Just For Canadian Doctors Fall 2019

Page 1

fall 2019

life + leisure

DOCTORS

rafting in the far

north sipping in the land of

oz

Publications Mail Agreement #41073506

inside: Continuing medical Education Calendar where will you meet? s e at t le

/

lyo n

/

n ag pu r

/

ko b e

/

m os h i

>>


Save 20% to Attend Any of these Premier CME Conferences ENTER DISCOUNT CODE CD2019

PAIN CARE/PRIMARY CARE

NOVEMBER 15-16, 2019

Earn up to 22 CME/CE Credits

Optional, Addiction and Medical Cannabis Workshops November 14

ORLANDO, FLORIDA

PCPC-cme.com

MENTAL HEALTH

PRESENT

DECEMBER 8-10, 2019 ENCORE!

PSYCHIATRY UPDATE2019 SOLVING CLINICAL CHALLENGES, IMPROVING PATIENT CARE

Optional Workshops December 7

LAS VEGAS CPAACP-CME.com/site/Encore

MARCH 26-28, 2020

PRESENT

PSYCHIATRY UPDATE 2020 SOLVING CLINICAL CHALLENGES, IMPROVING PATIENT CARE

GYNECOLOGY

Optional Workshops March 25

CHICAGO CPAACP-CME.com

GENERAL SURGERY

2019

PELVIC ANATOMY and GYNECOLOGIC SURGERY SYMPOSIUM

LAS VEGAS DECEMBER 12-14, 2019

PAGS-cme.org

MARCH 16-19, 2020 LAS VEGAS

OPTIONAL HANDS-ON WORKSHOPS

MISS-CME.org

December 11, 2019

DERMATOLOGY 15th Annual

Coastal Dermatology Symposium ®

October 3-5, 2019 Seattle, WA CoastalDerm.org

January 21-25, 2020

Paradise Island, Bahamas CaribeDerm.com

NOVEMBER 7-9, 2019 Las Vegas

FEBRUARY 16-21, 2020

GlobalAcademyCME.com/SDEFLasVegasDerm

GlobalAcademyCME.com/SDEFHawaiiDerm

MAUI, HAWAII

In association with

To register and for complete information, including accreditation information, please see our websites.


Just for C

a

n

a

d

i

a

n

DOCTORS life + leisure

fall 2019

contents

fall 2019

Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Ann Britton Campbell Tim Johnson Lisa Kadane Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Catherine Tse Richard Warren Cover photo Callum Jackson

28

14

Senior Account Executive Monique Nguyen Account Executive Wing-Yee Kwong Production Team Ninh Hoang Annie Do

PHOTOS: ann britton campbell, south australian tourism commission; south australian tourism commission / Callum Jackson

CE Development Adam Flint

Sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

Just For Canadian Doctors is published four times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian doctors. 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 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada www.justforcanadiandoctors.com Printed in Canada.

award winS! Stories and photographs that appeared in this magazine (and sister publication, Just for Canadian Dentists) won multiple awards in the 2018 North American Travel Journalists Association Awards, including silver.

FEATURES

14 Due North on the Yukon’s mighty Tat and beyond 28 The magic of Oz and its wonderful world of wine COLUMNS

DEPARTMENTS

9 pay it forward

5 Fall mix 19 CME calendar 37 sudoku 38 parting shot

Working with Canadian Physicians for Aid and Relief (CPAR) in East Africa

11 the thirsty doctor Sour beer sampler

12 motoring The future is…flying?

27 the wealthy doctor

Lessons from the founder of the low-cost index mutual fund

32 doctor on a soapbox

Photo prescription

we’re social!

Find + follow us on social media: facebook.com/ justforcanadiandoctors @justforcanadiandoctors #justforcanadiandoctors @JFCDoctors

The leader in dealing with illicit drugs is…Portugal

cover photo In Australia it’s now spring. Here, in Southern Australia, you can amble among beautiful blooming almond trees in Onkaparinga River National Park and then sample the wine of McLaren Vale (page 28).

Fall 2019 Just For Canadian doctors

3


from the editor

Get wild

D

rifting down the Tatshenshini and Alsek Rivers past grizzlies and icebergs… Things get wild in Canada’s North, deep in the Yukon and into Alaska. As our award-winning writer (see below) says of her 11-day journey by raft (page 14), “…we see constant reminders that this land belongs to the wild things.” Besides a family of grizzlies, she spots tracks and crosses the paths of moose, award win! r Ann ite wr g wolverines, black tin ibu Contr ll won third Britton Campbe bears, peregrine t or Sp venture, place for Best Ad falcons, bald the Travel in re atu Fe on or Recreati n of Canada’s eagles, belted Media Associatio r story, Into for he kingfishers… annual awards s, oc Chic- Ch the Snow in the oh my! bruary /Fe ary nu Ja in the r sister On another 2018 issue of ou maga zine. continent—and far

south—is another kind of wild. In the wine region of McLaren Vale, in southern Australia near Adelaide, is the rather out-there winery d’Arenberg. Its cubist, futuristic structure is a destination itself, and it’s only one player in this happening area (page 28). We also explore the next automotive wave: flying cars…really (page 12). Get wayout in Woodstock (page 5). And follow Dr. Stan Mayer to East Africa (page 9), where he shares his experience working with Canadian Physicians for Aid and Relief (CPAR). From icebergs to d’Arenberg cubes, it’s a wild late summer and fall. And social. Check us out on Facebook (facebook.com/justfor canadiandoctors), Instagram (@justfor canadiandoctors; #justforcanadiandoctors) and Twitter (@JFCDoctors). Let’s chat! comments /questions : feedback@InPrintPublications.com

Intercontinental Trio in

French Polynesia $

3779 STARTING FROM

Per person, in double occupancy, based on any stay between Jan. 4 and March 31, 2020

INCLUSIONS:

P Meet/greet service upon arrival in Papeete P All ground transfers P Domestic flights P 1 night in a Standard Room at the Intercontinental Papeete P 3 nights in a Lanai Room at the Intercontinental Resort and Spa Moorea P 5 nights in a Beach Junior Suite at the Intercontinental Le Moana in Bora Bora P Daily American breakfast

courtesy of d’arenberg (2)

In the wonderland of McLaren Vale: d’Arenberg Cube (below) and a cubist-inspired dish at its awardwinning restaurant (page 28)

The InterContinental Tahiti Resort facing the island of Moorea boasts a private natural lagoonarium, 2 separate fantasy infinity pools with jacuzzi, its own dive center, an algotherm spa and many other activities. The InterContinental Moorea Resort & Spa is close to Opunohu Bay on the northeastern coast of the island, offering the widest range of onsite activities from original activities such as the Moorea Dolphin Center or sea turtle clinic, to more sporty ones like outrigger canoe and kayak. The Intercontinental Bora Bora Le Moana Resort is located on the main island and also on the mythical Matira beach. If you are looking for a true Polynesian experience, a romantic and intimate spot, and enjoy the traditional way of living, this is the place to be.

Price is per person, in $ CAD, in double occupancy. NOT INCLUDED: Gratuities to hotel personnel, guides and drivers · Optional excursions · Beverages unless specified in itinerary. For more information and to book, please contact The Travel Experts.

Red Label Vacations Inc – d.b.a. .© 2019 Exotik Journeys, B.C. Reg. #3597, Ont. Reg. #50022275, Quebec permit holder #703376, with offices at 5450 Explorer Drive, Suite 400, Mississauga, ON L4W 5N1 • 2355 Skymark Ave, Suite 200, Mississauga, ON L4W 4Y6 • 1050 West Pender Street, floor 22, Vancouver, BC V6A 3S7 • 325-1257 Guy street, Montreal, QC H3H 2K5. | A8821

1-866-359-7327 www.travelexperts.ca


what/when/where > Fall

style | food | drink | festivals | places | getaways | gear…

mix

concert tripping

woodstock (still) calling

big

Bethel Woods Center for the arts

the iconic three-day concert that brought peace + love to a grassy field

event

F

ifty years ago this past August, young people in numbers approaching half a million converged on a dairy farm in the Catskill Mountains of upstate New York. Traffic on the remote, rural roads was so intense most people simply abandoned their cars and walked for miles to reach the farm. Their aim was to hear a lineup of musical luminaries that included the Grateful Dead, The Who, Jimi Hendrix and Janis Joplin. Formally named “Woodstock: An Aquarian Exposition,” the three-day concert has long been considered a cultural touchstone of its time, an iconic moment with enormous symbolic weight for a generation who hoped to change the world through peace and love. >> Fall 2019 Just For Canadian doctors

5


mix

e pi c l ra c u ltui p tr

Fall

big event

(re)live woodstock

The music + magic play on at this legendary lawn in New York State

“T

6

Just For Canadian doctors Fall 2019

bethel woods center for the arts

grass act

hose were such turbulent times,” said Bobbi Ercoline of Pine Bush, New York, who also stated she’s the woman captured on film in a serendipitous moment one early morning during the concert hugging her then-boyfriend and now-husband, Nick, in an image that landed on the Woodstock album cover. “There was so much violence in the country, and yet there was none of it at Woodstock. It was exactly how they described it in their promotions—‘Three Days of Peace and Music.’” Summertime concerts still continue at the site, now called the Bethel Woods Center for the Arts. But the real draw is its world-class museum that chronicles both the 1969 concert and the tempestuous period of history it took place in. Ample film footage of the original concert can be viewed, as well as newsreels and documentaries showing events of the late ’60s. The walls are adorned with period posters, photos and artifacts from the time, like a mini-dress, bellbottom jeans, draft cards and protest buttons. There’s even a psychedelically painted Love Bug. Exhibits also give a sense of what happened during those three days in August, including an extreme lack of food and sanitation and the epic, monsoon-like thunderstorms that created so much mud the enormous stage actually slid several feet downhill. The music carried on, in spite of concerns that the performers on stage could be electrocuted by the lightning. The huge meadow where it all happened, shaped like an immense natural amphitheater, still sits outside the museum. Although it’s hard to envision the sea of humanity that once covered this quiet, grassy spot, it nevertheless continues to attract pilgrims from around the globe. “Not a week goes by I don’t have people stopping in before or after they’ve visited the site,” said Stacy Cohen, owner of the Catskill Distillery and Dancing Cat Saloon, just a thousand feet away on a narrow rural road. “Their eyes light up in wonderment when they find out I was there.” Bethel Woods celebrated the 50th anniversary of Woodstock from August 15 to 18 with a series of concerts by Ringo Starr, the Doobie Brothers, John Fogerty and Carlos Santana. Fogerty and Santana are veterans of the original concert. A special exhibit, “We are Golden,” will be mounted inside the museum—and events take place here year-round. According to Jorma Kaukonen, who performed at Woodstock as lead guitarist for Jefferson Airplane, “the struggle for positive possibilities as manifested by the Woodstock spirit is still with us.” Bobbi Ercoline hopes the anniversary and ongoing events capture some of the allure of the 1969 concert. “There was nothing unhappy about Woodstock,” she said. “There was so much sharing and caring. If we could get just a little of that back, that would be really good news. And doesn’t the world need more good news these days?” — Rich Warren

if you go The spirit of Woodstock lives on at Bethel Woods Center, which has ongoing

events as well as a museum dedicated to the historic event. bethelwoodscenter.org


shop local must list

Fall

Home made x 7

From Canada, with love

2 mane addiction From their sleek, apothecary-esque packaging to their charitable mandate, it’s easy to love AG Hair without even trying their products. But they’ve been amassing a loyal following since 1989 for their gentle shampoos, nourishing conditioners and powerful styling products that are all overachievers without using common, harsh ingredients like salt, paba, parabens and diethanolamine (DEA). aghair.com 3 skin deep Born from a need to find relief from significant skin conditions that required prescription medications, Bill Baker created Consonant Skincare. His skin responded to natural solutions so he developed a full range of premium 100% natural skin and body care products. In 2013, their high-performance hydration booster, HydrExtreme, won the grand prize at the Canadian Beauty Innovation Awards. consonantskincare.com

2

Written + produced by Catherine Tse

Canuck chic

1 Canadian Sole Seventy years strong and still owned by the same family in Burlington, ON, Cougar Shoes has become a Canadian icon. Best known for their “real Canadian” winter boots, don’t overlook them the rest of the year. Their warmerweather collections are lighter and sleeker but every bit as comfortable and designed for “real Canadian” summers and falls— hiking, biking, camping (they’re great travel and resort wear too). cougarshoes.com

mix

4

3 1

6

7 5

4 Beauty Sleep Led by a small, independent, female-founded Canadian team, Flax Sleep brings French linen into your bedroom. Cozy yet cool, more resilient than cotton and less damaging to the environment during milling, linen also has the aesthetic power to transform your bedroom into a layout from a home in French Vogue. flaxsleep.com 5 A Cut Above Turning a passion into a side business, Brad Carlyle is taking his 17 years in the woodworking industry and creating beautiful pieces of furniture, from cutting boards to dining tables. Whenever possible, he tries to use reclaimed wood or offcut pieces of lumber, bits that would otherwise be discarded, and reworking them into works of functional beauty. bradcarlyle.com

6 Beauty Within Michelle Obama is a fan of withinUs’ collagen products, especially the ReHydrate formula with added electrolytes that help her recover from jet lag. The brand’s core collagen powder can be mixed into any drink or comes premixed with other formulations such as matcha or coconut creamer. Again: Michelle Obama is a fan. withinus.ca

7 Oh, Baby! Founded by twin sisters, Eleanor Lee and Angel Kho, Louloulollipop designs beautiful products that withstand the most extreme stress testers: babies. From wood and silicone teething jewelry to stunning muslin quilt blankets that depict various international cities, including several in Canada, this is a brand destined to create a new generation of heirlooms. louloulollipop.ca Fall 2019 Just For Canadian doctors

7


Remind your migraine patients about RELPAX

RELPAX is indicated for the acute treatment of migraine with or without aura in adults.

