology Conference
Fleming Gulf
919-84-4766782
fleminggulf.com
Nov 13-19
Cascais Portugal
2nd Eso-Estro Masterclass In Radiation Oncology
European School of Oncology
011-39-2-8546451
eso.net
Dec 06
Houston Texas
The Fidler Lectureship In Metastasis Research
M D Anderson Cancer Center
713-792-2223
mdanderson.org
Dec 09-11
Chicago Illinois
2010 Chicago Multidisciplinary Symposium In Thoracic Oncology
American Society for Radiation Oncology
703-502-1550
astro.org
Dec 13
Jeddah Saudi Arabia
Leukemia & Lymphoma Update
National Guard Health Affairs
011-966-2-6240000
ngha.med.sa
new CME list from American Adam Epilepsy Society
www.diabetes.ca/conference September/October 2010 Just For Canadian Doctors
23
Urology
Rural Medicine
Rheumatology
Psychiatry
Pediatrics
Pain Management
Ophthalmology
calendar c mcmee when where
topic
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contact
website
Sep 16-18
Ottawa Ontario
Sally Letson Symposia: University Of Ottawa Eye Institute
University of Ottawa Eye Institute
613-737-8575
eyeinstitute.net
Nov 19-22
New York New York
Ocular Surgery News New York 2010
Vindico Medical Education
856-994-9400
osnny.com
Dec 04-05
Toronto Ontario
Annual Walter Wright Day - Update In Ophthalmology 2010
University of Toronto
888-512-8173
events.cmetoronto.ca
Dec 09-12
Macau China
International Symposium On Ocular Pharmacology & Therapeutics
Paragon Conventions
011-41-22-5330948
isopt.net
Oct 14-16
La Jolla California
5th Annual Frontiers Of Clinical Investigation Symposium Pain 2010: Bench To Bedside
UC San Diego
858-534-3940
cme.ucsd.edu
Oct 28-31
Beijing China
14th World Pain Clinic Congress / 1st Asian Congress On Pain
Kenes International
011-41-22-9080488
kenes.com
Dec 03
Calgary Alberta
Calgary Pain Conference
University of Calgary
403-220-7240
ucalgary.ca
Oct 11-12
London England
Community Child Health
Imperial College London
011-44-207594-2150
imperial.ac.uk
Nov 04-06
Los Angeles California
8th Annual World Congress On Insulin Resistance, Diabetes & Cardiovascular Disease
Metabolic Endocrine Education Foundation
818-342-1889
insulinresistance.us
Oct 15-17
Boston Massachusetts
Psychopharmacology 2010
Massachusetts General Hospital Academy
866-644-7792
mghacademy. org
Nov 04-06
Montreal Quebec
26th Annual Meeting Of International Society For Traumatic Stress Studies
ISTSS
847-480-0928
istss.org
Dec 02-05
Boca Raton Florida
21st Annual Meeting And Symposium Of The America Academy Of Addiction Psychiatry
America Academy Of Addiction Psychiatry
401-524-3076
aaap.org
Oct 07-09
Ghent Belgium
7th International Congress On Spondyloarthropathies
Medicongress
011-32-9-3443959
medicongress. com
Nov 28Dec 01
Liverpool England
Osteoporosis Conference 2010
National Osteoporosis Society
011-44-176147-3281
nos.org.uk
Feb 1115 2011
Cancun Mexico
2011 Canadian Rheumatology Association (CRA) Conference
Canadian Rheumatology Association
905-952-0698
rheum.ca
Nov 14-20
Pacuare River Costa Rica
Jungle Medicine Training Course
Expedition Medicine Ltd.
011-44-1298871-156
expeditionmedicine.co.uk
Nov 17-20
Vicenza Italy
Advanced Wilderness Life Support
AdventureMed
801-990-2800
awls.org
Oct 10-13
Adelaide Australia
Fertility Society Of Australia 2010 Annual Conference
Waldron Smith Management
011-61-3-96456359
fertilitysociety. com.au
Dec 03-04
Henderson Nevada
Reconstructive Vaginal Surgery: A Hands-On Cadaver Course
Innovations in Medical Education & Training
856-427-6200
imetcme.com
For feedback, requests or to have your course featured please email cme@inprintpublications.com or submit your course via www.justforcanadiandoctors.com At Balmoral Hall School, we place a high priority on every studentĘźs personal and academic development.
Over 99% of Balmoral Hall graduates attend the university of their choice. We are committed to developing the whole student: young women who not only succeed but also strive to make a difference. Balmoral Hall is an IB World School.
