Just For Canadian Doctors Winter 2020 by Just For Canadian Doctors

winter 2020

life + leisure

DOCTORS

a walking safari in

manitoba 4 ways to win a n

Amazo gift c n ard see pa ge 29

Publications Mail Agreement #41073506

inside: Continuing medical Education Calendar where will you meet? w h i s t l e r

s a n j ua n

lo n d o n

a s pe n

t e l av i v

EXPOSURE TO LT-PRODUCING ENTEROTOXIGENIC E. COLI CAN HAPPEN DUKORAL® [Oral, Inactivated Cholera and ETEC Diarrhea Vaccine] is indicated for the prevention of and protection against cholera and enterotoxigenic Escherichia coli (ETEC)producing heat-labile enterotoxin (LT) (either LT alone or both LT and heat-stable enterotoxin (ST) together). Cholera: The vaccine is recommended for adults and children from 2 years of age who will be visiting areas with an ongoing or anticipated epidemic or who will be spending an extended period of time in areas in which cholera infection is a risk. ETEC-diarrhea: The vaccine is recommended for adults and children from 2 years of age who will be visiting areas posing a risk of diarrheal illness caused by LT-producing ETEC. DUKORAL® should not replace standard preventative hygiene measures. Rehydration measures must be taken in case of diarrhea. Consult the DUKORAL® Product Monograph at https://health-products.canada.ca/dpdbdpp/index-eng.jsp for contraindications, warnings, precautions, adverse reactions, interactions, dosing, and conditions of clinical use. The Product Monograph is also available through our medical information department. Call us at 1-855-356-0831.

Tell them to visit the consumer website dukoralcanada.com VALNEVA Canada Inc. 600-3535, Saint-Charles Blvd. Kirkland (Montreal), Quebec, H9H 5B9 © 2019 VALNEVA Canada Inc. All trademarks used under license.

TALK TO YOUR PATIENTS ABOUT

Just for C

DOCTORS life + leisure

contents

winter 2020

Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Lisa Kadane Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Jenn Smith Nelson Roberta Staley Catherine Tse Cover photo Jenn Smith Nelson Senior Account Executive Monique Nguyen

Account Executive Wing-Yee Kwong

Production Team Ninh Hoang Annie Do

FEATURE

10 A wild encounter with a polar bear on the far

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

shores of Hudson Bay in northern Manitoba, where a walking safari lets wildlife lovers get (really) close and (very) personal

COLUMNS

DEPARTMENTS

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.

9 the thirsty doctor

5 winter mix 15 CME calendar 29 sudoku 30 parting shot

In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

Things get smoky…

20 doctor on a soapbox Passing the stethoscope

22 motoring

Global perspective

The sporting SUV

27 the wealthy doctor

we’re social!

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

Prescription for building wealth

28 pay it forward Helping women across Africa

www.justforcanadiandoctors.com

PHOTOS: Jenn smith nelson

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.

cover photo A nature lover and photographer’s dream comes true on Churchill Wild’s Polar Bear Walking Safari in Canada’s Hudson Bay— home to the only fly-in polar bear eco-lodges on the planet (page 10).

Winter 2020 Just For Canadian doctors

from the editor

oming face-to-face with a polar bear… A frozen and unforgettable moment. Skiing down a chute at Whistler Blackcomb. A different kind of freezing and rush of adrenaline. Sinking in a steaming spa pool surrounded by freshly fallen snow and mountain peaks rising tall and sharp in a blue sky. Another chilly moment to remember. Award-winning writer Jenn Smith Nelson went far north and deep into Canada’s tundra to commune with wolves, but found herself crossing paths with a polar bear (page 10). The walking safari— led by longtime, professional guides—is the only such experience in the world and lets guests of Churchill Wild get up close (and rather personal) to the king of the north and winter.

There are other ways to get the heart pounding this winter, like taking advantage of Whistler’s early—and long—ski season and all the other highs of mountain village life, from a lit-up night stroll through the forest to a lake-inspired brew (page 15). From the Coastal Range to the Rockies, another woods-and-mountains getaway awaits in Kananaskis (page 5). Here, you may encounter a robust snowman, wee deer and a blanketful of stars… Share your up-close moments with us on social media: Facebook (facebook.com/ justforcanadiandoctors), Instagram (@justforcanadiandoctors; #justforcanadiandoctors) and Twitter (@JFCDoctors). We want to see where you’re going in 2020!

jenn smith nelson

Up close

In the far north of Manitoba, on the shores of Hudson Bay, Nanuk Lodge is base camp for some serious wildlife viewing (page 10)

comments/questions: feedback@InPrintPublications.com

Best practice information to guide you to diagnose, treat and manage Parkinson’s

COMM

Now Available!

The Canadian Guideline for Parkinson Disease

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Full Guideline

Resources for you & your patients

VISUAL FROM SUMMARY OF TH PARKIN E CANADIA RECOMMEN N SON DI DATION SEASE, GUIDELINE S FOR 2ND ED

DIAGNO PROGRE SIS AND SSION Parki

Visit ParkinsonClinicalGuidelines.ca to download:

Infographic

PARKINS DISEASE ON

This 2nd Edition includes 97 recommendations based on the best published evidence to guide you in clinical practice.

Executive Summary

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Aussi disponible en franÇais : Visitez le site Web ParkinsonGuideClinique.ca For print copies, contact: Education@parkinson.ca | 1 (800) 565-3000 | parkinson.ca Charitable Registration Number 10809 1786 RR0001

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Just For Canadian doctors Winter 2020

2019-11-18 12:17:03 PM

what/when/where > winter

mix

winter is here in kananaskis into the woods + mountains

barb sligl

geta way Sink in and watch the snow fall at this hideaway with a view ( from the nordic spa!) in the Rocky Mountains. . . Winter 2020 Just For Canadian doctors

mix

winter

getaway

mountain high

ace e m b r old! th e c

Only an hour from Calgary, Kananaskis Country is a winter wonderland

Just For Canadian doctors Winter 2020

Snowman with a view “Exfoliation Cabin” at Kananaskis Nordic Spa right

Early morning sun on the Rockies in Kananaskis Country left Fall colour overlaps with snow and icicles

Village Rim Trail right Furry friends

barb sligl

let it snow

t’s early morning. The trail that skirts the edge of the high plateau is quiet and shrouded in the last bit of night. My breath trails me in long, opaque wisps. A few faint stars still glitter as the mountain peaks seem to press closer, backlit with a luminous pink. Snow crunches beneath my boots. With each footstep, the pink gets brighter and the peaks closer. And then a riotous bit of radiance illuminates one mountaintop. Later, I meet a wee deer enjoying the sun just off the path… Short and super-easy, the Village Rim Trail around the Pomeroy Kananaskis Mountain Lodge is up-close access to the Rockies of Kananaskis Country—4,000 square kilometres that encompass five provincial parks, four wildland provincial parks and one ecological reserve. K-Country, as it’s referred to locally, was designated a protected park system in 1978 and since then has hosted the 1988 Olympics (the lodge was originally built for the athletes’ Olympic Village) and the G8 in 2002 (when it still included eight nations). Just an hour west of Calgary, this mountainside hideaway is an ideal weekend getaway—with a nordic spa. The hydrotherapy cycle—hot and cold water baths, steam and sauna cabins—includes a Russian-style banyan sauna, exfoliation cabin and so-called “winterized” hammocks in which you can zip up and cocoon as the snow falls around you. I try them all, and then watch flurries dance with the flames of one of the fire cauldrons. The alpine rejuvenation continues inside the lodge…where there’s yoga and the “Fireside Stories” series, told by people like the legendary climber Barry Blanchard, known for boundary-pushing alpine ascents in the Canadian Rockies and Himalayas. It’s all almost inspiring enough to don my boots again and hit the trail network of Barrier Lake or slopes of Nakiska Ski Resort, both just down the road from the lodge. But first: a Campfire Manhattan in the lobby bar (made with local Park Glacier Rye, distilled in nearby Banff, and a cedar-smoke infusion; see page 9 for more on smoky cocktails) with a side of views of Mount Kidd and Little Mount Kidd. And later: another fireside gathering, this time with s’mores and acoustic music. When in the wilds of K-Country…. — Barb Sligl

if you go Experience winter in the mountains at the Kananaskis Mountain Lodge, an Autograph Collection Hotel (marriott.com), and Kananaskis Nordic Spa (knordicspa.com).