© 2019 Pfizer Canada ULC, Kirkland, Quebec H9J 2M5

TM and ® are trademarks of Pfizer Inc. or its affiliates and are used under licence by Pfizer Canada ULC. ® Pfizer Inc., used under license. RELPAX ® Pfizer Products Inc., owner/Pfizer Canada ULC, Licensee

PP-PFO-CAN-0093-EN

Consult the Product Monograph at http://pfizer.ca/pm/en/RELPAX.pdf for contraindications, warnings, precautions, adverse reactions, interactions, dosing, and conditions of clinical use. The Product Monograph is also available by calling 1-866-463-6001.


pay i t f o r w a r d r o b e r ta s ta l e y Roberta Staley is a Vancouver-based magazine writer, editor and documentary filmmaker.

When you purposely prescribe the original brand RELPAX, help make sure your patient gets it.

1 Write the Pfizer original brand name, RELPAX, and include “no sub”, when appropriate, on your patient’s prescription.

2 Remind your patient to ask for the original brand RELPAX at the pharmacy.

3 Encourage your patient to visit the Pfizer Originals Program website at PfizerOriginals.ca for tips on how to ask for their Pfizer original brand medication.

PfizerOriginals.ca

Stranger things

Working with the Canadian Physicians for Aid and Relief

I

n 2017, Dr. Stan Mayer of Calgary was working in the emergency department of Fitche Hospital in Ethiopia when a mother brought in her six-month-old infant. The baby, she complained, was spitting up blood. Mayer began to tick off possible diagnoses. Could it be tuberculosis? Could the mom have a breast infection? Then, an Ethiopian colleague, fresh out of medical school, went over to the baby and peered into its mouth. His diagnosis was immediate—and puzzling. “Leech,” he told Mayer. “What do you mean, ‘leech?’” responded Mayer, who was at Fitche Hospital as a volunteer with Canadian Physicians for Aid and Relief (CPAR). “You get leeches from swimming in dirty water in a lake.” The Ethiopian doctor explained that people from the area around the town of Fiche, about 150 kilometres north of Ethiopia’s capital of Addis Ababa, often obtained their drinking water from ditches, scooping it up in 20-litre buckets to carry home. The foul, polluted water is full of leeches; obviously the infant had been given some to drink and unwittingly swallowed the parasite, which uses its teeth to attach to a host and feed on its blood. The cure ended up being as straightforward as the diagnosis. After administering a bit of inhaled anesthetic to the baby, a fat, four-centimetre-long worm was carefully extracted from the infant’s throat, Mayer says. The squirm-inducing affliction is but one of myriad diseases and ailments that medical staff at Fitche Hospital confront

on a daily basis. Diagnosis and treatment can be infinitely more challenging than in Canada, where hospitals are stocked with medications and well-trained staff operate high-tech diagnostic equipment. At Fitche Hospital, there are no Intensive Care units and basic blood tests are sometimes unavailable. Electricity and the water supply are often interrupted. When Mayer was there, the emergency department was small, the stretchers dirty and the equipment “very basic.” Since then, CPAR has renovated the ER, providing such equipment as infusion pumps, a defibrillator and an electrocardiogram machine, as well as rehabilitating the water system. Fitche Hospital has only a few specialists: an internist, one surgeon and one OB/GYN, in addition to nurses and health technicians whose basic knowledge, while excellent, might not include emergency skills such as advanced trauma life support, Mayer says. And, since there are no orthopedic surgeons, compound fractures must be transferred by road to a hospital in the capital of Addis Ababa, he adds. Upwards of 200 patients—about one quarter of these emergencies—come seeking help on a daily basis. They are from the town of Fiche itself as well as the surrounding catchment area, home to 1.5 million people. The three main afflictions are infectious diseases, respiratory illness and trauma from car accidents, fights, or, in the case of one boy, a severe brain injury sustained from falling off a horse. Mayer’s work with CPAR included not only

“It is the dedication and commitment of many that has led to the success of numerous projects and the longevity of the organization,” says Dr. Mayer of the work that CPAR has done for more than three decades in East Africa

Fall 2019 Just For Canadian doctors

9


pay i t f o r w a r d

r o b e r ta s ta l e y

training staff through mentoring, modelling and teaching critical medical skills related to these problems but strengthening the healthcare system by enhancing policies and processes. Building staff skills and knowledge is a long-term process. CPAR is in the third of a five-year Healthy Communities Project: ER Interventions in Fitche Hospital. In partnership with Selale University in Ethiopia, CPAR is establishing standardized teaching modules and initiating a sepsis research project in collaboration with physicians from the universities of Maryland and Calgary as well as John Hopkins. The body’s response to overwhelming infection, sepsis can quickly lead to multisystem organ failure. It is a common presentation at Fitche but often underrecognized and “not managed optimally,” Mayer says. As challenging as hospital care can be, Mayer says, the greater difficulty is addressing the underlying, systemic issues causing these afflictions. Diarrhea, for example, is “a big killer that is directly related to poor sanitation, no access to potable water and resulting malnutrition,”

THE REVOLUTIONARY

SeeMore™ Ultrasound Imaging System

SiMPLi Series linear and convex array probes

The affordable must-have tool for your office. Just plug the probe into the USB port of your Windows laptop, tablet or desktop and turn your computer into an ultrasound machine.

Call to order yours today! 1.800.927.4687 604.922.0874 info@seemore.ca seemore.ca SeeMore™. Do more. For your patients. Just for Canadian Doctors 10 Just Forx 4.875” Canadian doctors 1/6 Vertical : 2.25”w h FEB 2018

Fall 2019

says Mayer, who works in the emergency department of Rockyview General Hospital in Calgary and undertakes locums in rural Alberta when he’s not volunteering. Such social, environmental and economic realities drive CPAR’s multipronged approach in Ethiopia, which is to provide medical support and training as well as undertake initiatives that are guided by the United Nations Sustainable Development Goals principles, adds Mayer. CPAR first arrived in Ethiopia in 1984 when a calamitous famine killed 1.2 million people and left 200,000 children orphaned and 2.5 million internally displaced. Mayer says that droughts and famines have been part of Ethiopia’s history for millennia and the implementation of development projects by CPAR enhances the “resiliency

Dr. Stan Mayer (left) worked with Ethiopian general practitioner and surgery resident Dr. Andualem Senay at Fitche Hospital.

and capacity of the population so they can better face the next natural-disaster emergency.” This includes plans to change agricultural practices to ensure food security, says Mayer, who also volunteers with the Red Cross in places like Nepal, Bangladesh and Mozambique. Mayer finds his volunteer work “inspiring and reenergizing. You look at the adversity of what people live with and their resiliency and compassion and the care they have for one another and how they maintain their sense of humour. We could learn a lot.”

courtesy of Dr. Stan Mayer

INTRODUCING


the thirsty doctor lisa kadane Lisa Kadane is a newspaper and magazine writer who likes to travel and partake in the destination’s preferred tipple, whether it’s rum, wine, a margarita or whisky sour. She’s been sharing her thoughts on spirits and cocktails since 2010.

Pucker up for sour beer

The latest suds trend is fruity, refreshing and best for those who don’t like beer

from left: courtesy Halcyon Barrel house; Blake ford; Dandy Brewing co.

I

tried my first sour beer by accident at Una Pizza + Wine in Calgary. I decided that a fruity, lambic-style beer from Belgium sounded about right for a late lunch on a hot day. It arrived in a bottle with its own little cork. I poured, sipped, and was in awe over the nuanced, cherry-leaning, tart-but-still-beery fluid. I was hooked. I had stumbled upon my preferred beer style: sour (and preferably fruited). The original brewers from centuries ago probably chanced upon it as well. They stored their ale in barrels and—like milk sitting around at room temperature— naturally occurring bacteria caused it to sour as the beer aged. “There wasn’t as much knowledge of microbiology back then, so a lot of beers did turn sour,” confirms Bryce McBain, brewmaster for Halcyon Barrel House in Vankleek Hill, ON. This natural process spells trouble for dairy, but if you’re like me—a not-veryenthusiastic beer drinker who avoids bitter, hoppy brews—then purposefully using bacteria and yeast to sour and funk up beer as it ferments and ages (a process that traditionally takes months) is probably the best thing that’s ever happened to it. McBain thinks it’s pretty great, too, and Halcyon Barrel House focuses almost exclusively on mixed fermentation, barrel-aged, wild and sour ales. The Echo Chamber, for example, is a pleasing mix of crisp, tart apple, light hop and beery fizz. The iconic Gravity Well, aged in red-wine barrels, is dark and malty, with notes of

2 A Single Branch, Wild Ambition Brewing: Dry and sour, with apple and cherry flavours at the fore, this fruited sour is perfect for patio season.

Their barrel-aged red sour with cherries, called A Single Branch, is fermented in oak for five months before being re-fermented with sour cherries sourced from an orchard in nearby Oyama. The result is a cider-like beer, with crisp apple and cherry notes that balance the tart taste. Also approachable is Blending In, a bière de coupage with a dry hop that melds a cloudy, grapefruit-y sour with just a touch of beer’s bitter taste. “The response has been better than we expected,” says Kehoe, though he admits with a laugh that a few customers have accused their beer of not actually being beer. This happens a lot when people first try sour beer, says Benjamin Leon, co-founder of The Dandy Brewing Company in Calgary. “It’s beer, but it’s a whole new experience for beer,” says Leon, who recommends one of Dandy’s American-style kettle sours for customers who dislike beer—like the flagship Wild Sour Ale, a blonde kettle sour with appealing hopped grapefruit notes. Equally crushable is the Session Plum Sour, with a slightly tropical taste and hint of guava. Leon points out that Dandy’s sours are not made in the Belgian style. Created in stainless steel kettles, they sour quickly before fermentation in a process that takes days, not months or years. “We don’t want to hide what we’re doing,” says Leon. “It’s a very distinct style within the sour umbrella.” But no matter how breweries are making them, sours are here to stay. Says Leon: “There are a lot of people out there that, now they know sour beer exists, it’s their drink of choice.”

3

1 2

3 Wild Sour Ale, The Dandy Brewing Company: Sour, funky and hoppy, you’ll taste grapefruit and hints of white wine in this Dandy classic.