24
Just For Canadian Doctors
Toll-Free: 1-866-DREAM11 • www.balmoralhall.com
September/October 2010
cl a s s i f i ed ads
| positions / vacation properties / practices / locums positions available positions available practice for sale
PHYSICIANVACANCIES - Visit MDWork.comto access over 700 up-to-date Canadian physician vacancies. Save time andsimplify your jobor locumsearchwith all jobsononecomprehensivesite. Knowyour options —findthebest positionfor youat MDWork.com. SIDNEY, BC - Well established family practice in office shared with one other female MD. Admitting privilegesat SaanichPeninsulaHospital, noobstetrics or ER required. One in five weekend call. Great lifestyle in small seaside town near Victoria. Details at practiceinfo@shaw.ca
Start anewgroup, solopractice, wal-inshifts, locums. equal partnership in FHO. I amretiring. Completely Contact Dr Chris Kozanitis (613) 329-3604 or e-mail computerized EMR (Practice Solutions) with no cdkoz@bell.net. paper records, no hospital work, no OB. One day/ weekend in 14. Staff experienced with the system. MISSISSAUGA, ON - Part-time/fulltime family Perfect for a new physician or one contemplating practice/walk-in available. Ability to take over a a mid-life career change. K-W is a great place to familypracticeandjoinaFHG. Manypatients looking settle down. Hopingtofinda goodphysicianfor the for a new family doctor. Work in a positive practice families that have put up with me for almost two environment with support from the other MDs. generations. http://mydoctor.ca/drgeorgemiller For Lab, pharmacy, foot clinic, optometry on site. Email moreinformationE-mail gbmiller@sympatico.ca. doctorsearch@hotmail.comor call 416-844-8340.
OTTAWA, ON - Take over solo family practice located VICTORIA, BC- Burnside,TillicumandUptownMedical in large medical building adjacent to The Ottawa Clinics require a P/T or F/T GP and Walk-in doctors. Hospital, Civic Campus. Member of Family Health Email bridger@shaw.ca. Group with full night and weekend coverage. Approved for EMR funding beginning end of ETOBICOKE, ON - Walk-in/family practice group of May. Opportunity for teaching and hospital work. 3 clinics/8 MDs seeking MDto join in busy clinics in Telephone613725-1465, fax613725-0340or e-mail NorthEtobicoke. Attractivesplit. Call Yasmin416834- wjw@sympatico.ca. 2807or e-mail alkarim@damji.ca KINGSTON, ON - Opportunities in a new clinic! CDK practice for sale Family Medicine and Walk-in. Downtown Kingston. KITCHENER, ON - Family practice for sale. Full and
vacation properties SILVER SANDS, JAMAICA: EbbTide 4bd/4bth Beachfront Villa. Large, airy, comfortable, tastefully furnished. Weekly/nightly rate includes services of Cook & Housekeeper andfree airport transfers. Silver Sands Resort boasts arguably the most magnificent white sand beach on the Island. Great swimming, snorkeling, coral reef exploration, golf, dolphin encounters, horseback riding, river rafting, excellent shopping & dining close by. For contact details visit www.homeaway.com/265865
GIMBEL EYE CENTRE A Canadian Cataract & Refractive Surgery Centre of Excellence with multiple sites is seeking a MEDICAL OPHTHALMOLOGIST GLAUCOMA, CORNEA OR OCULOPLASTIC
employment
opportunities
Classifieds: fax 604-681-8149 • tel 604-681-1811 • email classified@InPrintPublications.com
Only Canadian qualified or those immediately eligible for Canadian licensure need apply. Interested candidates should submit their CV to
acstanwi@gimbel.com for consideration
26
Just For Canadian Doctors September/October 2010
FELLOWSHIP POSITION Available immediately for a
North-American-trained Ophthalmologist interested in an
Anterior Segment and Refractive Surgery Fellowship For more information, please contact Annette Stanwick, Vice-President, Medical Affairs, Gimbel Eye Centre, Calgary, Alberta, Canada at (403) 202-3318 or toll free: (800) 661-1138 or send a curriculum vitae via e-mail to acstanwi@gimbel.com
cruise
it! employment
opportunities
Southern Georgian Bay Midland/Penetanguishene, Ontario Only 90 minutes north of Toronto.
Where Doctors Practice Their Art! Opportunities in: Family Medicine Internal Medicine
Emergency Medicine Hospitalist
Hôpital général de la baie Georgienne
Create a flexible career by combining a family practice with Emergency or Hospitalist positions. Financial incentives and relocation costs provided.