give (and get) x 7 gift list

winter

’tis the season

mix

Gifts for everyone on your list Written + produced by Catherine Tse

2 Little Blue Bottles The next chapter in Tiffany & Co.’s fragrance story is an homage to the brand’s history of celebrating love. These dual fragrances each have their own unique profiles but share a common star ingredient, blue sequoia. Tiffany & Love For Him is a citrusy, wood-based fragrance; Tiffany & Love For Her is a modern woody floral. tiffany.ca 3 stats 101 The new Fitbit Versa 2 is clearer, brighter and faster than its predecessor, tracking your vital stats with more accuracy. You can view everything from steps taken to heart rate to quality of sleep. This version even integrates Amazon Alexa to help answer questions so you don’t ever have to miss a step. fitbit.com/en-ca/home 4 capsule wardrobe The effort-to-reward ratio using a Nespresso is so high, it’s easy to forget there’s any other way to make coffee. The capsules make it absolutely foolproof to brew the perfect cup, whether it’s an espresso, Americano or latté. Also, limited-edition holiday capsules offer festive flavours that turn your regular cuppa into a holiday treat. nespresso.com/ca/en/ 5 light bright Dyson’s new Lightcycle task light went through 892 prototypes, involving more than 90 engineers. The result is a light that actually tracks local daylight and self-adjusts depending on the time, task, location and your age to not only reduce eye strain but also minimize disruption to your circadian rhythm. And it’s beautiful. dysoncanada.ca/en/

editor's

pick

present sense

1 Multi-layered Canada Goose BRANTA is a new line of men’s and women’s contemporary coats that reflects Canada Goose’s performance-driven DNA, combining it with upscale style. The Viedma 4-in-1 coat features two separates that can be worn together for a warm winter parka or deconstructed to two parts: a Loro Piana Storm System® wool outer shell and a reversible quilted lightweight down jacket. canadagoose.com

4-in-1 1

6 all i ever wanted Singer and musician Lenny Kravitz has had a long-standing relationship with Dom Pérignon. As a connoisseur of the vintages, Kravitz was given complete creative freedom in creating this limited edition Vintage Brut 2008, a true reflection of artistic creativity combined with hallowed legacy. lcbo.com; saq.com; aglc.ca

7 jet set This new Canadian brand offers an antidote to today’s throwaway attitude of mass, fast consumption. Enter: Monos luggage made with the finest quality parts and materials sourced from around the world, creating premium suitcases at accessible prices. This is for those who yearn for fewer, better things. monos.com

Winter 2020 Just For Canadian doctors

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.

Just For Canadian doctors Winter 2020

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.

Fire-inspired cocktails

Infusing drinks with winter’s woodsy aroma is more than smoke and mirrors

photo courtesy of Fairmont Pacific Rim

team swirled inside the little the bar for evidence of the literal “smoking glassed-in brass lantern that housed gun” used to infuse them. my cocktail. I unlatched the clasp, “Aroma is such an important part to opened the miniature door, and watched a how a drink tastes. So a lot of people are cascade of fog billow out across the table. starting to play with smoking drinks,” says When it cleared, my Candy Cap Magic Sceney. “And in the Instagram world we cocktail revealed itself. Alit on a bed of taste with our eyes first.” moss, it appeared an elfin offering in an Drinks like Smoke on the Water go viral enchanted forest. on social media. Then, imbibers pilgrimIt smelled of damp earth and recent age to the bar so they can capture the rain, and tasted like vanilla-spiced whisky cocktails on camera (and drink them, of and maple syrup snuggled inside a humid course). But smoking or steaming drinks kiss of mist; a perfect accompaniment to also adds a level of flavour and complexity a chilly fall evening. It was but one choice that elevates the practice above a magifrom the “Cocktail Lab” inside the Botanist cian’s trick of smoke and mirrors. restaurant at the Fairmont Pacific Rim in “With a lot of bartending, things can Vancouver. Each drink on the list evokes trend toward show—more form than funcan element, from earth to fire, with the tion. But with smoke, it infuses a certain special effects to back it up. type of taste and texture to drinks you’re Not to be outdone, Smoke on the Water includes ingredients that have danced with Should I play with matches at my home bar? flames, from the burnt barrels that age its rum, to the charred It’s easy to smoke cocktails at home, says Grant Sceney of lemons that add a smoldering the Botanist in Vancouver. All you need is a cedar plank citrus hit, to the cedar chips (like one for grilling salmon) and a hand-held blowtorch that smoke the drink before (like what you’d use to scorch crème brûlée). it’s served. 1 Torch the plank until it starts to smolder. “We wrap the glass in 2 Trap the smoke by turning a rocks glass upside down burlap and it retains the smoke over top of it. from the cedar chips,” explains 3 Prepare your cocktail. Perhaps a rum old fashioned? Grant Sceney, the Pacific Rim’s 4 Pour it into the smoked glass. creative beverage director. “Every time you put it up to If you’d rather not set fire to anything, try using peated Islay your lips you can still smell it.” scotches or smoky mezcals to add that campfire flavour and Drinks like this are, in a aroma, says Frankie Solarik of BarChef in Toronto. word, intoxicating. And not just because of the ashen aromas that cling to clothes and nose and conjure the morning after a campfire. making,” says Brett Theriault, manager at They mesmerize with their theatrics, and Sticks and Stones in Saskatoon. make Tom Cruise’s shaker shenanigans in In his Fall Fuego cocktail, for example, the movie Cocktail look downright quaint. the use of smoke from applewood shavWhat’s more, they’re far more balanced ings enhances the herbaceous qualiand complex than anything created in the ties of the drink’s chartreuse and Maté saccharine decade that was the 80s. Amaro (from local distiller Stumbletown), No wonder smoking drinks is a trend and plays nice with the vanilla notes of that’s engulfing the cocktail world like Casamigos añejo tequila and the sweeta four-alarm blaze. From burnt cherry ness of Carpano Antica vermouth. Manhattans at The Guild in Calgary, to “The smoke is being used for the spesmoked mezcal jalapeño margaritas at cifics of the flavour. The fact it looks great Clandestino in Montréal, just look behind is a happy byproduct,” he says.

