winter 2018
DOCTORS life + leisure
a tale of two
rockies reflect in
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www.betterhere.ca
Dr. Henk van Zyl Emergency Physician Royal Inland Hospital
Average Commute Lower Mainland= 1 hour 22min Average Commute Southern Interior B.C. = 16 min
What will you do with an extra 24 hours a month? Live, work & play where others only vacation! It’s better here! ... and you can afford to buy a home!
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Just for C
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DOCTORS life + leisure
contents
winter 2018
winter 2018
Publisher Linh T. Huynh
Editor Barb Sligl
Art Direction BSS Creative Contributing Editor Janet Gyenes
Editorial Assistant Adam Flint Contributors Michael DeFreitas Janet Gyenes Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Jenn Smith Nelson Roberta Staley Cover photo Henry Georgi
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Senior Account Executive Monique Nguyen Account Executives Janice Frome Wing-Yee Kwong
Production Manager Ninh Hoang 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
clockwise, from top left: jenn smith nelson; barb sligl; Henry Georgi
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.
FEATURES
16 Self discovery in the wild beauty of Costa Rica 29 Two sides of mountain adventure in the Canadian Rockies COLUMNS
DEPARTMENTS
11 photo prescription
5 winter mix 21 CME calendar 37 sudoku 38 parting shot
The Garden Isle
13 pay it forward Providing ocular care in the developing world
On ice in Winnipeg
14 motoring Making racetrack notches
34 the wealthy doctor
In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada
Get to know your IPP
36 doctor on a soapbox
www.justforcanadiandoctors.com Printed in Canada.
want to reach us? check out our website!
Navigating the sticky situation of patients with vehicle-accident claims
cover photo Skiing nirvana is found on both sides of the Canadian Rockies—like here, a powder session in one of Fernie Alpine Resort’s five bowls (page 29).
Winter 2018 Just For Canadian doctors
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from the editor
Find your story
S
ometimes the act of travel—the escape from routine and then the immersion into unfamiliar territory— sparks something. A new story. Your story. One that may have been inside all along but only comes bubbling out when you gaze upon that beach, walk in that jungle, see that monkey or hear that tweet tweet early one misty morning. In Costa Rica, our writer travelled from a coffee plantation high in the hills to empty, pristine beaches on horseback and then into the rainforest chasing birds (page 16). There she found herself reflecting on past heartache and realized she had these feathered friends to thank for getting her where she was. A full, twittering circle. Far from the tropical heat, in the Canadian Rockies, a different story unfolds
4
(page 29). This is the tale of two Rockies, on the east and west sides, in Alberta and BC. Two ski towns, both still small enough (read not completely overrun by tourists) to be home to passionate locals (read great local establishments) who might rather keep these spots under the radar (sorry)… Back south, Miami has the usual and expected hot factor but we partake in a different heat…because the city is a modern-art mecca, from fab architecture (page 5) to interactive public art (page 21). So turn a page. Remember and reflect. Explore and engage. Write your own story, wherever you are, however far you go. And be generous (check out our gift guides, pages 6 – 8). Happy holidays!
Just For Canadian doctors Winter 2018
Any ideas, comments or questions? Reach us at feedback@InPrintPublications.com.
find your
costa rica
Jenn Smith Nelson
Bird- and monkeywatching and coffee cupping (catación) in Costa Rica (page 16).
what/when/where > winter
style | food | drink | festivals | places | getaways | gear…
night out
mix
a r ch i
Miami musicmaker
Wh er te e ct ur
nd ic a s u t m ee m e
barb sligl
get lyrical
Palms sway and symphonic notes stir. It’s warm enough to sit upon the grass in a sleeveless shirt and watch stars pop out one by one, surrounded by like-minded Miamians and feel abuzz in South Beach while also still in a moment of serenity. // This is Soundscape Park at the New World Center, home of the New World Symphony in Miami. Both educational campus and laboratory (it’s a post-graduate orchestral academy) and striking public park and architectural space (designed by architect Frank Gehry), it’s just steps from South Beach’s sand, water and Art Deco beauty, making it one of this city’s must-visit destinations. // Inside, the lyrical lines of Gehry’s design seem to mimic the curves and swoops of musical notes, adding another layer to this already multi-faceted place. From the rooftop garden there are wow views of that renowned beach, Biscayne Bay and the Atlantic (it’s also a great spot for group receptions, parties and performances). // But the encore is back outside, under those stars during one of the so-called Wallcasts, when musical performances are screened on the pristine-white exterior of the New World Center for picnicking guests spread out on blankets and folding chairs, sipping wine and soaking up the read more See story on Miami, page 21. sound beneath the palms. And come morning, there’s a yoga session under the same trees… Winter 2018 Just For Canadian doctors nws.edu — Barb Sligl
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mix
give or get
winter
age e n gh e t es s se n
so sensory For them…or you
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1 beat it [sound]These on-ear, noise-cancelling Beats Solo 3 Wireless headphones are hardcore (as created by Dr. Dre and Jimmy Iovine) but also oh-so-pretty in Porcelain Rose. $329.95, beatsbydre.com; available at indigo.ca
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2 dish out [taste] Celebrating food and culture, The Recipe Box: YVR shares 100 recipes from 50 of Vancouver’s most celebrated restaurants. The recipes cover a wide range of signature dishes from hot spots like Bauhaus (top left) and the Botanist in the Fairmont Pacific Rim (far left). Think sugar, spice and everything nice, whether ice cream, cocktails or must-try vegan treats—on recipe cards housed in a lovely ashwood or walnut box. $65; recipeboxyvr.com 3 blanket case [touch] Baby, it’s cold outside…but not with this soft-grey Klippan blanket. The Swedish company has been spinning and weaving home textiles for five generations, since 1879, and this “Trip” design by Akira Minagawa is sure to last a couple generations in your family. $329; klippan.ca
wrap it up
5 3
5 carry a tune [sound] Grab-and-go your tunes with the Wonderboom in a range of fab colours (we like this on-trend grey). $129.99, ultimateears.com
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gift guide x1
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4 Turn on [sound] Forget digital. The new Planar 1 turntable from UK company Rega is a sleekand-simple music-maker that’s a modern take on nostalgic LP sound—using manual mechanisms, of course. $425, rega.co.uk; available at shop.vanspecial.com
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Just For Canadian doctors Winter 2018
6 aroma therapy [scent] Saje’s essential oils (try the invigorating Mountain High blend) can now be used in this minimalistic Aromatime ultrasonic diffuser. Part alarm clock, part delicious-scent dispenser, it lets you set one aroma for morning, another for night. Good mornings and sweet dreams… $189.95, saje.com 7 light it up [scent] The smallbatch, hand-poured, coconut-wax candles (made in Whistler, BC) are the passion project of a former forester and tree planter. She named the company Hollow Tree 1871 after the beloved Stanley Park landmark, a Western Red Cedar that’s more than 800 years old. And this candle, Valley of a Thousand Falls, is inspired by an actual place in Mount Robson Park. Take a deep breath. Ahhh. $42, hollowtree.ca — B.S.