GEORGIAN BAY G e ne r al Ho spit a l www.gbgh.on.ca
Georgian Bay SOUTHERN
Physician Recruitment Recrutement de médecins Image by Diane Soward - www.artofdianesoward.com
doctorworkandplayongeorgianbay.ca
To learn more contact: David Gravelle, Physician Recruitment Officer gravelled@gbgh.on.ca 1-705-526-1300 Ext 3135 September/October 2010 Just For Canadian Doctors
27
opportunities
IMMEDIATE NEEDS Family Practice Emergency Medicine Internal Medicine Psychiatry GP/Anesthesia GP/Obs General Surgery
www.hpha.ca
Come join us on “Ontario’s West Coast” and enjoy the sandy shores of Lake Huron!
VISIT OUR SOUTH-WESTERN ONTARIO COMMUNITIES SERVED BY THE FOLLOWING HOSPITALS: • Clinton Public Hospital • Goderich Alexandra Marine & General Hospital • Seaforth Community Hospital • St. Marys Memorial Hospital • Stratford General Hospital
employment
WHY OUR MEDICAL COMMUNITY? World-class theatre, fine dining, beautiful beaches, agricultural landscapes & welcoming individuals surround the healthcare community. Incentives include: Under-serviced designation benefits, 6 FHT’s, Rural Locum Program, opportunities in group medical clinics, Emergency departments have 24/7 guaranteed hourly stipend, Resident/med students welcome for electives, Proximity to University of Western Ontario & University of Waterloo campuses, Research and teaching opportunities
www.amgh.ca For More Information Please Contact: GWEN DEVEREAUX Physician Recruitment Leader Phone: 519.527.8403 Cell: 519.870.3667 Email: gwen.devereaux@hpha.ca or gwen.devereaux@amgh.on.ca
28
Just For Canadian Doctors September/October 2010
Practicing in New Brunswick is more than a career choice. It’s a life choice.
L’exercice d’une profession dans le secteur de la santé au Nouveau-Brunswick s’avère plus qu’un choix de carrière, c’est un mode de vie.
Being in New Brunswick. Making life happen.
Soyez au Nouveau-Brunswick Vivez pleinement.
www.gnb.ca/physicians www.gnb.ca/médecins
opportunities
Travail. Vie. Équilibre.
employment
Work. Life. Balance.
travel the world
Viewing glaciers with the spotting scope on the top deck of the ship. below Remota blends with the landscape and recalls the sheep farms of the region.
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Just For Canadian Doctors September/October 2010
travel the world
Patagonia story + photography by Kevin Revolinski
“F ”
a cruise at the end of the world It is scarcely possible to imagine anything more beautiful than the beryl-like blue of these glaciers, and especially as contrasted with the dead white of the upper expanse of snow. —Charles Darwin rom a distance it had looked much smaller, almost quaint the way it lay along the land, nestled between mountains. But as we drew closer across the icy waters in our Zodiac, the Pia Glacier loomed up faster and larger than one might expect until we made landfall and now stand dwarfed by its massive wall of ice. The surface shows patterns of cracks and layered ice and sediment, varying colors—most notably the blues—and several spouts of meltwater cascading into the bay. The Mare Australis, anchored in this fjord in the northwest arm of Beagle Channel, lies behind us, now a toy, a mere earthly thing that has stumbled into the hall of the gods. This is the second full day of our expeditionary cruise of the channels and islands at the End of the World, the southernmost reaches of the Americas. This is Patagonia. We set sail from Punta Arenas, Chile and are bound for Ushuaia on Argentina’s Tierra del Fuego Island. In between lies a remote land of mountains and glaciers, of moody seas and scattered islands, and of creatures and plants tough enough to cling to it all. What sound like shotgun shots echo off the surrounding rock as the glacier cracks and shifts, and seemingly small fragments tumble from time to time, revealing their hefty size when they plunge dramatically into the sea. I look back across the water, so still on a windless day, to observe the clutter of broken ice chunks. One of them will find its way in pieces into our cocktails tonight. After a gourmet dinner back on board, we are treated to slideshows, videos and lectures about what we are seeing and are going to see the next day. Thanks to our naturalists, we are engaged with our surroundings and entertained by stories of Darwin and Captain Fitz Roy and other European ship captains and sailors who first braved these channels only to find that the Yámana aborigines were already living here. As we navigate through the Avenue of the Glaciers the next day, I head to the upper deck to take photos of each of them, many named for nations— Germany, France, Italy, Holland glaciers—and to get a closer look at hidden waterfalls using the ship’s mounted spotting scope. We sail from point to point and a variety of creatures make our acquaintance. Imperial cormorants, petrels, and albatrosses seem to hover as they match our speed and fly at eye level. A parcel of penguins pops above the surface for a moment to see us pass, and even a whale comes alongside for a spell.