Adding smoke to cocktails also works best with spirit-forward libations that use brown, aged spirits—think brandy, whisky, rye or tequila—as the base. This is why twists on smoked old fashioneds and smoked Manhattans seem to proliferate. In fact, the Vanilla Hickory Smoked Manhattan from BarChef in Toronto epitomizes this trend and is likely the drink that ignited it in the first place. To execute it, executive barchef and co-owner Frankie Solarik heats hickory chips and a vanilla bean with a blowtorch, and presents the drink on an ornate pedestal under a glass cloche that traps the smoke. “It was the first smoked cocktail. I came up with that technique 11 years ago. It was way before smoking guns,”

The Candy Cap Magic

says Solarik, who believes that multisensory drinks—that come with an elevated cost—will always have a place in cocktail bars. As much as I enjoyed my Candy Cap Magic, at $32 a show, it felt rather like a niche experience; something to sip on occasion next to a roaring fire. “If you sat by a campfire every night, you would stink forever,” quips Sceney. Indeed, his statement kind of sums it up—cocktails are probably best when smoked in moderation.

Winter 2020 Just For Canadian doctors

travel at home

the

( wi ld) rush of the

Nor th + photography by Jenn Smith Nelson

story

A tale of an arctic safari through 10

Just For Canadian doctors Winter 2020

travel at home

northern Manitoba’s remote wilderness

MM BMMP, BMM BMMP, BMM BMMP, BMM BMMP… My heart is beating with such intensity that it’s the only noise I hear. I don’t dare look down at my Fitbit to see my actual rate; it’s surely the highest it’s ever been while standing still. Adrenaline courses through my veins and I try to keep my body still and my eyes locked ahead. There’s no other way out of this situation but to face it: a polar bear. Four days prior, 15 of us arrived at Nanuk Lodge with Churchill Wild via a 45-minute flight from Churchill, Manitoba, for a few days of wildlife watching. Sandwiched between two biomes, marine and boreal, the seasonal lodge is known for its exclusive access to pristine woodland and coastal wilderness and diverse wildlife. Most people however, come to view polar bears—on foot, a practice unique to Churchill Wild. We’re already up to five or so bear sightings (or large white lumps as seen from the sky) on the short flight over milky swirls of tundra. With close proximity to Hudson Bay and a nearby polar bear denning area (one of the world’s largest at Wapusk National Park), the lodge is ideal for viewing bears in their natural environment. Ice freezes here first, and the bears patiently wait out the months in walking hibernation. But I was really here to see a wolf. Or 20 of them. In addition to bears (white, brown and black!), wildlife such as moose, fox and wolverines can be seen. For the past four years though, wolves—a large pack of them—have frequented the lodge and especially the runway in front of it, which, I learn, is a wildlife magnet. It also offers unobstructed glimpses of the elusive species—as do the lodge’s viewing decks and large windows. For nearly a year, I’ve been putting messages out to the universe with the hope of seeing a wolf at Nanuk. But now there’s a polar bear waiting to greet me instead. As we step off the plane, a massive male bear is just outside the lodge compound. He obliges a few photos before sauntering off. It’s early afternoon and there’s still time for an outing, so we don rain Winter 2020 Just For Canadian doctors

travel at home if you go gear and gather for It’s chilly and Be sure to book in advance. orientation. “Is that drizzling, far from Nanuk Lodge is open August another one out glamorous, yet there’s through the third week of November there?” a guest no place I’d rather and two weeks in March: churchill asks. “Yep, it’s a be. We stop quite wild.com. Churchill Wild runs four bear,” confirms far from the bear to lodges in northern Manitoba and guide, Emri gauge how she reoffers over a dozen itineraries. Canvin. “It’s laying sponds. Wind ripples And Nanuk Lodge is a National out there on its in puddles beneath our Geographic Unique Lodge of the World. back with its legs in feet as we line up to snap the air, chillaxin’.” pictures of her shifting We’re all eager to get sleeping positions. We move a back outside, but first, guide bit closer. She’s peaceful. Andy MacPherson runs through the We depart when we hear that the do’s and don’ts of approaching wildlife. same bear who greeted us upon landing “As a group we’re a huge presence. No (quickly dubbed Runway Bear) is waiting matter where we are, never run. It’s always just outside the lodge’s back fence. His nice, slow, deliberate walking, slow, delibeyes open and close as he sighs and sniffs, erate movements,” he stresses. taking in the fragrance of dinner wafting Approaching large wildlife on foot from the lodge. He allows us to approach requires keeping a distance of at least the 122-metre-long fence that protects 100 metres (and the 400–600mm lenses the back perimeter of the lodge and rolls nearly everyone is toting make perfect onto his back, seemingly comfortable with sense). We learn about bears’ body lanall the attention. guage and how to react should a bear ap“He’s getting to know each and every proach. “We go single file and always have one of you by your scent,” Canvin says. a guard at the front. Positioning is a very Maybe it isn’t dinner he smells after all, good deterrent,” MacPherson continues. If I think. the animal proceeds closer, “We talk to the We devour a home-cooked meal from bear, raising our tone, if necessary,” adds the lodge’s northern cookbook series, MacPherson. “If that doesn’t work, we use Blueberries & Polar Bears, and rehash the these,” he says, pulling two rocks from day while watching for wildlife outside his pocket and smashing them together the dining area’s windows. Just as we dig loudly. “Then, if it decides to come closer, in, a female moose, the first spotted at we happen to have a handy projectile in the lodge this season, interrupts dinner. our hand.” Other deterrents, a small pistol Cautiously, she scampers through a poplar (making banger and screamer noises), bluff and then disappears down the runbear spray and rifle are also carried. “So way. Minutes later, a little black bear does far this year we’ve never went beyond the the same. rocks, and we’ve never had to use a rifle,” I’m crushed the next morning to learn he assures. that the wolf pack hasn’t been spotted Outside, we climb into a rhino, an this year and has likely moved on. This open-bucket safari type-vehicle that can doesn’t stop me from getting up each trudge over most terrain, even water. We morning at dawn to scan the runway. travel westward to get a closer look at the Over the next two days, a routine bear spotted from the lodge. Tamaracks forms between lodge meals. Half-day have begun to turn, a sign of an early outings are spent crossing rivers and winter, along with other glints of yellows scouring for wildlife. We trek through and rust-oranges. mud on the marshy plains of the Hudson Leaving the rhino behind, we slowly Bay lowlands and slug through swaths walk toward the large snoozing bear, a of boreal or “moose habitat.” We see pregnant female, the guides suspect. plenty of evidence (poo, prints and fur) of “This is a good time to practise our single animals come and gone. Along the way, file,” says Canvin, as we walk across we spot a few new-to-us bears who want mucky tundra covered with goose tracks nothing to do with us and quickly disapand saturated sea asparagus. Following pear into willows. MacPherson’s lead, we gently zig and zag Trills, squawks and chirps of staging in unison. Slow and deliberate. birds fill the chilly air. We race golden With a sniffer that can detect prey 20 miles away, Runway Bear gets a whiff of the guests from top left Runway Bear leisurely strolls across the tundra in his pigeon-toed gait; Nanuk Lodge guides Andy MacPherson, Emri Canvin and Kevin Rednose; Aurora borealis is best seen after late August prevous spread