star gaze
T winter
black magic Explore the dark side this winter
gift guide x2
mix
k ly r a d oe s d it
black and blue There’s plenty of black beauty to be found in a particular blue box. From show sky high to more down to earth, these Tiffany & Co. pieces are a dark delight. Shooting for the stars…if a single piece of jewelry could evoke a constellation, it’d be the Schlumberger bracelet. Its celestial-like bands of platinum-set diamonds are ringed in 18-karat gold and wrapped around a black-onyx gleam. Designed by legendary jeweler, Jean Schlumberger, whose nature-inspired creations were beloved by stars like Elizabeth Taylor, it has an astronomical beauty (and price). Tiffany & Co. Schlumberger® alternating bracelet of diamonds and onyx, $305,000 ; tiffany.ca Practical yet luxe, the black-leather men’s tote is a modern new classic with a disarmingly simple silhouette and chic T-shaped hardware. Men’s tote in black leather, large,$2,150; tiffany.ca The black-leather Diamond Point card case has a dark edge—a studded statement piece that brings just a little bit of punk to its polish. Diamond Point card case in black leather, $235; tiffany.ca — B.S.
editor’s
pick
When Apple revealed its futuristic iPhone X, the electronics giant wowed the world once again with its new A11 Bionic processor, facial recognition technology and Super Retina gear Display, which harnesses OLED technology to make those bajillion pixels ultra black or super colourful. But how to safeguard all that gorgeous glass and stainless steel that’s bound to take a beating when the super-slim phone slips from your fingers? Well, one good design trick inspired another—the complete retooling of Mujjo’s leather iPhone wallets. Now in its sixth year, the Dutch company launched a new in-mould production process, allowing the slim profile of its premium full-grain leather to protect the iPhone, not hide it. Sophisticated and thoughtful touches include Japanese microfibre lining and a simple sleeve, which allows you to stash three cards (hello, driver’s licence!). Available in Black (pictured), Tan and Grey, $60; Mujjo, mujjo.com — Janet Gyenes
night moves
THE X-FACTOR
top 3 images: Tiffany & Co.
HEROIC STYLE OK, so neither Wonder Woman nor Thor wear wristwatches, but Fossil’s style hefty smartwatches are superhero worthy in our books. The second-generation rose-gold-toned stainless steel Fossil Q Wanderer is as hardworking as it is stylish, connecting to your smartphone and offering functions such as a built-in fitness tracker, voice-activated Google, social media alerts and more. The black stainless steel Fossil Q Nate gets its gravitas from military-inspired analogue styling and smart features that let you keep track of your training goals, emails, sleeps and even let you control your music or snap a photo with the press of a button. Superhuman feats indeed. Fossil Q Wanderer, $365, Fossil Q Nate, $235; Indigo, indigo.ca — J.G. Winter 2018 Just For Canadian doctors
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mix
T
the thirsty doctor
winter
in the spirit
For a hurrah to celebrate the end (and beginning) of the year and a last nod to Canada’s 150th, partake in these 5 bottles from distillers—coast to coast—that are an easy (and highly sippable) gift…just put a bow on it, year round
gift guide x3
li qu i d a s s e ts
local libations 1 [PORT] Capiteux is a maderized and fortified port-style wine with mmmmm aromas of vanilla, prune, nuts and roasted coffee. Made on the bucolic Île d’Orléans in Québec (by sample a très chic team of sisters and their father, thus the name, Cassis Monna & Filles), it’s a digestif that’s perfect with strong cheeses like Stilton or dark chocolate…or a cigar. $23.75, cassismonna.com 2 [AQUAVIT] Make like a Viking with BC distillery Okanagan Spirits’ caraway-and-cumin-tinged Aquavitus. Aquavit is the new “it” spirit, used by in-the-know bartenders in innovative concoctions (try it in place of the standard gin in a Negroni). And this particular aquavit won a double-gold at the World Spirits Awards held in Denmark in 2015. As Oluf Folkersen, President of the Danish Brotherhood says, “This Canadian Aquavit is excellent. I would rate it a 9/10. A fantastic pairing for pickled herring.” Skål! $40, okanaganspirits.com 3 [VODKA] Horilka, a traditional Ukrainian honey-pepper vodka, is affectionately called “the kiss and the slap” at Lucky Bastard Distillery in Saskatoon because “it starts off nice and sweet on the palate then slaps you in the face with the warmth of those Mexican chili peppers.” It’s traditionally used to toast—a lot—during meals. Or try it in a Caesar or with OJ for a Ukrainian screwdriver. Dybosia! $35, luckybastard.ca 4 [GIN] London-dry style Parlour Gin from Eau Claire Distillery in Alberta adds some Canadiana to the traditional juniper: Saskatoon berry, as well as rosehip, coriander, lemon, orange, mint and spice. And there’s a limited-release seasonal Christmas Gin inspired by the story of the gift-bearing wise men—infused with frankincense and myrrh, of course. $48.95 and $34.95, eauclairedistillery.ca 5 [RUM] The Bluenose Black Rum by Nova Scotia’s Ironworks distillery is named for that iconic ship…and this deliciously dark and rich rum (think caramel, molasses, spices), which won the top prize at the 2014 World Rum Awards in London, is perfection in a Dark ‘n’ Stormy. Arrrrr! $42.80 ironworksdistillery.com — B.S.