September/October 2010 Just For Canadian Doctors
31
travel the world Every day we are treated to a shore excursion. The first day in Admiralty Fjord we trekked along Ainsworth Bay with the Marinelli Glacier as our backdrop. Now in the distance, the ice sheet once covered the land we hike upon. A colony of elephant seals seemed to take little notice of us but the local birds came close to check us out along the trail among the unexpectedly bright colors of lichens and hardy plant life. An eagle-like caracara lighted in the upper branches of a nearby tree, and high up along the Darwin Peaks four condors rode the air currents. Our guide Eduardo kept a proper balance between lecture and the silence one requires to appreciate the great sweep of wind, chirping birds, babbling streams, and distant waterfalls. Several hikers claimed to have heard a fox bark. The cruise offers a perfect balance between luxury and adventure, activity and relaxation. Patagonia’s untouched splendor puts it in a must-see category and a small expeditionstyle excursion makes it all the more memorable. Our last shore excursion is truly the end of the world: Cape Horn. We climb to the lighthouse there and I imagine what sort of person might choose a solitary life out here as I look out over a sparkling sea. Invisible beyond the horizon is Antarctica. There’s no mistaking when the ship has left the relative shelter of the bays and channels. The sea starts to roll a bit and then really picks up steam when we round Cape Horn before becoming gentle again when we slip back among the islands for the final stretch north to Ushuaia. We disembark the next morning and I can’t help but feel like the child who has left the most amazing carnival ride of his life: I want to get back in line and start all over again.
Patagonian surf and turf?
While the cruise offers a few steps along terra firma, a landbased stay before or after is a great way to extend the Patagonian experience. On the Argentinian side is the port city of Ushuaia and the nearby Tierra del Fuego National Park. Hire a guide and trek through the mountains there, or take the End of the World Train to get to the park yourself. Send a postcard from the Post Office at the End of the World. On the Chilean side lies the magnificent Torres del Paine National Park and its unique set of mountain peaks totally independent from the Andes. Check in for a few days at nearby Remota Resort. Each evening guests sit down with their personal guides to discuss the next day’s activities. Do you prefer to go hiking? Horseback riding? Climbing? Perhaps a boat tour of the inlet? Remota offers a blend of luxury comforts—fine meals, regional wines, hot tubs—along with the rugged adventure excursions. The hotel’s design harmonizes with the terrain. Part of the structure resembles the sheep runs of the local farms, and the grass of the plains grows along the rooftops. Enjoy a view from the dining room of the sun setting behind the park’s three rocky “towers.” Watch documentaries and attend presentations about the land and its people. And most importantly, get out into the wild for some exploring. In the evening you can sip champagne and soak tired muscles in an outdoor hot tub with an impressive view.
if you go
+ 32
Cruceros Australis offers all-inclusive cruises between Ushuaia, Argentina and Punta Arenas, Chile for US$1,460 – 3,500 per person based on double occupancy: australis.com Remota offers packages ranging from 3 – 14 days, including meals and excursions. Double occupancy prices are $1080-5220 based on length of stay: remota.cl
Just For Canadian Doctors September/October 2010
Along with the enormity of glaciers and mountains are tiny beautiful details. below Cruise passengers board a Zodiac for a shore excursion. bottom Meals at Remota draw upon locally produced foods.
travel the world
The ship is dwarfed as it enters bays full of broken ice. below Challenging hikes in Torres del Paine offer grand vistas as a reward. left Hiking along shore brings travellers up close to the glaciers.