travel at home plovers, try to sneak up on skittish packs of sandhill cranes and witness a massive starling-like murmuration of Hudsonian godwits. There are more geese than we can count and an abundance of raptors, especially northern harriers, all pausing here en route to winter homes. Each day, we view the female bear who’s still asleep in the west, are faithfully welcomed home by Runway Bear after outings, and visited by the little black bear at dinnertime. Swirling green aurora or northern lights appear early in the evenings before we recoup from yet another fulfilling day of wildlife watching. But no wolves. By the end of day three, my hopes are renewed when we come across wolf tracks. “There were at least two here,” the guide says. Our last day is much like the others, but just before heading back to the lodge, we spot the creamy bulk of a bear walking in the distance near the shore and set out for a final excursion. As we head to a viewing spot, we notice the bear is travelling there too, and it’s surprising how quickly this bear has advanced. The bear is heading straight for us. 100 metres turns into 50, then 30… BMM BMMP, BMM BMMP, BMM BMMP, BMM BMMP. “Go around, bear,” says Canvin, right in front of me. He’s calm but his tone increases as the bear creeps closer. He repeats, “Keep moving!” as he kicks some sand and tosses a rock the bear’s way, causing a mere second-long pause. With relaxed body language, the bear continues, unbothered by our wall of people. Ten metres… My body is both numb and tingling as we stand eye-to-eye with Runway Bear, the 900-pound-plus apex predator with a pigeon-toed gait exposing colossal claws. As our guide instructs, we stop taking photos and take two steps toward the bear. Immediately, the bear pauses. Slowly, we all turn 25 degrees, encouraging the bear to peacefully pass around us. Runway Bear strolls into the sunset while adrenaline streams out of me in the form of tears. I may have come for the wolves but the king of the arctic, a graceful and beautiful giant, has capped my stay. Once I’m home, I find out that a wolf came down the runway two days after I left. But my tears remain a testament to Runway Bear. A female moose emerges from the brush; Sleepy Bear; Wildlife viewing from the lodge; A wolf was here!; Travelling in the rhino

clockwise from top left

whistler / san juan / london / aspen / tel aviv … | c a l e n d a r

cMe

A n int ern ation a l guide to continuing medica l Education

winte r 2020 + beyond

whistler

left Get “lost” in the beauty of Lost Lake, a short walk from the Upper Village right The dark-and-gnarly

form of Black Tusk pokes high out of the spread of mountains that surround Whistler Blackcomb

barb sligl

Time to hit the slopes in whistler (CME events in Whistler are in blue.)

n a bluebird day at Whistler Blackcomb (the ski resort’s long winter season has started…get geared up!), there are no bad runs. But if that sun is shining, take a ride all the way up the Peak Chair to 2,182 metres. From here, there’s Whistler Bowl (hello, moguls) back under the lift, but the easier way down is around the backside of Whistler Peak, stopping for selfies by the inukshuk with Black Tusk in the background, a gnarly finger pointing into that blue. Glide past the spread of Garibaldi Provincial Park (peak after peak after peak) and zip alongside Little Whistler Peak and into the opening of The Saddle (a Whistler-level “blue” run) next to Glacier Bowl. The steep drop will get your blood pumping. Yee-haw!

Next up: 1,925 hectares of skiable area, stars come out, go just beyond the buzz of the village to Cougar Mountain, where 1,530 metres of vertical, more than 200 runs, 37 lifts, almost 12 metres of snow… the award-winning multimedia forest walk and a wow traverse of the valley Vallea Lumina is now open throughout the winter season. between Whistler and Blackcomb [go] In the morning, if your legs via the Peak 2 Peak gondola, Hit the slopes: are still burning, stretch them the longest and highest whistler such lift in the world (with a slower way: a walk in the blackcomb.com Guinness World Records). Upper Village to Lost Lake (the More info: inspiration for that IPA—or Whew. Take a break from whistler.com the downhill action and recoup two—last night). The body of water is a serene spot best taken with après-ski in the village (from a chilled vodka in the ice in via the trail around its shores with room at Bearfoot Bistro to a well-deserved pretty vistas framed by stoic trees. In late bottle of Whistler Brewing’s Lost Lake IPA) fall, you’ll get the last glimpses of brightyellow leaves, another sunny counterpoint and then some cultural reflection at the to the snowy white of the ski hill, which Audain Art Museum (home to a beautiful collection of First Nations masks and works rises high above. Stay awhile and, yes, get by artists like Emily Carr). And when the lost in the Whistler vibe. — Barb Sligl Winter 2020 Just For Canadian doctors

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Aesthetics

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Jan 17-20

Orlando Florida

ODAC Dermatology, Aesthetic And Surgical Conference

ODAC Dermatology, Aesthetic and Surgical Conference

See website

orlandoderm. org

Feb 21-23

San Juan Puerto Rico

CosmoCaribbean 2020

xMedica

866-477-7153

cosmo caribbean.com

Apr 23-27

Las Vegas Nevada

American Society For Aesthetic Plastic Surgery Aesthetic Symposium 2020

American Society For Aesthetic Plastic Surgery

562-799-2356

surgery.org

Jan 08-10

London England

Association Of Anaesthetists Of Great Britain And Ireland Winter Scientific Meeting 2020 (AAGBI 2020)

Association Of Anaesthetists Of Great Britain And Ireland

44-020-76311650

anaesthetists. org

Feb 01-08

Aspen Colorado

Aspen Anesthesia Seminar

Holiday Seminars

877-859-0550

holiday seminars.com

May 02-03

Sacramento California

3rd Annual UC Davis Pediatric Anesthesia Update

University of California, Davis

events@ ucdavis.edu

health.ucdavis. edu

May 14-18

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

Jan 08-10

ZĂźrich Switzerland

Bypass 2020 - Anniversary Symposium

University Hospital ZĂźrich

bypass2020@ usz.ch

usz-microsite. ch/bypass 2020

Feb 05-07

La Jolla California

9th Annual Structural Heart Intervention And Imaging 2020

Scripps Conference Services & CME

858-678-6400

scripps.org

Feb 29Mar 10

New Zealand Cruise

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

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

Apr 02-05

Porto Portugal

6th International Congress On Cardiac Problems In Pregnancy 2020

Paragon Group

27-0-87-4700365

cppcongress. com

Jun 28-30

Tel Aviv Israel

12th International Conference On Acute Cardiac Care

ISAS International Seminars

972-2-6520574

cardiology-20 20.isas.co.il

Jul 26-28

Whistler British Columbia

Success With Failure: Strategies For The Evaluation And Treatment Of Heart Failure

Mayo Clinic

866-246-1581

radiology education. mayo.edu

Jan 11-13

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

Jeddah Saudi Arabia

Jeddah Dermatology And Cosmetics Conference 2020 (JeddaDerm 2020)

JeddaDerm

966-26240000

jeddaderm. co/wp

Jun 24-27

Ottawa Ontario

CDA 95th Annual Conference

Canadian Dermatology Association

800-267-3376

dermatology.ca

new CE to be placed

Just For Canadian doctors Winter 2020

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

General & Family Medicine

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Feb 27-29

Dubai UAE

10th Emirates Diabetes And Endocrine Congress (EDEC 2020)

MCI Middle East

971-4-3116300

edec-uae.com

Mar 25-29

New Orleans Louisiana

National Kidney Foundation Spring Clinical Meeting

National Kidney Foundation

855-653-2273

kidney.org

Apr 02-05

Vilnius Lithuania

7th International Conference On Prehypertension, Hypertension, Metabolic Disorders And Cardiovascular Disease