sip +
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Just For Canadian doctors Winter 2018
Daughters and dad …the très chic team of Cassis Monna & Filles in Québec. Salut!
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[meet the makers]
editor’s
pick
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2
winter
mix
sk i n e r h soot
[get the goods]
Visit Silk Road Tea in Victoria (store, spa, workshops), Vancouver (store, workshops) and online at silkroadteastore.com Tea Master Daniela Cubelic, called “Canada’s Queen of Tea,” trained with Chinese and Taiwanese herbalists and imparts that wisdom master through Silk Road Tea, the company she founded 25 years ago. But she goes beyond simple brewing, pairing tea with food, mixing it into cocktails, using it in cooking, incorporating it in skincare and designing teaware. She’s even collaborated on a 100% organic and compostable tea bag (the first of its kind in North America). Cubelic also offers instore workshops to share some of that know-how (kombucha, anyone?). l i
ta c oc kx e r fi
Holiday-making and bone-chilling
primp+ weather take a toll. Beau-TEA-ful pamper
tea is a tonic for tired-out skin, an antioxidant, alkaline-boosting blend of white and green tea leaves, rooibos, calendula, lemon balm, peppermint, citrus peel, lemongrass and lavender. From $4.99 Not a steaming cup of tea, but pocket-sized essential-oil concoctions are portable hits of goodness, like “Happy,” one of five go-to roll-on remedies in the Holiday Survival Kit (in a gift-worthy handmade paper pouch) to keep that jovial vibe going. $75.96 Your face needs oil—really. “Nourishing Dew” has been a cult favourite since it’s introduction more than 20 years ago. A few drops will dew it… From $29.99
tea
time
photo of Daniela Cubelic: Chung Chow; other photos: silk road tea
“Candy Cane” herbal tea is just what its name implies: fresh and minty peppermint flecked with hibiscus and Turn over a pink peppercorns. Steep this vibrant mix into a blush that’s a cheery, new [tea] leaf can’t-miss addition to wintery tipples by Barb Sligl like the aptly named “Rosy Cheeks”: stir ounce of tea mix one with two ounces of vodka. It’s even better garnished with a candy cane, of course. For a non-alcoholic option, mix equal parts of the brewed tea with cranberry juice and garnish with cranberries. Merry and bright, indeed. From $4.99
more tea
[toronto] lemon lily This tea emporium collaborates with tea estates and farms worldwide to bring certified organic teas to Canada. Try the line of chai and matcha teas like Chocolaty Matcha, Ceremonial Matcha and Turmeric Matcha. lemonlily.ca
Can’t decide which tea to get or gift? Get the black tea sampler kit with four mini-tins brew (or the green or herbal kit), packaged in that pretty paper pouch (made from recycled paper by a women’s co-operative). Our picks: London Fog, Berry Victoria, Mystic Rainforest, Mango Shade. $22.95
[Montréal] Camellia Sinensis A zen tea house with some 243 teas (all sourced directly from growers in Asia) that also runs two tea schools (in Montréal and Québec City) with more than 20 workshops and courses and has published award-winning books on the history, terroirs and varieties of teas. camellia-sinensis.com
Winter 2018 Just For Canadian doctors
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What are YOU doing this February? Join us in Orlando for neonatal-perinatal continuing education or board review led by industry experts. Hyatt Regency Orlando
www.neoconference.com
www.specialtyreview.com CHOOSE
OR W IE
FEBRUARY 20-25, 2018
IN
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The conference for neonatology
NATO EO L
One of the Premier Meetings in Neonatal Medicine
V
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FEBRUARY 22-25, 2018
O
CHOOSE
The Premier Board Review Course in Neonatal-Perinatal Medicine
NEO: The Conference for Neonatology addresses cutting-edge, yet practical aspects of newborn medicine. Educational sessions are conducted by many of the foremost experts, who address neonatal-perinatal topics for which they have become renowned.
Specialty Review is the most intensive and comprehensive review course of its kind in the country, designed to strengthen your pathophysiology knowledge and problem-solving skills in the field of neonatal medicine.
Target audience: All neonatal-perinatal providers, including neonatologists, advanced practitioners and staff nurses.
Target audience: Neonatologists, residents, fellows and advanced practitioners.
Themes covered:
Themes covered:
• Forging New Pathways in Neonatal Nutrition • The Future of Neonatal Medicine — Where Are
• Maternal-Fetal Medicine • General Care of the Neonate / Pharmacology/Fluids
• Controversies in Cardiology for the Neonatologist • Changing Thoughts About Neonatal Sepsis • Evolving Concepts in Neonatal Respiratory
• • • •
We Headed?