September/October 2010 Just For Canadian Doctors
33
the wine doctor dr. neil pollock Dr. Neil Pollock is a member of the Wine Writers’ Circle of Canada; visit his website on wine at vinovancouver.com or send feedback to drneil@pollockclinics.com. He practises no-scalpel, no-needle vasectomy and infant circumcision.
raise a glass to Israel
Award-winning, reasonably priced and palate pleasing, Israeli wines are a revelation
I
n discussions around my dining room table, Israel is most often paired with politics rather than pleasure. But the focus shifted from matters of politics to those of the palate after sampling several Israeli wines—a pleasurable and modern experience from a country that boasts some of the oldest appellations in the world. Grapes have been harvested and pressed in Northern Israel in the regions of the Upper Galilee and Golan Heights for close to a millennium, but there’s been a recent and dramatic rise in the popularity of Israeli wines when the Golan came under Israeli control in the mid-1970s. World-class wines are now exported internationally from close to 200 wineries, competing with premium wine-producing regions around the globe. Some of the most successful vineyards belong to Golan Heights Winery, a subsidiary of which is Galil Mountain. The explanation for the quality of Israeli wine and the success of the Golan Heights brands can be traced to the unique nature of Israeli topography—high altitudes (ranging from 1000 to 3600 meters) and mineral-rich volcanic soil combine to create a winning Chardonnay environment. And northern Israel receives an annual snowfall that facilitates the temperatures critical to quality grapes—a fact that startles almost everyone but Israelis! More moderate temperatures are found in the Central Golan for the production of sophisticated reds. My first sip of Galil Mountain Chardonnay was preceded by a lovely aroma of toasty green apples—the reward for the winery’s choice of blending grapes fermented in new-age stainless steel as well as French Oak. The wine itself is refreshingly crisp; the smoky citrus foundation is overlaid by a pleasing mixture of peach, citrus, and minty flavours. A few more sips of this wine and I was fantasizing about enjoying a second glass with a fillet of grilled halibut, marinated simply with lemon and butter. The 2007 winner of the Medium White category in Vancouver Magazine’s Wine Awards, this Chardonnay is a steal at $18 a bottle. Along with all of the Galil’s wines,
34
it is also kosher for Passover, so for those who have struggled as dinner hosts or guests to escape the traditional Manischewitz, here is an elegant solution. I then turned to a winner on the international stage—the Yiron. A subtle blend of Cabernet Sauvignon, Merlot, Syrah and a dash of Petit Verdot, this ruby-red vintage took me by surprise. The depth and finish were superb; the tannins were delicately integrated without compromising on firmness or richness of flavour. I savoured the berry aroma that wafted up from my glass. If one were to share a bottle of this wine over a rack of lamb grilled over cherry hardwood, the notes of black cherry, blue and red berries would reach breath-taking decibels. Here is a bottle of wine that settles once and for all whether kosher wine can hold its own at any table. It was rightfully described by Vancouver Magazine as “a revelation.” A third pleasure awaited me with the Sauvignon Blanc, a wine whose refreshing flavours attests to the growing skills of the teams that hand harvest these grapes in the Golan. Mediumbodied with scents of pear and passion fruit that float gently on an herbal wave, this wine will keep you cool on a hot late-summer night without making you reach for a sweater. Last, but hardly least, I sampled the Galil’s Pinot Noir. It
Just For Canadian Doctors September/October 2010
meets the challenge of crafting a quality Pinot Noir and exceeds expectations. Raspberry, sour cherry, and chocolate shades with hints of vanilla form a smooth texture that makes each sip a delight. This single varietal Pinot is mysterious; distinctive aromas and flavours emerge gradually over the long finish, and while the tannins are soft, the wine has a dense full flavour. Given my enjoyment of all these wines I’m pleased to note that they’re all also reasonably priced; you don’t need to set them aside for special occasions—they’ll add a splash of desert romance to any meal. If the revolution of the past 20 years in Israeli winemaking allows for any conclusions and predictions, it’s that Israel and fine wine is a natural pairing, and one that holds great promise in the years to come. “Le Chaim,” the Hebrew toast that means “to life,” can be made wholeheartedly with a glass of Galil Mountain Chardonnay. And as tastes of Israeli vineyards continue to gain recognition, I imagine many more will raise their glasses to Israeli winemakers.
t h e f o o d d o c t o r d r . h o l ly f o n g Dr. Holly Fong is a practising speech-language pathologist with three young children who is always trying, adapting and creating dishes.