Paragon Group

41-22-5330-948

prehyper tension.org

Oct 27Nov 03

Classical Danube River Cruise

Updates In Diabetes, Obesity, Preventive Cardiology, And Advanced Lipidology

Continuing Education, Inc./University at Sea

866-456-9464 See Ad Page 31

continuingedu cation.net

Jan 06-11

San Diego California

National Association Of EMS Physicians Annual Meeting 2020

National Association of EMS Physicians

800-228-3677

naemsp.org

Jan 08-11

Nassau Bahamas

Topics In Emergency Medicine

Northwest Seminars

800-222-6927

northwest seminars.com

Feb 23-26

Whistler British Columbia

33rd Annual Update In Emergency Medicine

University of Toronto

416-978-2719

cpd.utoronto.ca

May 27-31

Santa Fe New Mexico

Wilderness Medicine & Global Health

Center for Emergency Medical Education

971-236-8088 See Ad Page 32

wildernessmedicine.com

Jul 25-29

Big Sky Montana

Wilderness Medicine

Center for Emergency Medical Education

971-236-8088 See Ad Page 32

wildernessmedicine.com

Aug 14-21

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 17

seacourses.com

Feb 28Mar 01

Montréal Québec

Canadian Liver Meeting

CASL, CanHepC & CAHN

416-481-7776 ext 2 See Ad Page 16

canadian livermeeting.ca

Nov 05-08

Kobe Japan

Japan Digestive Disease Week 2020

Japan Digestive Disease Week

infoen@jddw.jp

jddw.jp/ english

Feb 10-13

Whistler British Columbia

Canadian Critical Care Conference 2020

Canadian Critical Care Conference

See website

canadian criticalcare.ca

Feb 14-17

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 14

dhc-fdn.org

Jun 06

Seattle Washington

Caring For Transgender And Gender Diverse Youth

Seattle Children’s Hospital

206-987-2000

seattle childrens.org

Jun 07-21

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

Nov 01-08

Antigua Sandals Resort

Respirology And Family Medicine

Sea Courses

888-647-7327 See Ad Page 17

seacourses.com

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Jan 18-19

Miami Florida

18th Annual Mild Cognitive Impairment Symposium, Special Topic Workshop & Alzheimer’s Public Forum

MCI Symposium

224-938-9523

mcisympo sium.org

Feb 13-14

London England

Dementias 2020

Mark Allen Group

44-0-20-75016796

dementias conference.com

Mar 19-21

Singapore Singapore

34th International Conference Of Alzheimer’s Disease International

Alzheimer’s Disease International

44-2079810880

adi2020.org

May 27-30

Washington DC

Interdisciplinary Symposium On Osteoporosis 2020

National Osteoporosis Foundation

703-647-3007

inter disciplinary symposium osteoporosis.org

Jan 30Feb 01

La Jolla California

12th Annual T-Cell Lymphoma Forum

Jonathan Wood & Associates

973-290-8200

tcellforum.com

May 14-16

Paris France

6th World Congresses On Controversies In Multiple Myeloma

CME Congresses

33-140582000

comy2020. cme-cong resses.com

Aug 06-09

Chantilly Virginia

ASH Meeting On Lymphoma Biology

American Society of Hematology

202-776-0544

hematology.org

Jan 15-17

Bangkok Thailand

22nd Bangkok International Symposium On HIV Medicine 2020

HIV-NAT

66-0-26523040

hivnat.org

Mar 02-06

Longboat Key Florida

Infectious Diseases: Adult Issues In The Outpatient And Inpatient Settings

American Medical Seminars

941-388-1766

american medical seminars.com

Apr 23-25

Buenos Aires Argentina

HIV & Hepatitis In The Americas

Ashfield Healthcare Communications

44-0-1625664390

hivhep americas.org

Jun 21-25

Toronto Ontario

International Symposium On Pneumococci And Pneumococcal Diseases Conference 2020

International Symposium on Pneumococci and Pneumococcal Diseases

31-20-763-05-18

isppd2020. kenes.com

Jan 27-31

Boston Massachusetts

Updates In General Internal Medicine For Specialists

Harvard Medical School

617-384-8600

gims.hmscme. com

Jul 13-17

Palm Coast Florida

11th Annual Essentials In Primary Care Summer Conference

Continuing Education Company

800-327-4502

cmemeeting. org

Nov 08-22

Japan, China and Taiwan Cruise

Update In Rheumatology

Continuing Education, Inc./University at Sea

866-456-9464 See Ad Page 31

continuingedu cation.net

Mar 16-18

Whistler British Columbia

CBT For Depression

CBT Canada

877-466-8228

cbt.ca

Apr 25-29

Philadelphia Pennsylvania

American Psychiatric Association Annual Meeting 2020

American Psychiatric Association

202-559-3900

psychiatry.org

May 14-16

Barcelona Spain

27th International Symposium On Controversies In Psychiatry 2020

International Symposium on Controversies in Psychiatry

34-934-161220

controversias barcelona.org

new CE to be placed

Just For Canadian doctors Winter 2020

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

Women’s Health

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Jan 10-12

Fort Lauderdale Florida

American Society For Peripheral Nerve (ASPN) Annual Meeting 2020

American Society for Peripheral Nerve

312-853-4799

peripheral nerve.org

Feb 13-14

Vienna Austria

European Conference On Controversies In Huntington’s Disease

Bio Events

44-203-0514032

ecch2020.com

Jun 20-28

Spain & Portugal Cruise

Palliative Medicine And End Of Life Care, Including Related Topics In Neurology

Continuing Education, Inc./University at Sea

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Jan 09-11

Houston Texas

NRG Oncology Meeting

NRG Oncology

267-519-6630

nrgoncology. org

Jan 31Feb 01

Whistler British Columbia

Canadian Breast Cancer Symposium

HayMatick Meetings & Events

778-882-4389

cdnbreast cancer.ca

Mar 07

Atlanta Georgia

Winship Melanoma And Cutaneous Oncology Symposium

Winship Cancer Institute

888-946-7447

winshipcancer. emory.edu

May 19-22

Calgary Alberta

Canadian Pain Society Scientific Meeting

Canadian Pain Society

416-642-6379

canadianpain society.ca

Jul 16-19

Lake Buena Vista Florida (Walt Disney World)

Headache Update 2020

Diamond Headache Clinic Research & Educational Foundation & Amita Health

312-867-9104 See Ad Page 14

dhc-fdn.org

Jan 05-10

Guanacaste Costa Rica

Breast And Body Imaging At The Beach 2020

Penn Radiology

215-662-6982

pennmedicine. org

Jan 06-10

Avon Colorado

Winter Imaging In Beaver Creek 2020

CME Science

855-383-7116

diagnostic imaging update.com

Jan 22-24

Las Vegas Nevada

A Comprehensive Tutorial In Musculoskeletal Imaging

Stoller

650-690-2634

stoller mskcourse.com

Feb 12-16

Dana Point California

American Society Of Spine Radiology Annual Symposium 2020

American Society Of Spine Radiology

847-752-5355

assrannual meeting.org

Mar 16-20

Telluride Colorado

18th Annual NYU Radiology Alpine Imaging Symposium

New York University Department of Radiology

212-263-3936

med.nyu.edu

Jan 02-06

Kohala Coast Hawaii

36th Annual Conference: Obstetrics, Gynecology, Perinatal Medicine, Neonatology, And The Law

Center for Human Genetics

617-492-7083

chginc.org

Oct 17-27

Sunshine in the Canaries Cruise

Women’s Health & Healthcare Communications

Continuing Education, Inc./University at Sea

866-456-9464

continuingedu cation.net

new CE to be placed

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

Winter 2020 Just For Canadian doctors

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.

Medicare metamorphosis

Passing the torch to the next generation of MDs—in a different medical sphere

’m formally surrendering my licence to practise in medicine. I graduated in the UK in 1969, which means I’ve been involved with medicine and Medicare for half a century. Not only as a physician but as a patient—who looks back now to reflect on the changes during those 50 years. I do, always have and will, support the publicly funded medical system—warts and all. There are undeniable shortcomings, but nobody in Canada need fear financial ruin as a result of medical problems. In the UK, in 1951, I was in one hospital having eye surgery, my sister was in another for abdominal pains and my father was in yet another with terminal gastric cancer. Despite being desperately distressing, it didn’t financially ruin us.