Fall 2019 Just For Canadian doctors

Try these sour beers

1 Gravity Well, Halcyon Barrel House: Sour, dark and malty, with plum, cherry and red wine notes, this beer might change your life.

plum, cherry and red wine that balance its sour soul. They’re perfect for late-summer patio sipping. Though sour beers are the latest taproom darlings, showing up in tasting rooms from Vancouver to Halifax, they’ve been around for centuries. The Belgians have perfected the process and their bestloved styles—lambics, Flanders reds and oud bruins—have become the benchmark by which other sours are judged. As with most Euro-trends, North Americans have been slow to catch on. After decades of bland macro beer, craft brewers began to up the ante with darker ales, bitter IPAs and now sours. “Sour beers were never popular in the Americas until recently and I think that has to do with the emergence of craft beer and craft brewers,” concurs McBain, who first tried a Flanders red from Belgium 15 years ago and was smitten. “We were inspired by those beers and wanted to take a shot at making them ourselves.” The challenge of making beer in the Belgian farmhouse style also appealed to Mitchell Kehoe, brewmaster at Wild Ambition Brewing in Kelowna. Kehoe and partner Teresa Cashen opened the small brewery and tasting room in an industrial part of the city—just off the Okanagan Rail Trail—in late 2018 with the idea to make all of their beers mixed fermentation ales. “I originally was a home brewer and I got into this style because I couldn’t just walk down the street and get beers like these,” says Kehoe.

11


motoring

D r . k e l l e n s i lv e r t h o r n Dr. Kellen Silverthorn is Just For Canadian Doctors’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

Siri, bring me my flying car

F

lying cars are the third in the trifecta of automotive futurism—after electric cars and autonomous vehicles. Electric vehicles (EV) already appear to have unstoppable momentum. And I wouldn’t bet against autonomous vehicles (AV) over the longer run either. But flying cars? Flying cars (FC) introduce a whole other dimension, literally, to daily transportation. Ponder for a moment where you live; if telephone poles, streetlights, tall trees or buildings would easily accommodate flight paths from your driveway in the family FC? Now add multiple propellers or jet engines to the mix. If we agree to dismiss FCs as flights of fancy, can we envision and accept Amazon delivering a FitBit by drone or Domino’s a cheese pizza? I’ll bet the answer is “maybe?” The gulf between the delivery drone that we (might) accept and the FC that we (likely) struggle with, is one of scale— and whether humans are aboard. Several realities are begging for disruption by flying cars. The first is gridlock by automobile commuters in major cities. Mass transit is a partial solution, though not taking quantum leaps forward anytime soon. Scooters and bikes work in some countries but not so much in snow, nor single-familydetached suburbia. Time lost, frustration and greenhouse gases emitted by those caught in today’s traffic have significant cumulative consequences for society. Short-haul commercial air travel also begs for disruption. I live on an island with 700,000 others. The flight time to the mainland is about 12 minutes at over 300 mph. Progress once airborne isn’t the issue. However, the commercial air industry sucks three hours of non-productive ground time from each individual who takes that oneway flight. Six hours if it’s a return trip. Ticket costs are also excessive. Disruption awaits! Intriguing is who among the 130 companies is spending research dollars in the FC space. We’ve got titans of airplane and aerospace (Boeing, Rolls Royce, Airbus, Bell), Silicon Valley types (Apple, Google,

12

Just For Canadian doctors Fall 2019

Amazon), as well as ride-hailers (Uber, Lyft). Car companies too: Audi, BMW, Tesla, General Motors, Toyota. The nationalist trend is also upheld by France, Netherlands, ItalDesign, Slovakia, the United States (Kittyhawk, TerraFugia) and especially China (Ehang, Yuneec, Lilium). Several of these have demonstrated early prototypes. Just like with AVs, FCs will need years of development, with human pilots ready to assume control during protracted machine learning. Taxi-like FC services will

also precede being able to order your own FC from Amazon or Apple. And we’ll need early-adaptor jurisdictions willing to work with FC companies to perfect the product and its integration into the transport system. Many thought the lack of willing jurisdictions—and willing insurance companies too—would prevent AVs from moving forward. That proved incorrect. The new AV industry brought with them high-tech jobs and smart young people. Cities competed to host AV programs from technology companies. FCs should enjoy a similar welcoming path. Key personalities will also be important. In EVs, Elon Musk of Tesla has been “that guy.” In the AV sphere there are a few candidates for “that guy,” including Musk again, but with Waymo now the acknowledged leader in bringing true AVs to market, I would argue that Sebastian

Thrun should be so-crowned. Of note, Thrun is also CEO of the FC start-up Kitty Hawk, and Musk is no stranger to aerospace moonshots. Ideally, FCs will incorporate many of the advancements underway in EVs and AVs. Progress in EV battery-energy-density will allow future generations of FCs to be cleaner and quieter battery-powered. Future AVs will provide the coding scaffold to render FCs pilot-less. The 130 FC companies, and their host countries, could agree on relevant standards prospectively, so we don’t repeat the Sony Beta versus VHS confusion. Huge challenges await the FC. The regulatory framework could stop the industry in its tracks. And yet it hasn’t stopped AVs. Several countries will steamroll their NIMBYs if the reward is leadership in a game-changing transportation (and military) revolution. (See “Made in China 2025” policy to steer away from cheaper factory-produced products to higher-value goods and services). Everyone who builds cars or aircraft today, or owns an airline, is like the horse-stable owner of circa 1898. Disruption awaits! Unit costs could also hamstring the industry. Flying cars will eventually need to cost little more than today’s new cars. Said FCs should still function on the ground equivalent to today’s conventional light vehicles. Not all trips will call for flight, and completing the changeover of the nation’s fleet from conventional cars to FCs could take decades. Integrating EVs and AVs into the transportation system of the developed world will be child’s play compared to integrating FCs. The Rubicon of trees, hydro poles, streetlights and the like will have to be crossed. That first 100 feet— and last 100 feet—of FC elevation will be critical to the industry’s success. Safely integrating FCs into our communities will significantly alter how they look and feel. Disruption awaits!

istock

Unlocking your inner George Jetson and tapping in to automotive futurism


Use ASPIRIN® to Help Your Patients Prevent Secondary Thrombotic Events Demonstrated %

26-28 REDUCTION

in the combined endpoints of MI, stroke, and vascular deaths with ASPIRIN® alone in patients with vascular disease (at doses of 75 to 325 mg daily)1

ASPIRIN®—Recommended for Secondary Prevention Following ACS Canadian Cardiovascular Society Guidelines2 “For all patients with ACS who survive to hospital discharge, indefinite therapy with low-dose ASA (75-162 mg daily) is recommended (Class I, Level A).” ASPIRIN® is indicated for: • Reducing the risk of transient ischemic attacks and for secondary prevention of atherothrombotic cerebral infarction. • Reducing the risk of vascular mortality in patients with a suspected acute myocardial infarction. Please consult the Product Monograph available at www.bayer.ca/ omr/online/aspirin-pm-en.pdf for information to assist in the benefit-risk assessment. Always direct the patient to read the label. The Product Monograph is also available upon request at 1-800-265-7382.

ACS = acute coronary syndrome; ASA = acetylsalicylic acid; MI = myocardial infarction. References 1. Bayer Healthcare. ASPIRIN® Product Monograph. April 13, 2017. 2. Bell AD, Roussin A, Cartier R, et al. The use of antiplatelet therapy in the outpatient setting: Canadian Cardiovascular Society Guidelines. Can J Cardiol. 2011 May-Jun;27 Suppl A:S1-59.

ASPIRIN is a registered trademark, used under licence. © 2019 Bayer Inc., Mississauga ON L4W 5R6 L.CA.MKT.CC.07.2019.1512


travel at home

Where the Wild Things Are Rafting the Tatshenshini and Alsek Ri vers in Canada’s North story

+ photography by Ann Britton Campbell

Soaring mountain peaks, glaciers, and icebergs on Alsek Lake make the Tatshenshini and Alsek river trip one of the world’s most breathtaking

14

Just For Canadian doctors Fall 2019


T

The grizzly bear emerges from the bush on the banks of Melt Creek, its low-slung head swinging side to side as it lumbers toward the swift-moving water. Two cubs follow, as oblivious as their mother to the fact that 15 slightly freaked out river rafters are watching from the opposite shore. Moments earlier Brad, lead guide on this 11-day Canadian River Expeditions rafting trip down the spectacularly remote Tatshenshini and Alsek rivers—from Dalton Post in southern Yukon, across the northwestern tip of British Columbia to Dry Bay, Alaska—interrupts a lazy afternoon around camp with a clarion call. “Everyone together. Here. Now!” We drop our books and campfire-side conversations and double-time it to where Brad and fellow guide Tyler stand overlooking the creek. We’re thrilled to see the bears and slightly crushed when we realize only Edna has a camera, and it’s a modest pointand-shoot. Tyler reads our wildlife-photo-obsessed minds and gives the order: “No one goes to their tents to get their cameras.” A third guide, Alene, returns from a sweep of camp (including the out-of-theway outdoor toilet) and confirms all 12 guests are assembled. The guides coolly unclip their bear bangers (noisemakers to launch above the bears’ heads should we need to scare them away) and bear spray (should the situation become dire). Note, we do not have a gun. We watch with mounting concern as the mother grizzly enters the glacier-fed creek and begins paddling toward a point of land 100 metres upstream from us. The cubs plunge in behind her and are quickly overwhelmed by the strong current. The mother spies her flailing offspring and launches toward them. With a powerful sweep of her forelegs she gathers in the cubs and heads back to the far shore.

clockwise, from top left

Glaciers hang between mountains, forming part of the largest icefields in the world outside the Poles; Rafts carry guests, gear and supplies for this epic 255-km river journey; Wildlife viewing parties, complete with binoculars and spotting scope, are near-daily affairs; The Fairweather Range, home to Mount Fairweather, BC’s highest peak at 4,663 metres, provides a dramatic backdrop for the final day on the Alsek River; Bocce is a rough-and-tumble affair; River guides including Brad (left) and Tyler keep spirits high and stomachs full with impressive riverside meals; A hike up Gateway Knob leads to a lookout over Alsek Lake September/October 2019 Just For Canadian dentists

15


travel at home The flight back to civilization includes bird’s-eye views over Glacier Bay National Park’s Alsek Lake and its glaciers below, from left Camp life includes time for reading and contemplating the spectacular surroundings; bear claw scratches are reminders that this remote wilderness is the bears’ playground

if you go

take the raft tour For more on Canadian River Expeditions’ Tatshenshini rafting trip: nahanni.com/river/ tatshenshini-river. explore farther To discover other adventures in the Yukon: travelyukon.com.

16

Just For Canadian dentists September/October 2019


travel at home Our collective sigh of relief is shortlived as the mother does a wet-dog shake on the gravelly bank and heads back to the water for a second try. Thankfully the cubs want nothing to do with it and head for the bush. The mother grizzly turns, sees her offspring disappear, and follows. With the danger passed, we all begin talking at once—loudly, excitedly, and with more than a little adrenaline coursing through our veins. It’s obvious that, although a deep desire to connect with pristine wilderness is why many of us signed on to this trip, few were prepared for how intense those wild encounters might be. Not that Meta Williams didn’t warn us. We meet Meta on our first day when the van shuttling us from Whitehorse to our launch site stops at Kwäday Dän Kenji, Long Ago Peoples Place. Meta leads our merry band of adventurers—eight Ontarians, two British Columbians and two Brits, ranging in age from 14 to mid-70s, as well as three guides—through a recreated traditional First Nations village. Along the way she shares stories of how her people have survived on the land for thousands of years. “We let the wilderness know we are here,” she says, explaining the importance of being heard in the bush. She stresses respect for bears. “We are in their playground.” In fact, over our 11 days, as the Tatshenshini grows from little more than a creek to a swift, broad, braided river that joins the mighty Alsek before emptying into the Gulf of Alaska, we see constant reminders that this land belongs to the wild things. Silty riverbanks are tattooed with moose, wolverine, black bear, grizzly and other predator and prey tracks. Bear claw scratches and snagged tufts of hair adorn spruce and aspen trees. Fresh scat with flecks of red berries serve as warning signs on the trails and open spaces we explore. Peregrine falcons, bald eagles, belted kingfishers and the like take wing above us. Exquisite blankets of wildflowers—pinky-purple River Beauty, magenta fuchsia, cottony mountain avens—are trampled in spots, suggesting creatures great and small have passed through. And what a stunning landscape it is to pass through. The Tatshenshini and Alsek rivers carve a verdant corridor through the peaks and glaciers of the St. Elias Mountains, home to the most extensive non-polar ice fields in the world. Hardly a day goes by that we aren’t ohhing and aahing over distant hanging glaciers or snowcapped mountain peaks or getting a close-up look at the effects of glaciation, none more vivid than the day we hike to the jagged, crystal-blue face of Walker Glacier.