slow-cooked salmon Succulent yet flaky, it’s the perfect late-summer dish slow-cooked salmon (serves 4) fish
.75 kg salmon filet (have fishmonger scale and cut your fish into 4 servings) salt and white pepper creamy sorrel sauce
1 tablespoon chopped chives extra chopped chives for garnish, optional 4 oz. sorrel leaves, rinsed, removing any fibrous middle stems 1 cup whipping cream salt and white pepper tender green beans
dr. holly fong
225g or ½ pound slender green beans, rinsed, ends trimmed salt 5 cloves of garlic, peeled
Pat salmondry withpaper towels. Sprinklewithsalt andpepper. Bringfilets toroomtemperature. Heat your gas barbecuetohigh. Scrubgrill clean. Carefully oil grill withanolive-oil-soakedwadof paper towel. Placefilets skinsidedownonthegrill andclose cover. Turntheheat downtolowfor 1½minutes. Turnoff grill. Donot lift cover! Let salmoncook for 23 minutes. If youdonot havea gas barbeque, preheat ovento 200°F(100°C). Placesalmonskinsidedownona baking dish. Bakeonmiddlerackof theovenfor 10minutes. Turn ovenoff andlet salmonrest 15 minutes witha gas oven, 10 minutes withanelectricoven. Donot openovendoor. Whilethesalmonis cooking, fill a largesaucepan with2 inches of water. Addenoughsalt sothat thewater is similar tosea water. Smashgarliccloves withtheflat bladeof a largekitchenknifeona cuttingboard. Add towater mixture. Bringtoa roaringboil over highheat. Addthebeans. Stir tolightlysubmergeall thebeans. Add morewater if neededtojust cover thebeans. Cook for approximately 5 minutes, uncovereduntil al dente. Using a slottedspoon, removebeans fromthepanontoa large plateor servingbowl. Set aside. Cut thesorrel by stackingleaves andlightly rolling intoa cylinder. Usinga sharpknife, cut intothinribbons. Ina mediumsaucepan, bringcreamtoa boil over medium-highheat. Turnoff andremovefromheat. Stir inthechoppedchives. Seasonwithsalt andpepper. Add sorrel. It will wilt very quickly. Immediately blenduntil smoothwitha handheldblender. Adjust seasoning. Servea pieceof salmonwithbeans, generously coveredinsauce. Garnishwithextra chives. Enjoy.
E
ating well doesn’t necessarily mean complicated. Some of the best meals are nothing more than fresh quality ingredients simply prepared to enhance their natural flavours. Over the last few years, the proliferation of farmers’ markets have made it easier for home cooks to find quality seasonal produce. Summer meals at my house are often inspired by what’s available at the market and by what’s growing in my small backyard garden. One of my family’s favourite late-summer meals is tender just picked green beans with slow cooked salmon in a creamy sorrel sauce and some crusty bread to soak up any remaining sauce. Slow cooking the salmon over a very low heat keeps the fish meltingly succulent. It will be bright orange—almost raw looking—but it flakes readily. The cream and sorrel sauce with its tangy lemon flavour enhances the natural sweetness of the salmon and the just-picked green beans. If you grow your own sorrel, pick young leaves about the size of a large bay leaf. Otherwise you will have to peel off the fibrous middle rib along the leaf before finely cutting the leaves into ribbons. When choosing a wine, look for a medium body wine with not much oak but good acidity to cut the richness of the salmon and the cream in the sauce, like a Pinot Gris or Sauvignon Blanc. For a change of pace, try an Austrian Grüner Veltliner. The Stift Goettweig 2008 Grüner Veltliner Messwein has bright acidity with a fragrant honeysuckle nose, tasting of lemon, green apple and a touch of mineral. The finish is long with a hint of pepper. This is a crisp wine with a slight creaminess that pairs well with the salmon and the sorrel sauce.
September/October 2010 Just For Canadian Doctors
35
t he w e a lt hy doctor manf r ed pu r tz ki, c .a. Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.
share office expenses Write off medical expenses without triggering a taxable benefit
M
any of my physician clients opt to share office space with colleagues in an effort to reduce practice overhead. I am a proponent of this cost saving strategy as along as there is a solid cost sharing arrangement in place. One critical aspect of this arrangement is the “allocation of expenses.” This is the topic that has the highest potential to trigger disputes among the parties as more often than not at least one of the group members feels that he or she is paying more than the fair share.