Management
• The Pharmacology of Neonatal Neurology — Where
and Electrolytes / Birth Transition/Derm
Neonatal Gastroenterology and Nutrition Neonatal Hematology / Bilirubin / Neonatal Nephrology Neonatal Respiratory System Neonatal Cardiovascular System
Are We Today?
HEALTH SOLUTIONS PARTNER
p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.
The Garden Isle
Kauai gets its nickname from its vast tropical rainforests and taro fields
destination photography
Practise your sunset shots (not cliché here!) in Hawaii’s Garden Isle of kauai
look up
michael defreitas
I
spent my first day on Kauai at Kilauea Point National Wildlife Refuge on the northern tip of the island. Besides its historic 1913 lighthouse, the point’s steep cliffs are one of the world’s prime nesting sites for the rare Laysan Albatross and the magnificent Red-tailed Tropicbird. After photographing the lighthouse, I shifted my attention to the birds coming and going to their nests. A 70–200mm lens is perfect as it allows you to zoom in as you pan the approaching birds. A shutter speed of 1/600 second allows you to freeze the bird’s fast beating wings while an aperture setting of f8 will render the entire bird in focus. Set your motor drive for a burst of five or six shots. To avoid a static looking image, I added the appearance of action/motion by framing the bird along a diagonal. I composed some shots with the bird’s wings pointing to the corners of the frame and some with its head and tail. Then I tried to get the wings on one diagonal as well as the bird’s head and tail along the other. It’s a lot harder than it looks, but my patience finally paid off with a few almost perfect double-diagonal shots. Always remember to compose with space in front of the bird to create the effect of the bird flying into the frame. Given the island’s nickname, I thought a good opening image might be the taro fields in Hanalei Valley. After shooting close ups of plants and fields on the valley floor, I moved to a higher vantage point for a panorama shot that included the island’s rugged mountains. Using f18 and my 24–70mm medium zoom I composed a number of different shots. I wasn’t happy with the clouds above the mountains so I used a nearby palm tree branch to frame the top of the image and break up some of the clouds. The branch was moving in the wind so I selected 1/250-second shutter speed to freeze it. What really separates Kauai from its siblings, besides its unique wildlife and majestic taro fields, is its unmatched natural beauty. And Kauaiians aim to keep it that way by designating almost 35% of their island to Forest and Wildlife Reserves. One of Kauai’s prized natural jewels is the Kalalau Valley in the Napali Coast State
I can’t stress enough the importance of perspective/scale in photography. Like my jeep near the Napali cliffs, I placed a woman in my rainforest shot to show the size of the trees and used the trail edge as a leading line. The leading line and the model looking up both help to draw the viewer’s eyes into the scene and up to the trees. I used a tripod and wide angle zoom set at 18mm with f5.6 and 1/30 second.
if you go
For more info on Hawaii and Kauai: gohawaii.com
Winter 2018 Just For Canadian doctors
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Wilderness Park. There are many great viewpoints on the park’s 20-kilometre trail that snakes along the 1,300-metre-high
ridges flanking the valley. My first few shots didn’t really capture the essence of the lush valley so I looked for a foreground element to help highlight the valley’s vegetation and its deeply eroded ridges. After finding a
12
large fern, I used a wide-angle zoom and f18 (for a wide depth of field) to create a more interesting and informative image. Another of the island’s crown jewels, the 16-kilometre-long and 900-metre-deep Waimea Canyon, is nicknamed the Grand Canyon of the Pacific. Vantage points along Highway 550 look upon outstanding views that are best captured in late morning when the sunlight penetrates to the canyon floor. I used f16 and the Waimea River as a leading line to draw the viewer into the canyon. Where I could, I used people to help provide perspective to the scene. Next on the jewels list is the majestic Napali Coast on the island’s west coast. A few dirt roads lead to the rugged coastline from Highway 550, but I managed to get some great shots of the cliffs from the beach at Polihale State Park. You can drive along the beach to the foot of the cliffs and I used my rental jeep to add scale to the image (below). The beach is also popular
Just For Canadian doctors Winter 2018
with surfers so after photographing the cliffs I turned my attention to these wave riders. I shot the windblown cliffs at f16 and 1/250 second and captured the surfers’ “rooster tails” at f8 and 1/800 second. And no trip to Kauai would be complete without a sunset. The trick is to avoid that “please not another sunset” response to the image. Insert something or someone into the image to create a bit of drama or interest (like my sunset hula girl with a tiny bit of fill flash). Making a great sunset image starts with an interesting location. On rocky Poipu Beach near a local beach bar, I found the perfect clump of coconut trees with Puuwai Island off in the background. Using a tripod and 70–200mm telephoto zoom, I composed my shot at f11 and 1/250 second (to almost freeze the swaying branches). Luckily, I didn’t have to wait long before a man wearing a hat walked out to the rocks and sat down (left). I got my shots and started packing up when I noticed someone from the beach bar lighting tiki torches near the beach. I repositioned and bingo. Just the interest I wanted.
michael defreitas
photo prescription [continued]
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, award-winning magazine editor and writer and documentary filmmaker.