Unfortunately (and surprisingly for a summer trip) there aren’t many days that don’t also include rain. We try to stay upbeat about the weather and make the most of every sunny break, to dry our gear, to hike and to play killer games of bocce. Certainly the guides keep us well fed, impressing us with blueberry pancakes, eggs Benedict and freshbaked cinnamon buns for breakfast, salads, sandwiches and, on one special day, elk sausage hot dogs with sauerkraut for lunch and hearty dinners such as lamb souvlaki with spanakopita and a Chinese-Canadian themed spread with chicken chop suey, spring rolls and fortune cookies. But there comes a moment on this soggy trip, after rain showers silence another round of optimistic chirping that maybe, surely, possibly the weather is improving, Keith suggests a drinking game. “One slug for each time someone says ‘it’s clearing.’ Two slugs if someone says ‘I see blue sky.” Thankfully, on day 10 we wake to bright, blue skies and fill our memory cards on a leisurely paddle amongst icebergs that float like ginormous white and aquamarine ice sculptures on Alsek Lake. Kent jokes, “I’ve got three pictures of trees, one of bears and 800 of icebergs.” Distant booms and thunder-like

rolls dial up the drama as enormous chunks of ice, some as large as apartment buildings, calve from the Alsek and Grand Plateau Glaciers and drop into the lake. In the afternoon we must wait for ocean-like waves caused by calving to subside before we can scramble along the vegetation-choked shoreline and up a steep, slippery path to a lookout on Gateway Knob. Brad describes the spot as “the best place in the world.” Looking across the icebergchoked lake to the massive glaciers and mountain ranges beyond, I have to agree. On our final day we enjoy a rare, clear view of the 4,600-metre-high peak of Mount Fairweather as we pack the rafts one last time and paddle alongside chunks of ice to our river journey’s end. There is one last thrill as our chartered aircraft takes off from Dry Bay’s grassy runway and circles up and up and up again so as to gain enough altitude to clear the mountains that lie between us and Whitehorse. I marvel at the on-high views of the majestic glaciers, soaring peaks and expansive river valley through which we travelled and imagine that, far below, I can spy a certain glacier-fed creek where a mother grizzly is teaching her cubs to swim.

Dragon® Medical Practice Edition 4 (this is the version you’ve been waiting for) Upgrade to cutting edge speech technology!

Dragon Software Installation & Support EMR Integration & Training

CONTACT US TODAY! speakeasysolutions.com

1-888-964-9109

speech technology specialists for 18 years Fall 2019 Just For Canadian doctors

17


Three Provinces, One Amazing Journey Nova Scotia, New Brunswick, Newfoundland & Labrador

Roosevelt Campobello International Park

Cabot Trail, Cape Breton Island

Sable Island

© M. Valberg, K. Bogner, D. Minty, D. Tangney Jr

Atlantic Canada Explorer June 15–26, 2020, aboard the 198–passenger Ocean Endeavour Discover the lively culture and surreal coastlines of Canada’s east coast in the comfort of a small expedition ship. Gaze at the wonders of Cape Breton, Digby Neck and Brier Island—by sea! Embark on guided hikes through the Acadian forest to stunning viewpoints, spot whales in nutrient-rich waters and witness the high tides of Bay of Fundy. Other highlight stops include old town Lunenburg (a unesco World Heritage Site)—and historic Fortress Louisbourg!

Learn from regional experts on board and on shore. Explore everything from local history to politics, arts, science and culture. EARLY BIRD SAVINGS SAVE 15% on 2020 trips when you book before October 31, 2019. Terms and conditions apply.

CALL FOR DETAILS

1.800.363.7566 adventurecanada.com Canadian-owned and operated since 1987 55 Woodlawn Ave, Mississauga, ON L5G 3K7 Canada, TICO Reg# 4001400


seattle

/

lyon

/

nagpur

/

kobe

/

moshi

|

calendar

cMe

A n intern ation a l guide to con tinuing medica l Education

fall 2019 + beyond

seattle

clockwise, from top left Nature and industry and stellar views of downtown Seattle at Gas Works Park, where an old coal gasification plant is now an art-like relic

on the shores of Lake Union; mandatory beer sampling at Fremont Brewing, in the “centre of the universe”; biking through Seattle Art Museum’s outdoor sculpture park on the Elliott Bay Trail; along the Burke-Gilman Trail; the Fremont Troll; Sir Mix-a-Lot at the Graduate Hotel in the University District

off to the emerald city Take a spin in Seattle (CME events in Seattle are in blue.)

barb sligl

T

he Emerald City is a fitting name for this shimmering—and, yes, green—metropolis of the Pacific Northwest. Trees and water temper its high-tech, corporate side (behemoths Microsoft, Starbucks, Amazon and Boeing are all based here) for a very west coast vibe; locals bike on single speeds and public e-bikes in a network of dedicated bike lanes, and there’s such a high concentration of microbreweries (each with its version of IPA, of course) that Seattle vies for beer capital of the US. Set up base downtown, near the Rem Koolhaasdesigned glass prism that’s Seattle’s Central Library. A few blocks from this futuristic glass edifice is the Alexis (alexishotel.com), an old-school building that harks back to the city’s Gold Rush days, when it was a treasurer’s office. Today, the Kimpton property is a hip hideaway close to Pioneer Square and the Seattle Art Museum and its outdoor sculpture park on the shores of Elliott Bay, just below the famous Pike Place Market.

Hop on one of the Alexis’ complimentary bikes (a cool Public bike, inspired by classic Dutch two-wheel design) and pedal up the city’s new Second Avenue Bike Lane (complete with footrests and handrails for cyclists at intersections) through Belltown (past funky bars and shops) to Seattle Center (seattlecenter.com), where there’s a Chihuly garden (the famous glass artist is a Seattle native), the Museum of Pop Culture (the Gehry-designed steel structure is said to resemble a melting guitar; an appropriate symbol for the home of grunge music, perhaps) and the iconic Space Needle. From here, go north and cross the canal at the Chittenden Locks (linger for some mega-yacht watching) to the historic ’hood of Ballard, where fishing and Nordic roots are strong (check out the swish new Nordic Museum). Ride along the much-beloved Burke-Gilman Trail, a bicycle path that’s one of the original rail-to-trail conversions and now used by thousands of commuters and day-trippers—everyday. Go west to Golden Gardens

Park for some beaching and then back east into Fremont, known as the centre of the universe…really (there’s even a proclamation that’s been ratified by the city council). Visit the Fremont Troll, who lives under the Aurora Bridge (a legendary public art installation), have an IPA at Fremont Brewing’s (fremontbrewing.com) hopping beer garden and then continue towards the University District, home of the University of Washington (or U-Dub, as locals call it). En route, Gas Works Park, where a rusting coal gasification factory is being reclaimed by [go] the greenery, is a prime picnic spot overlooking More info: Lake Union and the skyscrapers of downtown visitseattle.org Seattle on the far shore, where you started. Or, even better, join the Mountaineering Club at the U District’s Graduate hotel (where rooms pay homage to another local legend: rapper Sir Mix-aLot; graduatehotels.com/seattle), a rooftop bar where the views include yet another Seattle behemoth: Mount Rainier. Order an IPA, sip, stare, repeat. — Barb Sligl

Fall 2019 Just For Canadian doctors

19


calendar

topic

sponsor

contact

website

Oct 11-13

Newark New Jersey

Level 1 Certificate Course In Aesthetic Medicine

American Academy of Aesthetic Medicine

619-357-2423

aaamed.org

Oct 25-26

Toronto Ontario

Canadian Association Of Aesthetic Medicine 16th Annual Conference

Canadian Association of Aesthetic Medicine

604-239-2226

caam.ca

Nov 08

Las Vegas Nevada

Workshop 1: The Perfect Aesthetic Look - Stem Cells With An Artistic Application By Dr. Steven Warren

American Academy of Aesthetic Medicine

619-357-2423 See Ad Page 21

aaamed.org

Nov 08

Las Vegas Nevada

Workshop 2: Marketing Management Certification Program For Aesthetic Clinic Owners And Aesthetic Clinic Managers By Mrs. Manon Pilon

American Academy of Aesthetic Medicine

619-357-2423 See Ad Page 21

aaamed.org

Dec 02-15

Dallas Texas

14 Days Cosmetic Lasers, Injectables & Medical Aesthetics

National Laser Institute

800-982-6817

nationallaser institute.com

Oct 19-23

Orlando Florida

Anesthesiology 2019

American Society of Anesthesiologists

844-403-0896

asahq.org

Nov 04-07

Sedona Arizona

Sedona Red Rock & Grand Canyon Adventure 2019 Encore Symposium

Encore Symposiums

877-372-7627

escrnas.com

Feb 01-08 2020

Aspen Colorado

Aspen Anesthesia Seminar

Holiday Seminars

877-859-0550

holiday seminars.com

May 04-07 2020

New Orleans Louisiana

Cornerstone Anesthesia Conferences

281-836-0777

cornerstone anesthesia conferences. com

May 14-18 2020

San Francisco California

International Anesthesia Research Society Annual Meeting AUA - May 14 - 15 SOCCA - May 15 IARS - May 15 - 18

International Anesthesia Research Society

415-296-6924

meetings.iars. org

Oct 24-27

Montréal Québec

Canadian Cardiovascular Congress 2019

Canadian Cardiovascular Congress

866-317-8461

cardio congress.org

Dec 04-07

Los Angeles California

17th Annual World Congress On Insulin Resistance, Diabetes, And Cardiovascular Disease 2019 (WCIRDC 2019)

Metabolic Institute of America

818-342-1889

wcir.org

Feb 05-07 2020

La Jolla California

9th Annual Structural Heart Intervention And Imaging 2020

Scripps Conference Services & CME

858-678-6400

scripps.org

Feb 29Mar 10 2020

New Zealand Cruise

Preventive Medicine, Preventive Cardiology, Cardiometabolic Medicine, And Advanced Lipidology

Continuing Education, Inc./University at Sea

866-456-9464 See Ad Page 39

continuingedu cation.net

Apr 02-05 2020

Porto Portugal

6th International Meeting On Cardiac Problems In Pregnancy 2020

Paragon Group

27-0-87-4700365

cppcongress. com

1980

CE

CR

S

Since

AR

E/

• Taiwan, Philippines, Borneo & Indonesia • Eastern Caribbean Islands on Crystal Serenity • Yachting the Seychelles Islands

IN

Visit our website for more exciting trips!