methods of allocating expenses
solution from May/June 2010 contest
There are a number of options to allocate expenses, namely “equal,” “billings,” “days worked,” and “individual.’ If the doctors have the same size offices, then the occupancy costs, consisting of rent, property taxes etc. are often shared equally, as are equipment leases and capital expenditures. Certain expenses, such as medical
sudoku 2 harder solution 1 3 9 8 2 4 7 5 6 8 4 6 9 5 7 2 3 1 7 2 5 6 1 3 8 9 4 2 6 8 5 4 9 1 7 3 4 5 3 7 6 1 9 8 2 9 1 7 3 8 2 4 6 5 6 7 2 4 3 8 5 1 9 3 8 4 1 9 5 6 2 7 5 9 1 2 7 6 3 4 8
solution from page 37
Puzzle by websudoku.com
sudoku 1 easier solution 4 8 9 2 1 6 7 5 3 7 5 3 4 9 8 1 2 6 6 1 2 7 3 5 9 4 8 3 9 5 6 7 4 2 8 1 8 4 6 1 2 3 5 9 7 1 2 7 8 5 9 3 6 4 2 7 8 5 6 1 4 3 9 5 3 4 9 8 7 6 1 2 9 6 1 3 4 2 8 7 5
Puzzle by websudoku.com
36
supplies, are more related to the practice volume, so are usually allocated on “billings.” There is a great variation as to how practices allocate their single biggest overhead component: staff salaries. Some practices distribute common staff costs equally, following the rationale that the staff is available to the doctor during the office hours, even if he chooses to spend fewer hours in the clinic. Other practices find that allocating the staff costs on the number of days worked in the clinic works for them. In other groups, the doctors base wage expenses on their respective billings. The reasoning is that the higher the patient volume, the more demands the doctor places on the staff, along with a greater financial ability to contribute a larger percentage to the office overhead. From my observations, allocating office expenses based on each doctor’s billings seems to have the greatest longevity in a group practice arrangement. However, there are certain expenses that can only be paid by an individual doctor, such as an assistant working exclusively for the doctor, and individual professional expenses.
withdrawal of a doctor from the group As touched upon above, to avoid costly disputes it is important that the expense sharing is spelled out in legal documentation. But equally important is to ensure the agreement addresses the events surrounding the withdrawal of one doctor from the group. Here are some common scenarios. A standard clause in the buy-sell agreement is the right of first refusal. This clause states that no party can sell or transfer his interest in the practice to another party unless he has first offered to sell the interest to his partner physicians. Since the doctors do not know whether or not a new physician is compatible with their group, I advise that a provision be added that the new doctor must serve a probationary period for a predetermined length of time. In the current practice transition climate, it is not unusual for a doctor to leave a practice without having first secured a successor.
Just For Canadian Doctors September/October 2010
Often the doctors are both tenants and landlords in their own clinic, so the question arises should the remaining partners assume the financial burden of maintaining the building? One group practice I am familiar with solved this issue by including a clause in their cost sharing agreement ensuring that the physician who was leaving continue to contribute his share of the cost of the practice real estate, including insurance, mortgage payments, property taxes, etc. until his replacement was on board. If a partner dies, the surviving physicians can be required to purchase the deceased’s interest in the practice along with the real estate within a certain time after death. If the buyout is funded by an insurance policy, the purchase price can be fixed by an amount equal to the death benefit. A practice valuation will have to be undertaken to determine a purchase price if a partner becomes permanently disabled so the other parties can purchase his share of the practice at fair market value. This is usually done by the remaining partners making payments over a specified period of time. This is also the process in the case of a mandatory buyout, where the group decides that a partner is unacceptable due to professional and/or personal concerns. In the event a physician withdraws from the practice, it should be clarified whether or not he should continue to be liable for his share of any bank debt incurred by the group practice. If the departing physician is a guarantor for bank loans, then the agreement should provide that the other parties would make efforts to release him from the guarantee. When the time comes to part ways for any reason, a clear and concise cost sharing arrangement will save a great deal of time spent in contentious discussions and money spent on legal fees. Make sure that your group practice agreement is tailor-made to specifically address the needs of your practice. See your accountant and solicitor to discuss your options.
diversion
sudoku Solve puzzle #2 for a chance to win the Hemp Hat for Her + the Organic Cotton Airflo® Hat in the Escape with Elegance Tilley pack Sudoku is simple enough that anyone can play, yet difficult enough that anyone can improve at it. Each Sudoku puzzle has a unique solution that can be reached logically without guessing. Fill in the grid so that every row, column and 3x3 square contains the digits 1 through 9.