The problem is sub-adequate funding. Anybody with an urgent illness or major trauma gets adequate and timely care. Where we come off the rails is in follow-up care and investigation and treatment of less urgent problems. How “less urgent” is a patient who is walking on a bone-onbone knee for months and at risk of requiring narcotics for the pain? Prioritising medical needs is certainly not an easy task—and forecasting into the future often lays seeds of problems that germinate several years or even decades later. The 1980s policy to reduce the number of physicians (thought to be driving up the cost of Medicare) resulted in fewer medical school places. BC tried restricting billing numbers and forcing retirement at

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about 70 years old. Nobody anticipated that splitting up of primary care into hospitalists, dedicated assistants, ERPs etc. would result in the current shortage. Another significant factor is the advances in medicine, like the joint replacement surgery that now costs the system a fortune. Demand for replacement joints is increasing exponentially as a result of advances in medicine that increase longevity. My peer group has moved on from discussing birth control options to menopause symptoms, erectile dysfunction and artificial joints. Physicians (and patients) are adapting to this relentless metamorphosis of statesupported medical care. But it’s a slow process and doctors, on the whole, are a conservative group. A golden opportunity that’s been missed is the adoption of a Canada-wide EMR (Electronic Medical Record)—harder to remediate the longer it is left undone. Still, I have cautious optimism for the future when I consider the following… • •

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The gradual extinction of single-handed practices in favour of real or virtual group practices. Realistic expectations from new medical graduates. New MDs accept that they won’t earn the equivalent income of dentist or lawyer peers, but they also won’t endure the brutal hours that were the lot of my generation. An increasing proportion of female graduates with medical degrees endorses the preceding paragraph; based on many peer assessments, women are better able to look at the broader picture, delegate responsibly without feeling professionally threatened and have better life/work balance. The EMR has enormous advantages in patient safety and interprofessional communications; related to this is the vast amount of information readily available electronically for physicians.

I feel good about handing over to this new generation of physicians, and I hope that they’ll feel likewise when they retire.

Corporate-owned Life Insurance: Primer For Professionals KERRY SMITH, CPA, CA

ife insurance is an essential tool in traditional estate planning. It provides liquidity at the time of an individual’s death and offers peace of mind knowing their family is taken care of in case something should happen to them. But did you know life insurance isn’t just for emergencies? Structured properly, life insurance can also be an essential tax planning tool and provide significant benefits today – not just after your death. TYPES OF INSURANCE Life insurance generally falls into two categories – term and permanent. Term Insurance Term insurance is just that: insurance for a fixed period; typically 5, 10 or 20 years. Every year of the term has a set premium, with a fixed amount of insurance available during that time. When the term ends, the policy and insurance coverage expire. Due to its time-bound and fixed nature, term insurance tends to be inexpensive. Permanent Insurance Permanent insurance provides guaranteed coverage for life. The policy pays out the death benefit, regardless of your age or changes to your health, assuming you pay your premiums. In addition to the underlying insurance, permanent insurance policies include an investment component. Although permanent insurance policies require premium payments for life, they are generally structured so the investment component of the policy funds the premium payments after a fixed term. This means that you might only need to make premium payments for 10, 15, or 20 years – similar to a term insurance policy – however, the coverage continues for life. The self-funding nature of these policies makes them a solid method of creating wealth in the long term. TAX BENEFITS OF CORPORATEOWNED LIFE INSURANCE Cost to Acquire Policy Using a corporation to purchase insurance allows for faster accumulation of wealth. By using corporate dollars instead of personal funds to pay for the policy,

the same level of income can purchase significantly more insurance. If you were to buy insurance personally, you would need to pay personal tax on the money you’re taking out of the corporation and would therefore have less cash available to put towards the insurance policy.

Corporate-owned life insurance is an incredibly effective estate, tax and liquidity planning tool if used properly. The type, amount and structure of insurance needed vary significantly depending on personal needs and circumstances.

in the investment part of the policy. Since the CSV is a liquid and secure asset, financial institutions are typically happy to use the CSV as security for a loan. Some financial institutions will lend up to 100 percent of CSV. As the policy may be more than you intend to leave to your estate, you can access the value of the policy while you are alive by borrowing and using the policy as collateral. With leveraging you can access the wealth accumulated within an insurance policy during your lifetime, not just after your death. There are several ways to structure the borrowings. The corporation can borrow against the policy to either reinvest the funds, or make shareholder distributions. In some situations, and subject to addressing possible shareholder benefit issues arising from the use of a corporate asset to secure a personal loan, the individual shareholder may be able to borrow against the corporate-owned policy to either finance their lifestyle or investment needs. Depending on the use of the funds, interest on the borrowed money and a portion of the annual premium payments might even be tax deductible.

Tax Free Accumulation Structured properly, most permanent life insurance policies in Canada are known as “Exempt Policies”. Any investment income earned inside these policies grows tax-free. Also, investments within an insurance policy tend to outperform those within a standard investment account on an afterIS CORPORATE-OWNED LIFE tax basis because of the personal and INSURANCE RIGHT FOR YOU? corporate tax rates on investment income. Corporate-owned life insurance is an incredibly effective estate, tax and liquidity Tax Efficient Distributions When the insured individual dies, the planning tool if used properly. The type, corporation receives the tax-free death amount and structure of insurance needed benefit – including both the base amount vary significantly depending on personal and any accumulated growth in the policy’s needs and circumstances. Contact an MNP tax advisor today to learn whether investment component. The amount by which the death benefit corporate-owned life insurance could help exceeds the adjusted cost basis of the you reach your personal and professional policy is added to the corporation’s capital goals. dividend account. The corporation can pay this out to the remaining shareholders/ estate, who will subsequently avoid personal Kerry Smith, CPA, CA, is a Partner within income tax requirements – creating an MNP’s Professional Services team. For more information, contact Kerry at extremely tax-efficient outcome. 604.685.8408 or Kerry.Smith@mnp.ca.

Leveraged Insurance Options If you were to cancel an insurance policy at any time, the insurer returns an amount of cash to you. This is known as the Cash Surrender Value (CSV). Most policies include a guaranteed CSV and a variable component based on the growth Advertising Feature

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.

Sporting re-dimensioned The new sports car is…the SUV

y favourite automotive journalist’s event is the annual Run to the Sun (RTTS). The latest version had each participating scribe rotate through 24 aspirational vehicles over a three-day, 739-kilometre driving route. The spectacular Columbia River Gorge provided the scenic backdrop. And this year’s RTTS precipitated within me a re-evaluation of what constitutes a sporting vehicle. In particular, the Alfa Romeo Stelvio Quadrifoglio forced me to accept that a unibody SUV (or “cross-over”) could titillate its driver just like a sports car. To date, other SUVs and cross-overs had failed to instill in me that excitement.

Which got me thinking about the whole post-WWII evolution of sporting vehicles. The original sports cars, released a decade before I was born, were two-seat British roadsters. More civilized coupe versions of the same cars came next, which pleased the purists almost as much. In the 1960s, 2+2 coupes, like the Porsche 911 and BMW CS, came along and further broadened sporting enthusiasts’ horizons. The 1970s saw the OPEC Oil Embargo and the automotive industry convulsed into new realities. Sporting vehicle enthusiasts saw a new breed debut and welcomed the hot hatch, with the frontdrive VW Golf GTI as the prototype. Being university aged, I grooved to that beat.