Into the light
A Vancouver doctor helps alleviate vision impairments in the developing world
courtesy of Dr. Yin
P
eople from different cultures express gratitude in different ways. But the last thing Dr. Vivian Yin expected was a slap on the butt. Yin had recently undertaken successful cataract surgery on an elderly Filipino woman and was conducting a postoperative checkup at the ophthalmology clinic where the operation had been performed. The procedure transformed the septuagenarian’s world from grey shadows to colours and distinct, clear images. Delighted, the woman began slapping the derrières of clinic staff. “My initial reaction was shock; for North Americans this was highly inappropriate,” Yin recalls with a laugh. The Filipino nurses at the clinic reassured Yin: “She is just trying to tell you how happy she is. This is what grandmas do to children or grandchildren as a way of saying, ‘good job!’” Yin, an oculoplastic and orbital oncology specialist, has been to numerous countries around the globe, working to help alleviate the ophthalmological scourges predominantly found in the developing world. Recent World Health Organization statistics estimate that 36 million people around the globe are blind while another 217 million have moderate-to-severe vision impairment. About 19 million children are visually impaired. More than 80% of these impairments can be prevented or cured, with chronic eye diseases being the main causes of vision loss. The Filipino grandmother’s slap of gratitude, although startling, indicated how proper vision-care can impact an individual. “It is the reason I became a physician,” says Yin, adding that the elderly woman’s problem—cataracts— is the number-one cause of blindness worldwide. A Vancouver native, Yin is an assistant director at the University of British Columbia’s BC Centre for Epidemiologic and International Ophthalmology Centre in the Department of Ophthalmology & Visual Sciences, as well as a consultant at Vancouver General Hospital (VGH). This past fall, Yin took up a research and teaching position at Memorial Sloan Kettering Cancer Center in New York City. Yet Yin is most
passionate about the work she does as a board member with the Vancouver-based charity, Seva Canada Society. Seva, which means “selfless service” in Sanskrit, has been preventing blindness and restoring sight in the developing world for the past 35 years. Yin began working for Seva three years ago and has trained oculoplastic surgeons in Bangladesh, the Philippines, India and Nepal. Seva’s emphasis on capacity building has meant that Yin—rather than focusing solely on cataract removal surgery—is designing curriculum as well as teaching oculoplastic techniques to physicians in these developing nations. Under Yin’s direction, Seva piloted a teaching program last spring in Nepal at the country’s two tertiary medical centres: Bharatpur Eye Hospital and the Lumbini Eye Institute. Nepalese physicians undergo a four-week intensive in ophthalmology surgery under the tutelage of specialists such as Yin. Six months later, Yin and her colleagues will return to assess the Nepalese physicians’ mastery of the techniques during another four-week intensive training, possibly introducing them to one or two new techniques. The Nepalese physicians are highly enthusiastic, says Yin. “They want to start doing orbit surgery. I am holding them back—they have to show themselves proficient in other things first.” It is vital that physicians in the developing world learn complex ophthalmological surgical techniques, in addition to more common operations such as cataract removal. For example, people with hyperthyroidism can develop Grave’s orbitopathy, which is when the eyeballs protrude beyond their normal protective orbit. Nepalese with Grave’s orbitopathy simply go blind. “This is one of the surgeries they really want to learn in Nepal,” says Yin. Yin, who has a master’s degree in public health, is also working with Seva on sustainability, another key challenge for medical systems in the developing world. Less than two decades ago, both the Bharatpur and Lumbini hospitals were on the verge of bankruptcy. Seva helped both centres introduce a payment system,
Dr. Vivian Yin, an oculoplastic and orbital oncology specialist who works with Seva Canada Society
ans S eva me “selfless in service” it r k s n Sa
based upon the simple formula of pay what you can. Both hospitals have since become self-sustaining while ensuring access to poor patients. Yin was part of another innovation revolutionizing health surveys. A key part of global health is assessing the impact of foreign-aid programs, which is challenging in rural societies. Yin helped pilot the first rapid assessment of avoidable blindness (RAAB) methodology using a mobile data collection process on a smartphone app. Using clusters, rather than an entire population, researchers were able to compile accurate data about blindness rates in Nepal faster than conventional survey methods, says Yin. “We now have a new, faster tool that will allow us to change tactics or enhance programs in case things aren’t working as expected.” Yin recalls, as an introspective child, thinking, “If we’re all going to die, what is the point of living?” She decided that, whatever career path she chose, it would have to have impact, “so I could know, in my old age, that I had contributed something positive to the world.” Something a Filipino grandmother whose sight was restored by Yin would wholeheartedly agree with.
Winter 2018 Just For Canadian doctors
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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.
Is 30 a lot?
I
’ve notched the crash helmet 30 times. Figuratively that is, once for each different track raced or hot lapped. I’ve been conscious of that approaching landmark of 30 for a few years. Now that I’ve reached it, I’m curious—is 30 a lot? If you’re reading this magazine, then 30 years old is not a lot. Regardless of your age, and unless you are the character Dirk in the movie Boogie Nights, 30 different sexual partners would qualify as more than a few in most people’s books. Have I been swimming in 30 different lakes? I think so, but don’t ask me to name them (nor the partners). Played on 30 formal or semi-formal sports teams? No, not me.