sudoku 2 harder solution in next issue
sudoku 1 easier solution on page 36
winner of last issue’s sudoku contest: Dr. David Grotell, Toronto, ON
8 5
6 7 5 3 6 9 8 5 6 2 1 3 9 5 6 2 1 7 9 6 4 5 5 9 8 1 9 6 1 3 7
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Puzzle by websudoku.com
8 6
9 1 7 6 8 3 8 2 3 9 7 6 1 2 4 8 3 5 6 4 3
3
4 9
4 2 8 3 1 4
Puzzle by websudoku.com
entry form (please print clearly): Name: __________________________________________________________________ Address: _______________________________________________________________ City, Province, Postal Code: _____________________________________________
________________________________________________________________________ E-mail: ________________________________________________________________ Tel: ______________________________ Fax: _________________________________ Sudoku Puzzle Contest Rules: 1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles will be entered into random draw. 2. Send puzzle & entry form to Just For Canadian Doctors, 710 – 938 Howe Street, Vancouver, BC, V6Z 1N9 or by fax to 604-681-0456. Entries must be received by October 25, 2010. 3. Prize: Tilley Endurables Escape with Elegance Pack. Odds of winning dependent upon number of entries. Winner will be contacted by telephone and announced in the November/December 2010 issue. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications. Employees of In Print Publications and its affiliates are not eligible to participate. September/October 2010 Just For Canadian Doctors
37
“Travel bug” is the term that best describes this physician. She’s volunteered in Uganda and Vietnam and hopped across the globe from the seaside town of Cinque Terra in Italy to zip-lining across the jungle and rafting down the white waters of Costa Rica…Still on her list: India, Morocco, South Africa…And in the meantime she’s happy to watch her crush on How I Met Your Mother, snack on an Itzakadoozie popsicle and walk with her canine companion “lovely Tuffy.” Hakuna matata! travelled: Uganda for a medical elective The best souvenir I’ve brought back from a trip: Authentic wooden elephant bobblehead from Uganda A favourite place that I keep returning to: Vietnam, Vancouver My ultimate dream vacation: Round-the-world trip in a hot air balloon If I could travel to any time, I’d go to: 1950s Vietnam to see how my parents grew up My favourite book: the Harry Potter Series My favourite movie: Finding Nemo My must-see TV show: How I Met Your Mother My favourite music: The Element of Freedom by Alicia Keys My first job: Medical Office Assistant The gadget or gear I could not do without: My iPhone My favourite room at home: Kitchen, specifically the fridge My car: Honda Civic Hybrid My last purchase: Itzakadoozie popsicle (highly recommended) My last splurge: Likely something related to food Most-frequented store: Aritzia, Ikea
My name: Tram T. Nguyen I live and practise in: I live in Toronto and practice in Hamilton, Ontario My training: BSc (Hons), MD UBC, Pediatric Residency McMaster University Why I was drawn to medicine: I love working with children, they are inspiring and have incredible resilience. My last trip: Backpacking through Costa Rica The most exotic place I’ve
My closet has too many: Jeans that do not fit me My fridge is always stocked with: Lactose products that I am intolerant to My medicine cabinet is always stocked with: Ibuprofen My guilty pleasure is: Chocolate -covered Macadamia Nuts My favourite activity: Dog walking My favourite sport to watch: Hockey My celebrity crush: Fictional character Ted Mosby on How I Met Your Mother
I’d want this item with me if stranded on a desert island: My dog, Tuffy My secret to relaxing and relieving tension: Hot Tubs and bubble baths A talent I wish I had: Singing My scariest moment: Emergency airplane landing including dropping of oxygen masks on my way home to Vancouver. My fondest memory: Being downtown Vancouver during the Gold medal Mens Hockey Game. A big challenge I’ve faced: Moving away from my family to another province One thing I’d change about myself: Being less fearful of being wrong The word that best describes me: Travel bug I’m inspired by: My dog, Tuffy, who enjoys his life thoroughly, which consists mainly of eating, short walks through parks, and sleeping. My biggest ego boost: Compliments from patients and parents My biggest ego blow: Not being able to save everyone I’m happiest when: I am well fed and in good company My greatest fear is: Being attacked by pigeons and seagulls My motto is: I don’t really have a life motto, but hakuna matata is a good one A cause close to my heart: Providing medical care to underprivileged populations. I have done some volunteer medical work in Vietnam that has been extremely rewarding. Something I haven’t done yet that’s on my must-do list: Hang gliding. I also have an extensive list of must-see places including Morocco, S. Africa, Australia, India, Malaysia… If I wasn’t a doctor I’d be: Food connoisseur or writer for Lonely Planet
from top Dr. Nguyen white-water rafting in La Fortuna, Costa Rica; Zip-lining through the rainforest in Monteverde, Costa Rica; With her canine inspiration, “lovely Tuffy”; Volunteering in Dong Binh, Vietnam, with two of her favourite kids; In Cinque Terre, Italy.
38
Just For Canadian Doctors
September/October 2010
courtesy Dr. tram t. nguyen
s m a l l ta l k
doctors share their picks, pans, pleasures and fears
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