CM

Healthcare Perspectives from Down Under January 10 – 26, 2020

CIETY

New Zealand & Australia Land Program

L EDUCATIO NA N IO

SO

Professional Education Society — CME/CE Cruise & Travel Seminars

SE

M

new CE to Anesthesia Update In The Easy beBigplaced

SS

Cardiology

Anesthesia

Aesthetics

cme when where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

PROFE

cme

UI

SE & RAVEL T

West Coast Culinary Cruise on Windstar Southern France on Uniworld Medical Seminar at Sea & Well-Being Updates May 5 – 15, 2020

Medical Symposium Confronting Healthcare Needs July 19 – 26, 2020

Norwegian Fjords on Holland America Egypt & the Nile on Uniworld Medical Seminar at Sea & Scandinavian Healthcare June 7 – 21, 2020

info@PEStravel.com 20

Just For Canadian doctors Fall 2019

Sleep Medicine & Effective Planning for Healthy Aging October 31 – November 11, 2020

Call Toll Free 877-737-7005

www.PEStravel.com

a divisio


MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

Emergency Medicine

Diabetes

Dermatology

Collaborative Health

cme when where

calendar

cme

topic

sponsor

contact

website

2019 Academy Of Integrative Health & Medicine Annual Conference

Academy of Integrative Health & Medicine (AIHM)

858-240-9033

aihm.org

888-995-3088

acam.org/ 2019Meeting

Oct 12-16

San Diego California

Oct 17-19

Nashville Tennessee

Updates In Collaborative Functional Medicine

American College for Advancement in Medicine & American Academy of Physiological Medicine and Dentistry

Oct 03-06

Budenheim Germany

16th International Workshop On Langerhans Cells

Conventus Congressmanagement & Marketing GmbH

9-3641-3116-314

lc2019.de

Dec 06-07

Singapore Singapore

Dermatology, Skin Care And Skin Professionals Meet 2019

Lexis Conferences

505-557-2157

lexis conferences. com/skincare

Jan 11-13 2020

Moshi Kilimanjaro Tanzania

Tropical Dermatology In Tanzania - A Unique Experience At The Regional Dermatology Training Centre

American Academy of Dermatology

847-240-1280

aad.org

Feb 19-22 2020

Jeddah Saudi Arabia

Jeddah Dermatology And Cosmetics Conference 2020 (JeddaDerm 2020)

JeddaDerm

966920003800

jeddaderm. co/wp

Apr 08-15 2020

Paris, Normandy and the River Seine Cruise

Procedural Approaches To Dermatologic Diagnosis And Treatment For Primary Care Providers

866-456-9464 See Ad Page 39

continuingedu cation.net

Jun 24-27 2020

Ottawa Ontario

CDA Annual Conference

Canadian Dermatology 800-267-3376 Association

dermatology. ca

Oct 02-05

Winnipeg Manitoba

2019 Diabetes Canada/CSEM Professional Conference

Canadian Diabetes Association

800-226-8464

diabetes.ca

Oct 30Nov 02

Boston Massachusetts

ISPAD 2019 - 45th Annual Conference

International Society for Pediatric and Adolescent Diabetes

49-0-3024603-210

ispad.org

Dec 02-06

Busan South Korea

IDF Congress 2019

International Diabetes Federation

congress@idf. org

idf2019busan. org

Dec 03-06

Las Vegas Nevada

Original Emergency Medicine Boot Camp 2019

Center for Medical Education

800-458-4779

ccme.org

Jan 06-11 2020

San Diego California

National Association Of EMS Physicians Annual Meeting 2020

National Association of EMS Physicians

800-228-3677

naemsp.org

Jan 08-11 2020

Nassau Bahamas

Topics In Emergency Medicine

Northwest Seminars

800-222-6927

northwest seminars.com

Aug 14-21 2020

Alaskan Cruise

Updates In Emergency Medicine, Transgender Health & Sexual Medicine Onboard The RCI Ovation Of The Seas

Sea Courses

888-647-7327 See Ad Page 23

seacourses. com

Continuing Education, new CE to at Sea Inc./University be placed

Fall 2019 Just For Canadian doctors

21


cme

calendar

General & Family Medicine

Gastroenterology

Endocrinology

cme when where

22

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

topic

sponsor

contact

website

Nov 03-07

Las Vegas Nevada

Obesity Week 2019

Obesity Society and American Society for Metabolic & Bariatric Surgery

844-440-6338

obesityweek. com

Nov 21-24

Nagpur India

Endocrine Society Of India 49th Annual Conference 2019

Endocrine Society of India

76-8791-9788

esicon2019. com

Mar 25-29 2020

New Orleans Louisiana

National Kidney Foundation Spring Clinical Meeting

National Kidney Foundation

855-653-2273

kidney.org

Dec 05-07

New York New York

Gastroenterology, Hepatology & Nutrition 36th Annual Conference

Columbia University Medicine

212-305-5960

columbia.edu

Feb 28Mar 01 2020

Montréal Québec

Canadian Digestive Diseases Week

Canadian Association of Gastroenterology

888-780-0007

cag-acg.org

Nov 05-08 2020

Kobe Japan

Japan Digestive Disease Week 2020

Japan Digestive Disease Week

infoen@jddw.jp

jddw.jp/ english

Oct 25-26

Beachwood Ohio

Wake Up To Sleep Disorders 2019: A Cleveland Clinic Sleep Disorders Center Update

Cleveland Clinic Sleep Disorders Center

216-448-8710

cleveland clinicmeded. com

Oct 30Nov 02

Vancouver British Columbia

Family Medicine Forum 2019

800-387-6197

fmf.cfpc.ca

Nov 15-16

Orlando Florida

561-777-9426 See Ad Page 2

PCPC-cme. com

Dec 30 2019Jan 06 2020

United Arab Emirates Cruise

Family Medicine

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

May 05-15 2020

West Coast San Diego to Vancouver

Medical Seminar At Sea & Well-Being Updates / 10-Night Cruise On Windstar Star Breeze

Professional Education Society

877-737-7005 See Ad Page 20

pestravel.com

Jun 06 2020

Seattle Washington

Caring For Transgender And Gender Diverse Youth

Seattle Children’s Hospital

206-987-2000

seattle childrens.org

Jun 07-21 2020

Norwegian Fjords & the Midnight Sun

Medical Seminar At Sea & The Scandinavian Healthcare System / 14-Night Cruise Along Norway’s Scenic Coast On Holland America’s Newest Ship

Professional Education Society

877-737-7005

pestravel.com

Jul 16-19 2020

Lake Buena Vista Florida (Walt Disney World)

Headache Update 2020

Diamond Headache Clinic Research & Educational Foundation & Amita Health

312-867-9104

dhc-fdn.org

Jul 19-26 2020

Southern France River Cruise

Medical Symposium Confronting Healthcare Needs / 7-Night All-Inclusive River Cruise On Uniworld S.S. Catherine

Professional Education Society

877-737-7005 See Ad Page 20

pestravel.com

Nov 01-08 2020

Antigua Sandals Resort

Respirology And Family Medicine

Sea Courses

888-647-7327 See Ad Page 23

seacourses. com

The College of Family

new CE toPhysicians of Canada Pain Care For Primary Care Academy for placedGlobal (Optional Addiction & Medical be Cannabis Medical Education Workshops Nov 14)

Just For Canadian doctors Fall 2019


MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

Mental Health

Internal Medicine

Infectious & Chronic Diseases

Hematology

Geriatrics

cme when where

calendar

cme

topic

sponsor

contact

website

Oct 03-05

Québec City Québec

10th Canadian Conference On Dementia

University Health Network

416-597-3422

canadian conference ondementia. com

Oct 18

Seattle Washington

The Aging Lung: Respiratory Disease In The Elderly

Virginia Mason

206-341-0142

virginia masoncme.org

Nov 06-09

Rio de Janeiro Brazil

Brazilian Congress Of Hematology, Hemotherapy And Cell Therapy - HEMO 2019

Brazilian Congress of Hematology, Hemotherapy and Cell Therapy

55-16-21019344

hemo.org.br

Dec 07-10

Orlando Florida

61st American Society Of Hematology Annual Meeting & Exposition

American Society Of Hematology

202-776-0544

hematology. org

Jan 30Feb 01 2020

La Jolla California

12th Annual T-Cell Lymphoma Forum

Jonathan Wood & Associates

973-290-8200

tcellforum.com

Aug 06-09 2020

Chantilly Virginia

ASH Meeting On Lymphoma Biology

American Society of Hematology

202-776-0544

hematology. org

Nov 07-09

Johannesburg South Africa

8th Federation Of Infectious Diseases Societies Of Southern Africa Congress

Federation of Infectious Diseases Societies of Southern Africa

079-491-7109

fidssa.co.za

Jan 15-17 2020

Bangkok Thailand

22nd Bangkok International Symposium On HIV Medicine 2020

66-0-26523040

hivnat.org

Mar 31Apr 03 2020

Orlando Florida

Anogenital & HPV-Related Diseases

Cervical Pathology

301-857-7877

asccp.org/ 2020meeting

Jun 21-25 2020

Toronto Ontario

International Symposium On Pneumococci And Pneumococcal Diseases Conference 2020

International Symposium on Pneumococci and Pneumococcal Diseases

31-20-76305-18

isppd2020. kenes.com

Nov 04-08

Duck Key Florida

10th Annual Essentials In Primary Care Fall Conference Session I

Continuing Education Company

800-327-4502

cmemeeting. org

Dec 05-07

Amsterdam Netherlands

International Society For The Study Of Bladder Pain Syndrome Annual Meeting 2019

Essic International Society for the Study of BPS

39-0523338391

essicmeeting. eu

Dec 08-10

Las Vegas Nevada

Psychiatry Update 2019 Encore Presentation (Optional Addiction & Medical Cannabis Workshops Dec 07)

American Academy of Clinical Psychiatrists

561-777-9426 See Ad Page 2

CPAACP-cme. com/site/ Encore

Dec 14-21

Disney Fantasy Cruise

CBT Tools With Dr. Greg Dubord

CBT Canada

877-466-8228

cbt.ca

Apr 25-29 2020

Philadelphia Pennsylvania

American Psychiatric Association Annual Meeting 2020

American Psychiatric Association

202-559-3900

psychiatry.org

May 14-16 2020

Barcelona Spain

27th International Symposium On Controversies In Psychiatry 2020

International Symposium on Controversies in Psychiatry

34-934-161220

controversias barcelona.org

new HIV-NAT CE to be placed American Society ASCCP 2020 Annual Scientific Meeting On of Colposcopy and

How do you get your CME hours?

Over 30 conferences a year Destinations all over the world Relevant and popular medical content

EXPLORE. LEARN. CONNECT.

CME…AWAY

Call us today to reserve your CME in paradise.

Fall 2019 Just For Canadian doctors

23


cme

calendar

Women’s Health

Pain Management

Orthopaedics

Oncology

Nutritional Medicine

Neurology

cme when where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

topic

sponsor

contact

website

Oct 21

Davis California

Neurology Update 2019 For The Primary Care Provider

University of California, Davis

events@ ucdavis.edu

ces.ucdavis. edu/ neuro2019

Jan 10-12 2020

Fort Lauderdale Florida

American Society For Peripheral Nerve (ASPN) Annual Meeting 2020

American Society for Peripheral Nerve

312-853-4799

peripheral nerve.org

Oct 15-18

Dublin Ireland

13th European Nutrition Conference

Federation of European 353-1-400Nutrition Science and 3626 The Nutrition Society

fens2019.org

Dec 12-14

Lyon France

WAO World Allergy Congress 2019

World Allergy Organization

33-4-67-1092-23

wac2019allergy.com

Nov 04-06

Orlando Florida

National Hospice And Palliative Care Organization’s Interdisciplinary Conference 2019

National Hospice and Palliative Care Organization

703-837-1500

nhpco.org

Jan 09-11 2020

Houston Texas

NRG Oncology Meeting

NRG Oncology

267-519-6630

nrgoncology. org

Oct 22-25

Berlin Germany

DKOU 2019 - German Congress Of Orthopaedics And Traumatology

Intercongress GmbH

49-61197716-0

intercongress. de

Jun 10-12 2020

Vienna Austria

European Federation Of National Associations Of Orthopaedics And Traumatology 21st Congress 2020

European Federation of 41-21-343National Associations of Orthopaedics and 4400 Traumatology

congress.efort. org

Nov 14-16

New Orleans Louisiana

American Society of Regional Anesthesia and Pain Medicine

412-471-2718

asra.com/pain

Nov 23

Chicago Illinois

Update In Headache 2019

Diamond Headache Clinic Research & Educational Foundation & Amita Health

312-867-9104 See Ad Page 25

dhc-fdn.org

Feb 14-17 2020

San Diego California

The 33rd Annual Practicing Physician’s Approach To The Difficult Headache Patient

Diamond Headache Clinic Research & Educational Foundation & Amita Health

312-867-9104 See Ad Page 25

dhc-fdn.org

Oct 24-31

Rhine River Cruise

Current Topics In Women’s Health

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

Kohala Coast Hawaii

Jan 02-06, 36th Annual Conference: Obstetrics, Gynecology, Perinatal Medicine, Neonatology, And The Law Jan 06-08, 20th Annual Conference: Medical Negligence, Risk Management, Medicine, Surgery, Emergency Medicine, Radiology, And Family Medicine

Center for Human Genetics

617-492-7083

chginc.org

Jan 02-08 2020

new CE to ASRA 18th Annual Pain Medicine Meeting be placed (Novel Opioid Targets, Alcohol Use In Chronic Pain, Advances In Advanced Interventional Care, Fibromyalgia, Chronic Fatigue Syndrome, Headache, Intrathecal Therapy, Electrodiagnostics, Dedicated NP/PA Program)