mountain climbing expedition. The racing part has gotten far more accessible in recent years, although there are still far more ski hills or golf courses or mountain peaks than racetracks. Do you know where your nearest permanent road-racing circuit is? (Not the roundy-round kind). There are less than 10 across Canada, and none currently between the Okanagan and Peterborough. Insurance requirements at most racetracks mean someone organizing a full complement of corner workers and safety response personnel. If your goal is to race against other cars then a sanctioning body (similar to a College of Physicians and Surgeons) will have all kinds of requirements
hot laps
Two of 30: Daytona (left and bottom right) and Laguna Seca are checked off the list
I seem more drawn to individual or paired endeavours. (No wise cracks on that one.) Thirty “rated” mountain peaks climbed? That feat would impress me, as I’m a little bit afraid of heights, and I know many efforts are not successful in reaching the peak. Ski hills? I can think of four that I’ve visited more than 30 days each. But 30 different places? (Pause for count). Yes, I’m just over 30 across three continents, but I’ve seriously stalled on accumulating more. For many of these activities, it’s mostly a matter of just showing up. If you don’t have the equipment, you can typically rent it or swim commando or take a little blue pill. And a hundred bucks is usually tops. Racing a car around a real racing circuit is almost as logistically challenging as a
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for approving racing cars, racing drivers and the administration of the race. This description of road racing makes getting to race sound daunting. Fortunately, the various Crap-can racing organizations make it all surprisingly affordable and accessible. I’ve raced Daytona and Laguna Seca and four other great tracks this way, with “cold call” postings on their on-line forums. I’ve made a lot of friends through my involvement in these semi-affordable endurance races too. I’ve raced at night. I’ve been pitstop crew for my fellow team drivers. I’ve gone sleepless for no pay, just like on-call. I’ve even won this continent’s only 36-hour race ever held. Not quite ready to find your inner Mario Andretti? Fear not, there are other options
Just For Canadian doctors Winter 2018
short of a racing licence to get you on track. First, starring in Las Vegas, is the Super Car Laps concept. Pay hundreds, not thousands, and take a Ferrari, Lambo, McLaren, Aston etc. around that racetrack with an instructor riding shotgun. And Super Car Laps equivalents are now playing and/or coming soon to a number of Canadian racetrack venues. Perhaps a special gift for someone you know? (Or a certain columnist?) Less “costly” than Super Car Laps, and more conducive to becoming a better performance driver, is to take your own performance car to a DE (Driver Education) Event held at various tracks. The Porsche club or BMW club are usually involved. Club volunteers provide the instruction and supervision as you gradually build speed throughout the day. A caveat is that unless you have the right car model for this useabuse then your tires and brakes may get thrashed—penny-wise but pound-foolish. Many tracks have commercial race driving schools within their operations that will rent performance cars upon enrolment. Some even offer single-seater, open-wheel racers. This tuition is more expensive than DE enrolment, as well as Super Car Laps quickies. The upside of the commercial school is professional instruction through the day and your car expenses are a known. (Of course, if you crash in any DE commercial school car or a Super Car Laps vehicle, you’re on the hook for the repairs). So, back to “is 30 a lot?” Yes and no. Thirty isn’t a lot if you’re a seasoned pro or long-suffering amateur. If you’ve put in your 10,000 hours to mastering performance driving, then 30 tracks is a given. Even Crapcan racing will cost you more than $200 per hour of track time, so 10,000 hours is hardly for the feint of wallet. Scions or the truly gifted line up here please. For most of the rest of us, 30 race helmet notches would require a family that tolerates spending all discretionary time and money (and then some) on racing. I’ve bucked convention in getting to 30 tracks without having to do that. Mostly, I’ve been at this for 30-some years trying to add one new track a year. Boogie Nights meets middleaged motoring male.
courtesy of Blane Aarup (bottom right) and Brian Peele (left and top right)
It’s an investment to race a car around a real racing circuit…or is it?
travel the world
connecting in
Costa Rica story
16
+ photography by Jenn Smith Nelson
Just For Canadian dentists November/December 2017
travel the world
Atop a mountain in Uviata, guests are eye level with the clouds at Kura Design Villas. below A ChestnutMandibled Toucan chows down on vegetation. opposite page, top White-headed Capuchin monkey on a beach minutes from Lapa Rios. opposite page, bottom Costa Rica’s incredible scenery as seen on a horseback ride with Rancho La Merced.
“B
irds saved me once,” I confide to my travel partner who replies, “Sounds like there’s a story there.” Over the coming week in the tropical forests, valleys, cliffsides and seascapes of Costa Rica, amidst a cacophony of wildlife, I learned how right she was. My journey begins in Costa Rica’s highlands, in the eco-paradise of the Central Valley of San Jose. The capital city welcomes me with a warm hug of humidity to its urban jungle surrounded by hills, mountains and volcanoes that meet rain- and cloud-forests.
November/December 2017 Just For Canadian dentists
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It’s late and dark when I arrive at Finca Rosa Blanca, a boutique property and organic coffee plantation. Twenty minutes from the airport, positioned 4,000 feet above sea level, it’s just far enough from the city to enjoy sprawling views of neighbouring hillsides and the valley below. Fourteen casas with private verandahs feature bespoke tile, artwork and murals, handcrafted furniture and architectural design elements like art nouveau-inspired columns, rounded archways and window frames. I explore the 40-acre plantation the next morning and learn about the property’s shade-grown organic coffee production and how it’s cultivated, harvested and processed by hand. Strolling under tree-shaded pathways, I also learn a thing or two about crossspecies interdependency. Despite the beauty of the décor and the storytelling on sustainability, I’m distracted—the landscape and wildlife compete for my attention. A group of cicadas nearly deafen me at one point, and vibrant birds, ranging from stunning red Summer Tanagers to Bluecrowned Motmots with feathers of orange, green, blue and black, constantly keep me on the lookout. My ears perk up when guide, Ulysses, explains the significant role birds play on the plantation as our group watches a tiny Rufus Capped Wren jump from plant to plant. “Wrens are one of the most important birds we have here for insect control, which help protect our trees,” he shares. The property’s 5,000 planted native trees (and 50+ species) also give back to the birds by producing shade and nitrogen, acting as a biological corridor for the 200 or so species of tropical migrants. Post tour, I put my taste buds to work with a cupping experience called catación, during which I attempt to discern what makes a good cup of joe (distinguishing and recognizing aroma, acidity, body, flavour and finish). And those who really dig coffee can request a five-course menu featuring coffee as the main ingredient (think Coffee Rubbed Beef Tenderloin). I also indulge in the Pura Vida Coffee Scrub at El Targuá Spa. Fully caffeinated, I take flight again the next morning, this time landing in Puerto Jimenez, the Osa Peninsula’s largest city along the country’s southwestern coast. My local guide promises plenty of wildlife during the 35-minute drive, including, of course, birds. Ten minutes in and two birds checked off my life list, I’m propelled to my happy place. My squeals of delight over the sighting of a Dalton Lapwing, followed by a Tropical Screech Owl, quickly reveal my fanaticism for wildlife. Continuing over small rivers and alongside teak-wood plantations, my travel companion and I ask to stop every five minutes. Our heads hang outside the windows catching the south’s warm breezes as we scour the landscape. Every minute, new birds appear. Great Kiskadees line up, littering barbed-wire fences and fields are full of egrets hitching rides atop cattle. By a stream, I see a Green Kingfisher balanced on a branch looking for lunch, while on the ground across the way is a Crested Caracara, a strikingly patterned bird of prey that sports a signature black cap and intimidating yellow talons. The guide spots a two-toed sloth tightly bundled up high in a tree, then a Cayman Alligator, some turtles, and even more if you go birds. His promise holds true.