Just For Canadian doctors Winter 2020

It wasn’t until the 1988 BMW M5 exploded onto the scene that a decentsized sedan could be considered a sporting steed. Intended for boomerswith-kids, BMW, Mercedes, Audi and Volvo all soon offered high-performance wagons too. Enthusiasts now had quite a roster of choices: sports cars, sports coupes, sport 2+2, hot hatches and sport sedans/wagons. Yet, since the 1990s, all of these market segments have experienced shrinking market share. Whole car lines are disappearing as the manufacturers re-direct investment to where sales are bullish: the SUV/cross-over and pick-up truck segments.

doug berger

motoring

D r . k e l l e n s i lv e r t h o r n

For me, it takes more than generous horsepower to render a vehicle truly “sporting.” Tall centres of gravity, long suspension travel and ponderous weight all constrain a light truck’s sporting bona fides. Buyers flock to these light trucks regardless—for their higher vision perch, ease of ingress and egress, practical interior volume and butch “outdoorsy” looks. For the past 15 years car companies have been edging some of their crossover offerings closer to “sports.” These sports cross-overs would show up at journalist’s events, even at race tracks. I couldn’t see the point of them. My thinking was if you want utility, buy a SUV/ cross-over. If you want sports, buy a sports car. Yet years have passed and it’s time for me to reassess such biases. Most of my car-fanatic friends drive their family’s cross-overs far more than they drive their sports cars. I’m as guilty of this as anyone. If only SUV/cross-overs could be just a little more compellingly sporting, and without giving up too much of their inherent utility… Ergo the brilliance of the Alfa Romeo

Stelvio. With it I finally experienced a cross-over product that suits both of these driving moods and needs: sports car and SUV. The Stelvio is the one vehicle that could replace the two I have. Which was somewhat the same “one vehicle” goal that created those past cross-segmentcrashers of sports coupe, sports 2+2, sports sedan/wagon and the hot hatch. Granted, the Quadrifoglio version of the Stelvio isn’t exactly cheap (from $95,000), but excellence, combined with 505 hp, seldom is. The V-6 engine’s soundtrack alone is reason enough for a test drive. The Alfa’s size feels just right; sportingly close-quartered but sufficiently spacious for reasonable utility. She’s also a good dancer through the twisties. It isn’t a coincidence that the manufacturers are now boasting Nürburgring lap times for their hottest cross-overs. The 505 hp Stelvio lays down the current record-setting cross-over lap time of seven minutes, 52 seconds—right up there in performance with similarly priced sports cars, sports coupes, sports sedans and hot hatches. For insightful

recruitment 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 rural medicine Good money, short daily commute, nice people. Join us in Red Lake, ON where you will work in our clinic and small 18 bed hospital. Weekend/weekday 24- hour emergency shifts and there is always a back-up physician available. Opportunity for return of service/ rural initiatives and moving stipend for candidates who are eligible for licensure in Ontario. Oh, and beautiful lakes & scenery included. Please contact us! Ph: 807-727-2617 x228 or email gschuurman@ redlakehospital.ca

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comparison, 10 years ago the iconic (E90) V8 BMW M3 was an 8:20 Nürburgring car. I’m confident the Stelvio won’t be the last cross-over to light my fire. Virtually every purveyor of sporting vehicles, including Ferrari and Aston Martin, are focusing their brightest minds on this same challenge. Expect ever-more technological innovation and engineering attentionto-detail to be heaped on hot-selling sporting cross-overs. Don’t hold your breath on the rise of sporting minivans or pick-up trucks. And don’t be surprised if sports cars, sports coupes, sports sedans and hot hatches continue to fade from relevance.

Ageless Living is an innovative, cutting edge medical clinic transforming patients by providing proprietary comprehensive anti-aging services. We focus on preventative rather than reactive Medicine. We are looking for physicians who are trained in hormone balancing (bio-identical hormones, hypocortisolism, hyper-/hypo-thyroid) and neuromodulator (e.g. Botox) treatments. Interest in nutrition and the gut microbiome as it relates to chronic diseases is an asset. Should hold certification (or in the process of being certified) in anti-aging medicine (e.g. A4M, IFM, etc). • • • •

Ownership opportunity with multiple income streams Private pay patients Established clinic with strong patient base Flexible schedule

Services: • Hormonal balancing • Neuromodulator treatment • Skin care (microneedle, facials, etc) • Nutrition • Biohacking Location: • Victoria, BC (current) • Vancouver, BC (2020) • Calgary, Toronto, Montreal (TBA) Contact Jean Paul Lim, MD, FRCPC Jplim@agelessliving.ca | Agelessliving.com | 604-603-0725

Winter 2020 Just For Canadian doctors

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The Alfa Romeo Stelvio Quadrifoglio leads the pack in the Run to the Sun

employment opportunities

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

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

Explore Meadow Lake, Saskatchewan Where outdoor beauty is at your doorstep Opportunities for family physicians including physicians with enhanced skills in S urgery, Obstetrics and Anesthesia, as well as Locum opportunities

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 d d a A e e M th Join

Just For Canadian doctors Winter 2020

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 elia.vany@ s as k healthauthority.ca

DISCOVER MORE AT

healthmatchbc.org Health Match BC is a free health professional recruitment service funded by the Government of British Columbia (BC), Canada. Phone (Toll-Free): 1.877.867.3061 | Email: welcome@healthmatchbc.org

employment opportunities

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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.

Prescription for wealth Building your wealth in six simple steps

hy are some doctors so successful at accumulating wealth while their colleagues with similar income and expenses fail? Building wealth is not the result of making more or having a financial whiz on your team. It’s the result of spending more of your time to reach your financial goals. If your most important goal is to pay off the mortgage or save for retirement, how much effort are you putting in to reach it? Here’s a prescription for building wealth…in six simple steps.

practice income, personal and living expenses, income taxes, etc. Also prepare a summary of your assets and liabilities: a net worth statement. Net worth and cash flow 10 years statements should be 20 years updated every quarter. 30 years 3 Invest automatically. Take a fixed portion of your income each month and invest. Systematic investing reaps great rewards. Consider strategies such as dollar cost averaging. By using this technique, you will purchase an investment with a specific 1 Have written goals. amount of money at specific intervals. It does Write down your goals, 6 tips that not matter whether the whether purchasing a you should home, setting up a market is up or down, you invest the same practice, financing prescribe to amount. With the dollar your children’s you rself cost averaging method, education or saving for when prices are down you retirement. Write them down to give yourself the buy more shares than when the prices are high. It’s not a visual reinforcement of guarantee of success—you still what you want to accomplish. Doing this dramatically increases the need to find the right investment vehicle—but it does decrease emotional, chances of attaining your goals. Make knee-jerk reactions to market declines time by setting aside a couple of hours and makes you a disciplined investor. each week—and stick to it.

5 3 6 7 8 1 2 4 9

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Puzzle by websudoku.com

10% $259,374 $672,748 $1,744,930

15% $404,553 $1,636,640 $6,621,140

The rate of return has a big impact on your investment balance. Just look at what happens if you are able to double your returns on a $100,000 investment from 5% to 10%. Your investment will quadruple in 30 years from $430,000 to $1.75 million. Minimize your income tax. Income tax is your biggest expense; explore all available tax-saving opportunities. For instance, you could save hundreds of thousands of tax dollars by reporting shareholder draws from your professional corporation as a capital gain instead of the higher taxed dividend. 5

6 Live frugally. What determines the size of your investment is not how much income you generate but how much money you spend. When you’re saving for your retirement nest egg, most financial planners will recommend that you spend no more than 4% of your investments each year.

sudoku 1 easier solution

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service

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solution from page 29

sudoku 2 harder solution

4 Start investing early. Invest early and experience the miracle of the compounding effect. The table above shows the

5% $162,889 $264,328 $432,191

at your

solution from Fall 2019 contest

2 Project cash flow. Start by preparing personal cash-flow projections for the next 12 months. These include expected

effect of investing $100,000 at 5%, 10% and 15% for 10, 20 and 30 years.