For feedback, requests or to have your course featured please email cme@inprintpublications.com or submit your course via www.justforcanadiandoctors.com

NYU Radiology CME Presents

38th Annual Head to Toe Imaging Conference December 16-20, 2019 • The New York Hilton Midtown • New York City

Earn over 40 AMA PRA Category I Credits www.med.nyu.edu/courses/cme/h2t19

24

Just For Canadian doctors Fall 2019



How To Attract New Physicians To Your Clinic – And Keep Them TAMMY WYLIE, CPA, CA, CGA & TIM DAWSON, CPA, CA

P

hysician shortages in Canada are changing the way clinic owners conduct business. Significant disruption to health care operations and changes to the delivery of patient care are just some of the issues facing physicians. Alterations to funding agreements, tax rules, practice models, fee schedules - all are contributing to increased financial pressure. Clinic owners face several headwinds which eat into profitability, primarily real estate and payroll costs. Fewer physicians want to work in a traditional clinic model, resulting in a larger percentage of overhead for those who do. Physicians need to adapt to attract members to a shared practice. Traditionally, family physicians complete residency and begin their practice in some type of clinic model. They share the costs of the lease, staff, supplies and maintain a steady patient roster. However, new practice models are emerging, including telehealth, locum practices or hospitalists. At the same time, work-life balance has become more of a priority, changing the dynamics of physician / patient interactions. WHAT NEW PHYSICIANS WANT Perceived costs versus the benefits is a key deterrent to attracting members. Overhead is the largest expense for a physician when operating in a clinic model and the percentages have been increasing. For new physicians coming into the market, supposed additional economic burden competes against other practice opportunities with lower or no financial investment, such as hospitalists, locum assignments and specialized payment arrangements. When physicians look to utilize space in a clinic, they look for the lowest overhead, plus flexibility in negotiating terms and conditions. This is increasingly true for those who are not practicing a full-time practice. It’s not impossible to run an efficient and profitable clinic. But moving forward, physicians need to focus on running a leaner, more patient-centric operation that attracts and retains new members.

Consider the reputation of your business. of the questions clinic owners need to ask What is the community saying about your include: clinic? This is critical to attracting new members - those who believe overhead is too • How many appointments are high for services received are not going to be booked monthly? an ambassador. Instead, if they are part of the • Are patients rescheduling? conversation and have a clear understanding • Is the clinic using time and of the costs and allocation, they will attract resources efficiently? like-minded members to the team. • Is inventory managed effectively? Real estate and financing costs add • What do the patients like or dislike financial pressure if not properly managed: about the clinic? consider reviewing your contracts’ financing • Have clinic owners considered auxiliary services such as X-ray and arrangements on a regular basis and check to see if there is room for negotiations. lab services? Like all business, the profitability of a clinic depends on sound business planning, OVERCOMING BARRIERS strong financial management and impeccable TO ENTRY client services. Now, your clinic requires Making the clinic easy to access online strategic thinking. Proper advice mitigates benefits patients, plus provides attractive financial risks, ensures your corporate incentive for new physicians who are structure minimizes taxes and costs while considering where to operate their practice. In increasing the overall health of the business. addition to the aesthetics that add to the feel Having the right team in place to ensure you of the clinic, technology can help operations are positioned in the best possible way and receiving the right advice goes a long way to to enhance efficiency and marketability. Client automation software provides creating a successful sustainable business. online booking and chat functions and sends email or text reminders a few days ahead of the scheduled appointments. This helps manage resources, staff requirements and adds to the overall efficiency of the practice. In turn, the practice requires less administrative overhead. These systems have been proven to increase patient conscientiousness and follow through as well as increase the existing client bases. The low barrier to entry and ease of services doubles as an attraction to new and perspective patients, and a useful marketing tool. MANAGE RISK

Understanding how the business allocates costs helps clinic members understand what they are receiving for the overhead being contributed. Manage these risks with transparent contracts and regular communication. Proper contracts with the physician members are key. An understanding of what the revenue for the clinic enables clinic owners to budget properly, forecast expenses OPTIMIZE OPERATIONAL and use the correct resources. Cost sharing PERFORMANCE arrangements are important incentives and “What gets measured gets done.” This should be reviewed at least once a year to saying has never been more pertinent. Some ensure they are still realistic and balanced.

Tammy Wylie, CPA, CA, CGA is a Partner in MNP’s Professional Services Team. You can reach her at 807.623.2141 or tammy. wylie@mnp.ca Tim Dawson, CPA, CA, is a Partner in MNP’s Professional Services Team. You can reach him at 780.451.4406 or tim. dawson@mnp.ca

Advertising Feature


t h e w e a lt h y d o c t o r M a n f r e d p u r t z k i Manfred Purtzki, CPA, CA, is a principal in the Vancouver office of Purtzki Johansen & Associates. He can be reached at: Manfred@purtzki.com or 604-669-7558.

A lesson from Bogle

The father of the low-cost index mutual fund has a simple strategy to boost returns

J

ohn C. Bogle, the founder of Vanguard Investments, invented the first lowcost index mutual fund in 1975. It put millions of dollars into the pockets of many investors of moderate means. Bogle’s innovative idea was that the index fund would mimic the stock index performance in the long run and outperform the high-cost fund managers who were trying to beat the market. Bogle’s approach paid off. With $5 trillion under management, Vanguard has become the giant in the financial industry. Bogle died earlier this year at the age of 89 but his commonsense approach to investing is as relevant as ever. Here are his simple rules for investors.

istock

1 Invest for the long term. Bogle’s key advice is that you should not try to outsmart the market. Buy index funds for the long term and you will be diversified. It’s not surprising that Bogle disciples, after 10 years of investing, belong to the top 20% of all investors. It’s not the timing of the market that is critical, it’s the time in the market. According to Bogle: “After nearly 50 years in this business, I do not know of anybody who has done it successfully and consistently. I don’t even know anybody who knows anybody who has done it successfully and consistently.” 2 Keep your costs down. What made Vanguard so attractive to investors was the low-fund expenses. This is because Vanguard has no outside owners; the company is owned by its funds, which in turn are owned by their shareholders, which includes you, if you are a Vanguard investor. Instead of paying outside shareholders of a typical investment company, the profits are

returned to the actual investors in the form of lower expenses. 3 Beware of the experts. Bogle was not impressed with the expert money managers, who all missed the warning signs of the 2008 financial crisis and ignored the “toxic-filled, leveraged balance

st o Bo

40% American, 30% Canadian and 30% from countries outside North America. The management fee is 0.22%. For the fixedincome component of the remaining one third of his portfolio, the investor selected a five-year GIC, issued by the new online bank called “motusbank,” with a return of 2.95% (a decent rate right now).

r e tu r y ou

sheets” of the banks. He’s said that you only need a financial planner to get started with your investments, after which you don’t need a money manager at all. 4 Diversify. “Don’t look for the needle in the haystack. Just buy the haystack,” is another Bogle maxim. By purchasing the index fund, you buy the whole stock market. One investor shared his strategy of using Vanguard ETFs (exchange-traded funds) with The Globe and Mail’s finance columnist Rob Carrick. It’s both simple and smart. This reader used two thirds of his funds to invest in the Vanguard All-Equity ETF portfolio (VEQT). VEQT holdings are

rns

4 strategies from the guy who invented

He chose GICs over a index more traditional bond mutu al portfolio to funds avoid negative repercussions from fluctuating bond values. Many investors are not aware that when interest rates go up, the value of bonds decline. And when interest rates go down, bonds appreciate in value. The GIC avoids this investment risk. To compare, the yields for Bond ETFs for the entire bond market are currently about 2.1%. A GIC rate of 2.95% looks rather good by comparison. Fall 2019 Just For Canadian doctors

27


travel the world

the many (curious) charms of

The d’Arenberg 28 Just Cube For Canadian dentists September/October 2019

courtesy of d’arenberg

M cLaren Vale


Irre verent and qu irky, this region imbu es its Australian wines with personality story by

Tim Johnson

E

thereal and outsized, the five-story eminence emerges from the red-brown soil like a vision, blocks stacked on blocks, a reflective Rubik’s Cube rising above the vines like a Picasso fever dream. Winding through the bucolic landscape, rolling up from a small country road, I can’t quite believe my eyes. But I’ll soon find out that it wasn’t a man named Pablo who designed this glassy tower. Borne in the mind of an Aussie winemaker, I’ll find both Salvador Dali, plus a bit of the (slightly) absurd—an offbeat museum and a strange theatre—plus amazing views and a wine tasting, just through those doors and atop the cubic structure. It’s the latest—and perhaps most famous—addition to the McLaren Vale. Sometimes overshadowed by the better-known Barossa Valley, the McLaren Vale, just south of Adelaide, is filled with relatively small boutique wineries. Best known for their dry reds—especially Shiraz, Mourvèdre and Grenache—this wine region is also set apart by its personality, charm and quirk. It’s historic, too, with millions of years of geology, thousands of years of indigenous heritage, and vines growing since if you go 1838—two years tour with Coast & Co., which offers after Australia was non-traditional, daylong wine tours in established. Now a four-wheel-drive safari vehicle that can home to some 80 include rides on e-bikes, beach walks and tasting rooms, I’m hikes: coastandco.com.au. taste at any of here to drink it all in. the following wineries: d’Arenburg (darenberg. My guide, Simon com.au), Wirra Wirra (wirrawirra.com), Bekkers (bekkerswine.com). lunch at Red Poles, Burley, is the owner which is a restaurant, Aboriginal art gallery, of local company B&B, cellar door for wines and craft Coast & Co., which beers AND a live-music venue—all offers immersive tours. in one: redpoles.com.au. “Our goal is to go well beyond the standard wine tour,” he explains as we head from downtown Adelaide onto the Fleurieu Peninsula that juts into the crashing waves of the Southern Ocean. And the d’Arenberg Cube is far from standard. Built on a winery of the same name just two years ago, the design sprung from the mind of Chief Winemaker (and fourth-generation scion) Chester Osborn. Family-owned since 1912, the winery had a reputation for being staid and traditional—which the Cube has completely reversed. Entering, the ground floor is occupied by a whimsical installation called the Alternative Realities Museum, where I spend time in the “aroma room” squeezing oldJust For Canadian doctors

29


travel the world

Kayaking and ambling (left) in Onkaparinga River National Park below Husband-and-wife team at Bekkers

30

Just For Canadian doctors Fall 2019

school bike horns to produce different wine-related smells, then head next door to stand in a 360-degree theatre to watch a fairly psychedelic film that features a tiger selling wine from his trench coat. Ascending, I pass an award-winning restaurant (that offers a season-sensitive degustation menu prepared by husbandand-wife chefs trained in a Michelinstarred restaurant), and a temporary exhibit, running until the end of the year, of Dali bronzes, including a five-metre-tall monumental statue. I arrive on the top floor for a tasting in a room that features crazily multicoloured couches, where I slip out onto an open-air balcony to sip Shiraz and Riesling. Burley takes me beyond wineries, too. We walk across broad beaches, and hike along the rim of the Onkaparinga River Gorge, a place with a rich indigenous history and 650 million years of geology, a Mediterranean climate, olive trees and sweeping views. Peregrine falcons soar overhead. “And just think, this is all just a half hour from the city,” Burley remarks. And we taste more wine. At Wirra Wirra—“water, water” in the local indigenous language—the tasting room manager, James Braybrook, takes me back into the barrel halls and fermentation tanks. He explains that they’re completely organic and biodynamic, and use hand plungers to extract juice from the grapes, the most thorough and natural way. Braybrook gives me a chance to try my hand at it—hard work, churning with both hands, as it turns out. Then, he takes me to the catapult. Founded back in 1894 by an eccentric cricket player, the winery eventually fell into complete disuse and disrepair until its purchase by Greg Trott, another nonconformist. Among his additions is a bell, which guests are encouraged to ring, because Trott believed it helped bring people together. After pulling the cord and listening to its deep, even tone resonate across the vineyards, we make our way to the catapult. “Greg had a vision for all the wineries around here to have one,” Braybrook explains, noting that Trott also had hoped they could share vintages by launching barrels to one another. That never happened. “Now, we occasionally fling watermelons from it, for no particular reason,” Braybrook says. And Trott turned Wirra Wirra into the producer of one of Australia’s favourite wines, a blend of Cabernet Sauvignon, Merlot and Shiraz called Church Block. Taking its name from the original parcel

photos, from top, courtesy of: wirra wirra vineyards; southern australian tourism commission (2; left photo by Callum Jackson); Bekkers Wine / don Brice