Want to visit a resort that is committed to sustainability and authentic experiences? Book into one of these or other properties offered by Cayuga Collection: cayuga collection.com
We pull into Lapa Rios Eco Resort and are welcomed by a congregation of high-energy Spider Monkeys who pause as they swing through the trees as if to get a good look at this new group of visitors. Known for its seclusion and pristine beaches set next to some of the country’s oldest growth forests, Lapa Rios is also recognized as a National Geographic Unique Lodge of the World. I soon find out it’s also THE lodge in Costa Rica for wildlife, especially bird lovers (with 300+ species). There’s everything from insects and lizards to marine animals and rainforest-dwelling species like monkeys, armadillos, opossums and even the very elusive pumas. And I’m warned by staff of the resort’s natural “howler” alarm clocks. I make my way down what feels like a million steps following the forest’s natural ridgeline to my bungalow on the rainforest floor (it’s actually 269—I counted between panting breaths later on the way up). Damp with sweat, I crash onto my mosquito-netted bed for a bit, and then step onto the balcony. An unobstructed view of the rainforest and Pacific meets me outside. Lush landscape is abuzz with hummingbirds flitting furiously between heaps of birds of paradise flowers. I hear monkeys in the distance and see a toucan on a branch mere metres away plucking away at vegetation. It’s difficult to pull myself away but a sunset bird tour is calling. Along the same road we came in on, our birding group observes the antics of a male Black-Throated Trogon as it passionately courts a nearby female. Being so close to so many new birds, I’m hardly able to contain my excitement. Reacting to every sound and movement, I’m like jungle paparazzi. The only problem is I’m so animated my hands shake wildly, blurring my images. “You’ve got warbler’s neck,” a woman jokes while I try to work out kinks from my strained neck. After a few dreamlike hours filled with more brilliantly hued birds like Cherry Tanagers, Scarlet Macaws and Crimson-Fronted Parakeets, we turn back. Tropical Kingbirds perched on posts remind me of Western Kingbirds back home. And my ex-husband, who introduced me to birding. In happier times, we’d take long drives along country roads in Canada’s prairies in search of bluebirds, owls and hawks. He’d help me identify ducks, which, at the time, all looked the same. Over the years, my interest in birding increased as his seemed to wane. When our marriage finally fell apart after 14 years together, I weathered the tough times outdoors, listening to and watching birds. Mesmerized, I’d sit for hours soothed by the meditative sounds of their trills and chirps. Through these small slices of solace I became part of the landscape—deeply rooted to the environment, my avian friends and myself. This daily practice connected me to something larger and allowed for healing. The birds saved me. And it’s the birds, not the howlers that wake me the next morning. Bird chatter urges me to peel open my eyes and welcome the dawn. It’s another glorious day and before starting out on the Ridge Hike, I spot a male three-toed sloth and two species of monkeys— the adorably small Squirrel Monkey and, finally, the notorious noisemakers: Howler Monkeys. Weaving through regenerating trees and carefully stepping over massive green roots, my hiking compadres and I trek between
opposite page, top row from left Beautiful design elements allow the outside world in at Finca Rosa Blanca; Collared Anteater; Namesake sushi, the Kura roll topped with crispy onions and carrots. middle row from left “Pura Vida,” a common phrase in Costa Rica, describes its natural beauty and optimistic spirit of its people; Sunset reflections in Kura’s gorgeous infinity pool overlooking the ocean; Squirrel Monkeys, one of four monkey species found within the Osa Peninsula. bottom row from left Cupping experience or catación at Finca Rosa Blanca; Staring contest with a Common Black Hawk near Lapa Rios; Sticky Chicken Strips at Kura.
Winter 2018 Just For Canadian doctors
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Just For Canadian doctors Winter 2018
primary and secondary forests. Fivehundred-year-old trees tower above and leafcutter ants transporting leaves march purposefully below. The hike quickly turns into another bird-watching expedition, thanks to a birding couple in the group. Sensing our enthusiasm, our guide Edwin, switches gears. Soon we all work together to identify each sighting. Using a laser, he points to spots he’s scouted over his 21 years guiding. He shows us a Crested Owl, perched so high and camouflaged so well, we’d likely never spot it on our own. Later, we’re deep into the secondary forest ambling alongside walking palms with stilted root systems. In a hollowed tree hangs a group of long-nosed bats and moments later we stumble upon a Collared Anteater clumsily trying to slide down a tree trunk, slipping every few metres, attempting to get out of sight. It’s December, the tail end of the rainy season (May to November), and for a short while, light rain trickles, cooling us down. At a shallow yet steadily flowing river we remove our shoes to cross, and then follow the path to a small waterfall before heading back to the resort. Leaving the next day is hard, but the blow is softened at Kura Design Villas. A modern, luxurious six-room (adult-only) property in the small village of Uvita, it’s set atop a mountain with an infinity pool overlooking the ocean and Marino Ballena National Park. After jungle trekking, my trip ends with a couple days of posh pampering, cocktails and cuisine. I fill up on a locally inspired menu with microgreens produced onsite and freshly caught seafood like octopus, seabass and yellow-fin tuna served in various forms of ceviche, rolls, tartare and sashimi. Relaxation and reflection come next. Settled poolside, I spot a hawk fly by at eye level and break into a wide grin. Costa Rica’s birds have won me over (and all of its wildlife and landscape, from anteater to howler, coffee plantation to valley floor to cliff-side infinity pool). But, actually, the birds had me at first tweet. Then I realize it. It’s bird therapy—at home or with the 300-plus species in Costa Rica. Birds will always be there to connect with throughout travels and life to remind me how far I’ve come on my journey. But it took the Costa Rican birds to remind (and tweet) me that.