Puzzle by websudoku.com

Winter 2020 Just For Canadian doctors

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.

Hidden scars

n northeast Calgary where Dr. Angela Deane has worked, many patients are immigrants or refugees from Africa. The newcomers hail from Somalia, Sudan, Egypt and Eritrea, places of oppression, war and drought. But the women have suffered even greater hardship. Up to 85% of them have undergone female genital mutilation (FGM), a practice pre-dating Islam and Christianity that holds many traditional societies in a cultural

professionals from gynecology, obstetrics, family medicine, plastic surgery and psychology. Deane is well on her way to addressing these issues with the initiation of a local study, “An Assessment of the Knowledge, Attitudes and Practices of Healthcare Workers in Regards to Female Genital Cutting,” that has been submitted for publication. It is the surgical aspect of FGM/C that promises to dramatically change Dr. Angela women’s lives. This past Deane performs March, Deane was one of 15 restorative the sole Canadian surgeries during a twophysician invited to a week philanthropic two-week mission to mission to Nairobi, Nairobi to undertake Kenya, in Africa clitoral reconstruction surgery (CRS) under the tutelage of renowned gynecologist and transgender surgeon Dr. Marci Bowers of San Francisco. The trip was funded by the Nevada-based, non-profit group Clitoraid, which seeks an end to FGM/C. Deane first met Bowers in the fall of 2018 when the American doctor was in Calgary giving a presentation. Proving Canada’s chokehold. (The practice is also referred to inertia on FGM/C care, Canadians must as “cutting,” or FGM/C.) travel to Bowers’ clinic for clitoral reconThe repercussions—social, physical struction. The two women’s mutual interand mental—can be “horrific,” Deane est in FGM/C led Bowers to invite Deane to says. “I’ve met these women in labour and her clinic to watch her perform surgery. delivery and been aghast at what they’ve Bowers also invited Deane to Kenya to been through.” Not only do they have a two-week mission to perform CRS in the higher C-section rates, vaginal tearing, clinic of Dr. Abdullahi Adan, who is that increased bleeding and longer hospital country’s top plastic surgeon. In nine days stays following birth, they have endured of surgery, 80 women underwent CRS, pain, difficulty urinating and menstruatsays Deane. ing and profound sexual dysfunction The women who came to Adan’s ever since being cut, says Deane, a former Nairobi clinic hailed not only from Kenya nurse who finishes her five-year residency but Tanzania, Sudan and Somalia, hearing as an OB/GYN next year. about it via word-of-mouth and social meCanada has no formalized medical dia. Their ages ranged from 21 to 65; some clinics specifically addressing FGM/C, were urban, educated and employed, unlike the UK, Belgium, Switzerland, others were rural women. France and Norway. Deane is determined FGM significantly alters a woman’s to rectify this; her vision is to provide colanatomy. It may involve removing the exlaborative care by developing a team of ternal clitoris and clitoral hood. The most

Just For Canadian doctors Winter 2020

extreme version is infibulation, where the clitoris, labia minora and majora are cut and then sewn almost closed. Infection is common, as the cutting equipment is rarely sterile. The practice of FGM/C can cause life-long urination and menstruation problems as well as often-agonizing sexual relations and an inability to orgasm. According to the Orchid Project, a British charity seeking to end FGM/C, girls and women suffer this abuse in 45 countries around the world. More than 200 million girls and women globally are affected by the practice. Deane says it is considered a purifying ritual for girls and, in some regions, an “uncut” girl is considered “unclean” and has less value as a wife. For example, in some communities, when a girl is sold in marriage, “a cut girl will go for 10 to 12 cows whereas an uncut girl will go for six cows.” It was in Nairobi, under the watchful eye of Bowers, that Deane undertook 15 reconstruction surgeries, rebuilding or restoring the anatomy by removing scar tissue, allowing urine and menstrual blood to be expelled normally. The clitoral reconstruction portion, a technique pioneered by France’s Dr. Pierre Foldès, releases the clitoral body from the suspensory ligament, allowing it to come forward where it is attached to the skin surface, creating a neo-clitoris. Following surgery, almost all women have decreased genital pain and improved sexual function. In a study, Foldès found that 50% of women unable to orgasm were able to achieve orgasm following the procedure. The patients were profoundly grateful, seeing the surgery “as a turning point in their life, a restoration and a reclaiming of their dignity,” says Deane. But it was their narratives that touched her the most. “They had these really profound stories,” says Deane, who plans to return to Kenya early in 2020 to undertake more surgery, and will undertake her first reconstructive surgery in Canada this winter. “After they were cut, some of them describe a light going dim within them. It really altered the trajectory of their life and shaped how they saw themselves in the world.”

courtesy of Dr. deane

Helping to heal the stigmatized pain of the survivors of female genital mutilation

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

4 ways to win a $50 Amazon gift card! Follow us on either Facebook, Instagram or Twitter contest! (or all 3!), facebook.com/ OR solve justforcanadiandoctors Sudoku @justforcanadiandoctors puzzle #2. #justforcanadiandoctors @JFCDoctors Each social Contest closes February 21, 2020 media follow and is open to practising Canadian doctors. = one entry! 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. GOOD LUCK!

sudoku 2 harder solution in next issue

sudoku 1 easier solution on page 27

$50 Amazon Gift Card winner: Dr. Rachel Abel from Halifax, NS

9 5 6 3 1 3 2 5 7 3 5 1 6 7 8 2 6 8 3 4 5 9 2 3 8 5 4 7 1 6 4 2 3 5 7 8

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. 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

6 2

1 7 5 4 2

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Sudoku Contest entry form (solve + send in sudoku!) 3 7

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Puzzle by websudoku.com

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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 February 21, 2020. 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.

Winter 2020 Just For Canadian doctors

pa r t i n g s h o t

photo prescription

dr. Les Kalman is an Assistant Professor at the Schulich School of Medicine & Dentistry, Western University, in London, ON.

“

photo details

The image was taken with the Insta360 One X camera. The image is a 360-degree photo taken on auto mode and then converted manually to a tiny planet image. Post processing was delivered with Luminar.

Dr. Les Kalman

I was fortunate enough to be invited as a speaker to [Los Angeles]. I had some free time to enjoy Venice Beach and took this image.”

Send your “wow” photo (high-resolution) 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!

Just For Canadian doctors Winter 2020

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

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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.

September 05 - 12, 2020 7-Night Greek Isles Round-trip Venice, Italy Royal Caribbean’s Rhapsody of the Seas October 17 - 27, 2020 10-Night Sunshine in the Canaries Round-trip Southampton, England Royal Caribbean’s Anthem of the Seas

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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

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EXCITING CME ADVENTURES WORLDWIDE See wilderness-medicine.com for more CME destinations & dates Everest Base Camp Trek April 23 – May 10, 2020

Fiji Scuba and Snorkel

January 30 – February 8, 2020

Bhutan Exploration

September 21 – October 2, 2020

Inca Trail/Machu Picchu/ Amazon Rainforest October 11 – 21, 2020

Africa Safari w/optional Kilimanjaro Climb October 4 – 18, 2020