Ringing the bell at Wirra Wirra


photo courtesy of red poles

travel the world of land, which sat next to an 1850s chapel, it’s now sold in 25 countries. Deep and balanced, it’s easy to taste how it became so popular, and I continue sipping as the bell continues to ring in the background, someone pulling the cord over and over again. “Church Block runs through our veins,” Braybrook tells me. “It’s everything to Wirra.” Back with Burley, we lunch across the road, al fresco, on a lush lawn, feasting on local ingredients at a destination restaurant called Red Poles, which includes a small gallery and an indigenous artist-inresidence—and tasting paddles for three on-site breweries. We also make a brief stop at Hugh Hamilton Wines, which was founded by the oldest grape-growing family in Australia—they’ve been making wine since 1837. The self-professed black sheep in the family, Hugh parted ways with his siblings to start his own tasting room and winery—where all the labels feature black sheep in different configurations, and the vintages have names like “The Rascal” and “The Floozie.” The tasting room manager notes that they’re available only in one place—right here. “We only sell to our

own flock,” she says, tongue firmly in cheek. bring the best to their product home— personally pour each one, explaining the We finish with a tasting at Bekkers. Small and stylish, they’re open to the public just unique traits of each vintage. Sitting there in the sun, savouring the flavours, chatting three days a week. Burley notes that they with this remarkable couple, I have all the make some of the very best vintages in the region, the result of a somewhat unlikely union. Their wine is the product—literalAl fresco fare ly—of a marriage of French at Red Poles and Australian winemaking. Settling into a sunny tasting room with floor-to-ceiling windows just a few feet from their vines, Toby—an Aussie who hails from right here, and his French wife, Emmanuelle, walk me through their wines. They limit the wines to three reds—Syrah, Grenache, and a Syrah Grenache, plus a Chablis that Emmanuelle makes in France and imports back to Australia. They’re all excellent, and the best of this iconoclastic region right here— husband-and-wife duo—she a winemaker, easy-sipping wine, quirky and riveting he a viticulturalist, both of them passionate, personalities, and a rather impressionistic travelling around Europe each year to cubist vibe—all in one place.

Fall 2019 Just For Canadian doctors

31


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 is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him via his website at drpeng.ca.

Portugal’s perspective We could learn from the attitude towards illicit drugs in Portugal

It is a courageous, caring program with emphasis on the carrot rather than the stick

• fines ranging from $36 (CAD) to $220 (based on the minimum wage in Portugal of $700 per month), effectively penalizing by hours of work lost • suspension of the right to practise if the user is a licensed professional (driver, physician, dentist…) • restriction on attending “high-risk areas”

32

Just For Canadian doctors Fall 2019

groups of trained professionals who will go out to the streets of Portugal giving clean needles, alcohol swabs and condoms—and sometimes nutritious food. Substitution therapy has been facilitated by the easing of access to methadone as well as buprenorphine with and without naloxone. These come along with a constant written and verbal reminder of the options for quitting the addiction. The forward-thinking program is based on a three-pillar philosophy: • There is no differentiation between hard and soft drugs—only healthy and unhealthy relationship with these drugs. • Most persons with a problematic relationship with drugs are concealing some other major traumatic dysfunction in their lives. • Total elimination of drug abuse is not a realistic goal. Portugal is not the land of milk and honey of unrestricted government-subsidized narcotics for all and any who ask for it. It is a courageous, caring program with emphasis on the carrot rather than the stick.

solution from Summer 2019 contest

• foreign travel ban • requirement to appear regularly and on demand to the Commission • suspension of subsidies or allowances from the public purse • loss of the right to carry a gun If the Commission feels that the person is addicted he/she is offered expeditious admission to a drug rehabilitation facility; there is also the option of being given community service. The committee cannot mandate compulsory treatment, but its brief is to encourage addicts to enter and remain in treatment. There is the realistic attitude that compulsion into drug rehabilitation is unlikely to succeed without the entire total commitment of the addict. The Commission is able to lift any of the sanctions if the person does appear to be compliant and participating in a treatment program. In researching this essay I found it difficult to find consistent hard numbers. Since 2001 there has been a 90% reduction in drug-related HIV infections. The number of drug-related deaths has reduced from 131 in 2001 to 20 in 2008. As of 2012 Portugal’s drug death rate is at three persons per million in comparison with the European Union average of 17.3 per million. There have also been some unintended but useful spin-offs: the decrease of drugrelated criminal justice workloads, as well as the street value of most illicit drugs. Another part of this far-reaching strategy is the attitude of the general public who are gradually dropping the term “junkie” in favour of “people with addiction disorders.” In other words, the stigma is lessening. The result of this is that drug addicts are no longer as reluctant to seek help because they no longer face potential incarceration. The other part of this overarching program is that there are many active outreach harm-reduction measures in place. There are

sudoku 2 harder solution 1 9 4 7 6 3 2 5 8 8 2 7 5 9 1 6 3 4 5 3 6 2 4 8 7 1 9 2 6 3 9 1 4 5 8 7 7 8 9 3 2 5 1 4 6 4 1 5 6 8 7 9 2 3 3 5 8 1 7 6 4 9 2 6 4 2 8 5 9 3 7 1 9 7 1 4 3 2 8 6 5

Puzzle by websudoku.com

solution from page 37

I

am starting with a confession; I assumed that the current “opioid crisis” was due in large part to the easy access of drugs on the street and internet. This certainly is one factor, but a recent report from the National Institute On Drug Abuse (albeit an American study) indicates that about 25% of patients, prescribed opioids for chronic pain, misuse them. About 80% of people who use heroin first misused prescription opioids. [For heroin I would also read fentanyl]. So physicians’ need for hypervigilance of this distressing situation won’t lessen any time soon. Rumbling away in the background of North America’s opioid crisis, I keep hearing about the total decriminalization of all drugs and free drugs for addicts “like in Portugal.” Portugal has done a fantastic job with marked reductions in blood-borne infections, court costs and accidental deaths. But this has been done by moving drug abuse away from a criminal offence to an administrative one—by a law passed in 2001. In Portugal, it’s still illegal to possess restricted drugs but if a person is found in possession of no more than a 10-day supply of an illicit substance, the drugs are confiscated and a summons is issued to appear before a Commission for the Dissuasion of Drug Addiction that comprises of a social worker, a psychiatrist or a medical doctor and a lawyer. (Drug growers, dealers or traffickers are dealt with to the full extent of the law.) The Commission, on the other hand, has a broad range of sanctions, which include:

sudoku 1 easier solution 2 6 7 5 9 8 3 1 4 8 1 5 2 3 4 6 7 9 3 9 4 7 1 6 8 5 2 5 2 8 1 4 7 9 6 3 6 7 9 3 2 5 4 8 1 1 4 3 8 6 9 5 2 7 9 8 2 4 5 1 7 3 6 7 3 6 9 8 2 1 4 5 4 5 1 6 7 3 2 9 8

Puzzle by websudoku.com


FAMILY PHYSICIAN OPPORTUNITIES 100 Mile House, Cranbrook, Oliver, Lillooet, Trail, British Columbia

~ Rural Incentives ~ Relocation Support ~ Diverse Practice Options

APPLY TODAY

www.betterhere.ca PhysicianRecruitment@interiorhealth.ca


employment opportunities

THE COMMUNITY OF CHAPLEAU is seeking ONE FAMILY MEDICINE PHYSICIAN to join an established RNPGA

LA COMMUNAUTÉ DE CHAPLEAU est à la recherche D’UN(E) MÉDECIN DE FAMILLE dans le cadre d’une entente établie relativeau groupe de médecins en milieu rural et dans le Nord (EGMMRN)

Our clinic and hospital is located in Chapleau, Ontario, a friendly and open community with rich character in both English & French traditions. The town has a population of approximately 2,779 and is nestled in the heart of the Canadian Shield with access to provincial parks and year-round recreational activities. We offer and you will find a great work-life balance in a friendly community, come and visit.

Notre clinique et notre hôpital sont situés à Chapleau, en Ontario, une communauté accueillante, ouverte et riche de traditions francophones et anglophones. La ville, nichée au cœur du Bouclier canadien et offrant un accès aux parcs provinciaux et des activités récréatives toute l’année, compte environ 2 779 habitants. Si vous êtes à la recherche d’un excellent équilibre entre votre vie personnelle et votre vie professionnelle au sein d’une communauté amicale, venez nous visiter.

About the Hospital: Our Acute Care wing (13 beds), Long-Term Care wing (25 beds), Diagnostic Imaging, Laboratory and Emergency departments ensure all basic services are met. Patient care is integrated with the Chapleau & District Family Health Team and the numerous programs and clinics that are offered. About the position: The position follows the Rural Northern Physician Group Agreement. Emergency and Hospital call arrangements are shared equally between four physicians. French Language Skills are an asset. For community, Hospital or Physician Practice information, contact: Jean-Marc Desmeules, CEO and/or Dr. Kendra Saari, Chief of Staff Chapleau Health Services | 705-864-3053 More information can be found at the following web-sites: Chapleau Health Services at: www.sschs.ca Community Information at: www.chapleau.ca

À propos du poste : Le poste respecte les modalités de l’Entente relative au groupe de médecins en milieu rural et dans le Nord. Quatre médecins se partagent également la charge de travail au Service des urgences et à l’hôpital. Des aptitudes linguistiques en français sont considérées comme un atout. Pour obtenir des renseignements au sujet de la communauté, de l’hôpital ou de la pratique médicale, communiquez avec : Jean-Marc Desmeules, directeur général, ou Dre Kendra Saari, médecin-chef Services de santé Chapleau | 705 864-3053 Vous trouverez d’autres renseignements ci-dessous : Services de santé Chapleau : https://sschs.ca/general/homeFR.html Pour obtenir de l’information au sujet de la communauté, visitez le site Web suivant : www.chapleau.ca

Services de santé de Chapleau Health Services (SSCHS) has been awarded the rating of "Accredited with Commendation" award from the national Accreditation Canada's Qmentum accreditation program.

Agrément Canada, dans le cadre de son programme National d'accréditation Qmentum a accordé au Services de Santé de Chapleau (SSCHS); l’agrément avec Mention. Ce dont nous sommes très fiers.

Come and find new ways to become lost in your passions!

Venez découvrir de nouvelles façons de vous abandonner à vos passions!

Practise Where You Can Live Community, Practise Opportunities, Incentives, Recreation Barry's Bay is: -190 km from northwest from Ottawa -310 km northeast of Toronto - 30 km south of Algonquin Park

34

À propos de notre hôpital : Notre aile de soins actifs (13 lits), notre aile de soins de longue durée (25 lits), notre service de visualisation diagnostique et notre service des urgences permettent d’offrir tous les services de base. Les soins aux patients sont intégrés à l’équipe de santé familiale de Chapleau et du district ainsi qu’aux multiples programmes et cliniques que nous offrons.

Just For Canadian doctors Fall 2019

For more information or to schedule a site visit: Taflyn Janzen Physician Recruiter Coordinator Barry's Bay and Area 613-553-4635 physicianrecruiter@sfmhosp.com


The municipal-operated Keyanow Medical Centre in the community of Wabasca is located 1.5 hours NE of Slave Lake and 3.5 hours north of Edmonton. Living in the heart of the boreal forest means enjoying year round recreation such as hunting, fishing, snowmobiling quadding and boating. Nestled between two large lakes, Wabasca has a population of approximately 5,000 and is growing. There are amenities such as Lakeview Sports Centre, Eagle Point Golf and Country Club, a bank and a registries office.

This opportunity is a contract position, not a fee for service, with a guaranteed annual income of $360,000. The on call ratio is currently 1:4 with hospital billings going to the physicians, RRNP eligible to max of $60,000. Accommodation in a newer three-bedroom, two bath home is included in the contract!

F O R E N S I C M E N T A L H E A LT H

R E G I O N A L P S Y C H I AT R I C C A R E

ONTARIO

employment opportunities

GEORGIAN BAY

Your opportunity awaits‌.

Contact us by email or telephone for more details

Bill Kostiw, Chief Administrative Officer Tel: (780) 891-3778 Email: CAO@mdopportunity.ab.ca Michelle Grach, Clinic Manager Tel: (780) 891-2847 Email: mgrach@mdopportunity.ab.ca

OPPORTUNITIES IN: ACUTE CARE G E R I A T R I C M E N T A L H E A LT H F O R E N S I C P S Y C H I AT R Y TEACHING AND RESEARCH WAY P O I N T C E N T R E . C A 1.877.341.4729 x2206

Expl ore Mea dow La ke, Sa ska tchewa n Where outdoor bea uty is a t your doorstep O ppo rtunities fo r fam ily phys icians including phys icians w ith enhanced s k ills in S urgery, O bs tetrics and A naes thes ia

Pra ctice Overview: Prima ry Ca re Cl inic Tea m: fa mil y physicia ns incl uding those with enha nced skil l s work in tea ms with a RN ca se ma na ger, NP, dieticia n, dia betes nurse educa tor, chronic disea se educa tors, pha rma cist, menta l hea l th counsel l or, sexua l hea l th cl inic Anticipa ted Ca l l : ER 1:8; Obstetrics (optiona l ) 1:5 Pa rta ke in Medica l Educa tion: Undergra dua te & Postgra dua te Loca l CME: MoreOB & PBL EMR: MedAccess

ewan h c t a , Sask ure e k a ow L vent Mead in the Ad Jo

Competitive Compensa tion & Benefits: Pa yment Model : Bl ended (hourl y ra te & fee- for- service) SMA Benefits: CMPA Reimbursement Fund, CME Fund, Retention Fund

Rura l Physicia n Incentive Progra m: up to $47,000 over 4 yea rs for recent FM gra dua tes who commence pra ctice in a community in Sa ska tchewa n with a popul a tion of 10,000 or l ess

F or additional details or to apply contact: C am m ie V any, P ratitioner S taff A ffairs C oordinator S as k atchew an H ealth A uthority cam m ie.vany@ s as k healthauthority.ca

Fall 2019 Just For Canadian doctors

35


employment opportunities

ENGLEHART AND DISTRICT HOSPITAL

at your

service

KIRKLAND AND DISTRICT HOSPITAL Full-time And Locum FAMILY MEDICINE OPPORTUNITIES AVAILABLE Come practice medicine in beautiful Northern Ontario! Join a dedicated group of physicians who have chosen to make Northern Ontario their home!

Englehart and District Hospital: Locum emerg and hospitalist rotations available throughout the year! $100 per hour for emerg; $6000 per week for hospitalist. 5% shadow billing.

Englehart and District Family Health Team: High income, salaried position under the RNPGA contract. Northern Rural and Recruitment Initiative Grant of $114,000 over 4 years available from MOHLTC. Eight weeks paid leave for CME and vacation. Housing incentive. Weekend ED coverage at the Hospital is optional.

Kirkland and District Hospital and Kirkland and District Family Health Team: Opportunity for a lucrative, satisfying practice. Overhead in a modern Family Health Team is only $2,000/month all-inclusive. Eligibility for HealthForce Ontario Northern and Rural Retention Initiative of approximately $111,600 over 4 years. Remuneration may include blended capitation for family practice, alternate payment plan in the ER, stipend and FFS for hospitalist medicine. Assistance with re-location expenses provided. Locum and emerg hospitalist rotations available throughout the year!

Check us out on HFO Jobs! ENGLEHART » hfojobs.healthforceontario.ca KIRKLAND LAKE » hfojobs.healthforceontario.ca

Contact: nperrault@kdhospital.com

WE LOOK FORWARD TO MEETING YOU!

36

Just For Canadian doctors Fall 2019

classifieds PROVENCE, FRANCE – YOUR VILLA Les Geraniums, a luxury 3-bedroom, 2 ½-bath villa, is your home in the heart of Provence. Expansive terrace with pool and panoramic views. New kitchen and bathrooms. Walk to lovely market town. One hour to Aix and Nice. Come and enjoy the sun of southern France! 604-522-5196. villavar@telus.net

PHYSICIANS FOR YOU – LEADERS IN PHYSICIAN RECRUITMENT No time to look for a new role? Call the trusted recruitment team. Our strong reputation is built on exceptional service and results. Locum, contract, long-term, city or rural, we have it all. Whether you are a Physician looking for roles across Canada, or a medical facility that requires Physicians, we can help. Let our 10 years of experience in Canada and our extensive knowledge of the licensure and recruitment processes work for you. View our current job postings on our website today. Website: www.physiciansforyou.com Office: (778) 475-7995


diversion “Never doubt that a small group of thoughtful , committed citizens can change the world; indeed , it's the only thing that ever has.”

sudoku

~ Margaret Mead

Solve puzzle #2 for a chance to win a $50 Amazon gift card! 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.

Planet Smile will make a difference with your help. Every year, more than 3,000 children are born with cleft lip and palate (CLP) in Vietnam - 10 times the Canadian annual total.

GOOD LUCK!

sudoku 1 easier solution on page 32

7 8 1 5

sudoku 2 harder solution in next issue

$50 Amazon Gift Card winner: Dr. Sharon Barton of Burnaby, BC

2

6 1 9 7 4

2 8 2 6 1

7 3 8 9 4

7 3

3 6 8

3 4 6 8

5 1

5 2

4 9 2 3 1

1 4 5 2

Many children with CLP are at risk for having fluid in the middle ears which affects hearing. By identifying children who are not able to hear properly, we can help them get the treatment they need and give them the best chance at developing clear speech. In Vietnam, there is currently no comprehensive audiological care for children with CLP. With specialized audiology equipment, we can identify the presence of middle ear fluid and perform hearing tests. We are raising funds to purchase audiology testing equipment for the National Hospital of Odonto-Stomatology in Ho Chi Minh City, Vietnam. Please donate to greatly improve the outcome of children with CLP. Thank you for making a difference.

604-616-9706

planetsmileforkids.org

Puzzle by websudoku.com

5 3 1 2

5 3 2 6 6 9 5

3 4 7 2 1 4 4 1 5 9 6 4

Puzzle by websudoku.com

Sudoku Contest entry form (solve + send in sudoku!)

Yes, I would like to receive the CME newsletter & updates by e-mail.

NB: Information collected will not be shared with any third party.

Name: __________________________________________________________ Address: ________________________________________________________ City, Province, Postal Code: _________________________________________

E-mail: _________________________________________________________ Tel: ____________________________ Fax: ____________________________ sudoku Contest Rules:

1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles entered into random draw. 2. Send puzzle + entry form to Just For Canadian Doctors, 200 – 896 Cambie St., Vancouver, BC, V6B 2P6 or fax 604681-0456. Entries must be received by November 15, 2019. 3. Prize: $50 Amazon Gift Card. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications. 6. Employees of In Print Publications and its affiliates are not eligible to participate. 7. In Print Publications is not responsible for lost or stolen prizes.

Fall 2019 Just For Canadian doctors

37


pa r t i n g s h o t

photo prescription

dr. lawrence yanover, who practises in St. Catharine’s, ON, took this up-close photograph of an orangebreasted sunbird on a protea, the national flower of South Africa, in Kirstenbosch Botanical Gardens, Cape Town.

It was our last day in Cape Town and the one thing we needed to still see was the botanical gardens. What a lovely surprise. Between flora and fauna I could hardly put my camera down. It was a highlight of a trip full of highlights. A must see for anyone visiting Cape Town.”

38

Just For Canadian doctors Fall 2019

photo details

Olympus E-M5 Mk2 ISO 320 75-300 mm f4.5-6.7 II lens at 150 mm 1/250

Dr. Lawrence Yanover

Have a “wow” photo you’d like to share and potentially see published in Just For Canadian Doctors? Send a high-resolution image to feedback@inprintpublications. com, along with a few words on the context of the photograph (including time, place, technical details and equipment/ gear). We want to see what you’ve captured on your travels!


For more information Call 866-456-9464 or visit www.ContinuingEducation.net Continuing Education, Inc. University at SeaTM

Emergency Medicine and Pediatric ENT

Primary Care and Women’s Health

8-Night Scandinavia and Russia Cruise Conference Round-trip Copenhagen, Denmark Royal Caribbean’s Jewel of the Seas August 8 - 16, 2020

8-Night Inaugural Spain & Portugal Cruise Conference Round-trip Southampton, England Celebrity Apex April 5 - 13, 2020

Hospital Medicine and Preventive Medicine

Critical Care, Emergency Medicine, and Neurology

Primary Care and Women’s Health

Family Medicine & Behavioral and Developmental Pediatrics

November 11 - 20, 2019 9-Night Pacific Coastal Cruise Conference Round-trip Los Angeles, California Celebrity Eclipse

December 22 - 29, 2019 7-Night Eastern Caribbean Cruise Conference Round-trip Miami, Florida Royal Caribbean’s Oasis of the Seas

Family Medicine

December 30, 2019 - January 06, 2020 7-Night United Arab Emirates & Muscat, Oman Round-trip Dubai, United Arab Emirates Royal Caribbean’s Jewel of the Seas

Developmental & Behavioral Pediatrics and Child & Adolescent Psychopharmacology

June 5 - 15, 2020 10-Night Italy and Best of Greek Islands Round-trip Rome (Civitacecchia), Italy Celebrity Cruises’ Celebrity Edge

June 13 - 20, 2020 7-Night Alaskan Explorer Cruise Conference Round-trip Seattle, Washington Holland America’s Eurodam

Cardiology and Geriatrics

June 18 - 28, 2020 10-Night Scandinavia & Russia Cruise Conference Copenhagen, Denmark to Stockholm, Sweden Royal Caribbean’s Jewel of the Seas

Current Topics in Family Medicine

January 18 - 25, 2020 7-Night Hawaii Cruise Conference Round-trip Honolulu, O’ahu Norwegian Cruise Line’s Pride of America

July 19 - 26, 2020 7-Night Norse Legends Cruise Conference Round-trip Amsterdam, The Netherlands Holland America’s Nieuw Statendam

Topics in Family Medicine, Hematology and Oncology

Infectious Diseases and Immunizations: A Comprehensive 2020 Update

Procedural Approaches to Dermatologic Diagnosis and Treatment for Primary Care Providers

Emergency Medicine and Pediatric ENT

March 14 - 21, 2020 7-Night Mexican Riviera Cruise Conference Round-trip San Diego, California Holland American Line’s Oosterdam April 8 - 15, 2020 7-Night Paris, Normandy and the River Seine Cruise Round-trip Paris, France Amadeus River Cruises’ Amadeus Diamond

Allergy, Immunology and Infectious Diseases May 1 - 9, 2020 8-Night Spain & France Cruise Conference Round-trip Southampton, England Celebrity Silhouette

Selected cruises listed here. See a complete program listing at www.ContinuingEducation.net Accreditation:

Continuing Education, Inc is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

July 30 - August 8, 2020 9-Night Best Of Italy Cruise Venice, Italy to Rome (Civitavecchia), Italy Celebrity Cruises’ Celebrity Constellation August 8 - 16, 2020 8-Night Scandinavia and Russia Cruise Round-trip Copenhagen, Denmark Royal Caribbean’s Jewel of the Seas

Women’s Health & Healthcare Communications October 17 - 27, 2020 10-Night Sunshine in the Canaries Cruise Conference Round-trip Southampton, England Royal Caribbean’s Anthem of the Seas

Call 866-456-9464 or 727-526-1571 or visit www.ContinuingEducation.net Please visit our website for current fees and cancellation policies. Florida Seller of Travel Reg. #14337


MADE IN ITALY VELE DINING TABLE | TITANIUM MIRROR CLOCK | PRISMA MIRROR SPEEDFORM CHANDELIER | SEGNO BUFFET | SIT CHAIR - DESIGN BY PININFARINA

221 10th Ave SW CALGARY, AB 403.262.6813 luxuriesofeurope.ca Instagram: @loeyyc


Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.