miami
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hokkaida
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berlin
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cMe
A n intern ation a l guide to c ontinuing medica l Education
winte r 2018 + beyond
miami
“Le Corbusier” public art
“Sprache der Vögel,” Margulies Collection
Wynwood Walls Inside the de la Cruz Collection
Miami vibes on South Beach
South Beach “Fly’s Eye Dome” public art
[more]
miami modern: Where art is hot (CME events in Miami + beyond are highlighted in blue.)
barb sligl
A
h, Miami. It conjures hotness…as in beach, beach bodies and spicy Cuban fare, moves and music. And, yes, there’s all that. But there’s a hot factor in its art scene too. The city has become a modern-art mecca, which Art Basel Miami shines a bold spotlight on. The see-and-beseen party gets the glitterati out (think Leo and George and such), mingling, critiquing and buying contemporary artwork (this year it’s on December 7 – 10). But to partake in Miami’s art scene all you need to do is walk through Wynwood Arts District (wynwoodmiami. com). Edgy and all things hip, this once industrial ’hood is now home to more than 70 art galleries, performance spaces, shops, bars and restaurants. And its crown jewel is the Wynwood Walls street-art installation (thewynwoodwalls.com). Beyond those vivid walls are galleries within old warehouses, now showcasing museum-worthy private collections. Your mind may be blown at the Margulies Collection at the Warehouse (margulieswarehouse.com), housed in a 45,000-square-foot retrofitted warehouse that presents seasonal exhibitions from the vast collection of renowned art collector Martin Z. Margulies.
Sample artwork: the spread wings of a three-ton sculpture by German artist Anselm Kiefer. Sprache der Vögel, or “Language of the Birds,” refers to 20th-century French alchemist Fulcanelli’s ideas on hidden truths and the transformative nature of alchemy. Stand beneath its massive wingspan and let its meaning soak in. There’s more to ponder at the de la Cruz collection (delacruzcollection.org), in the nearby Design District (miamidesigndistrict.net). An extension of billionaire art lovers Rosa and Carlos de la Cruz’s home, it’s another massive (30,000 square feet) contemporary art space showcasing mind-boggling sculptures, paintings and installations. And it’s free to the public. Also free in the Design District is the Institute of Contemporary Art (icamiami.org), which is all about experimentation in contemporary art. A new 20,000-square-foot exhibition space and 15,000-squarefoot sculpture garden (yes, Miami likes to go big) open on December 1, 2017. Still in the Design District, meander the pedestrianfriendly maze of shops and office spaces to find various public art pieces like Neo-Futuristic architect Buckminster Fuller’s “Fly’s Eye Dome,” which is…just that. A 24-foot
Check out miamiand beaches.com
fly-eye-like sphere that’s considered a green-architecture pioneer—an interactive sculpture that the artist called the “autonomous dwelling machine.” It connects underground parking to the sky and courtyard above (part of the Palm Court shopping centre and another must-see design project composed of glazed-glass fins by architect Sou Fujimoto), where you’ll find a giant bust of Le Corbusier by French artist Xavier Veilhan. Surreal. Just south is the Pérez Art Museum Miami (pamm. org), Miami’s main art museum, which, besides the art inside, is set in a 200,000-square-foot showpiece by Pritzker Prize-winning architects Herzog & de Meuron. Its simple-and-sleek three-storey slatted canopy, hanging vertical garden and expansive deck overlook Biscayne Bay—a celebration of the city’s tropical vibe. And on the other side of Biscayne Bay is the Art Deco wonderland of South Beach, where there’s both eye and ear candy… Gape at the curvaceous shapes and pastel palettes of iconic architecture from the Rat Pack era and then have picnic in the park while listening to the New World Symphony (nws.edu) projected on the façade of yet another architectural masterpiece, this time by Frank Gehry (see page 5). It’s Miami modern. — Barb Sligl
Winter 2018 Just For Canadian doctors
21
Diabetes
Cardiology
Anesthesia
Alternative Medicine
c Mcmee when calendar where
MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/
topic
sponsor
contact
website
Feb 17-18 2018
Vancouver British Columbia
Hypnosis: The Language Of Change: Clinical Training Workshop For Health Professionals (Levels 1 & 2)
Canadian Society of Clinical Hypnosis
604-868-5910
hypnosis.bc.ca
Mar 21-22 2018
Rotterdam Netherlands
2nd Probiotics Congress: Europe
Global Engage
laura@glo balengage.co.uk
globalengage.com
Apr 12-14 2018
Hollywood Florida
26th Annual Spring Congress Of American Academy Of Anti-Aging Medicine (A4M)
A4M
888-997-0112
a4m.com
Apr 25-28 2018
Ojai California
5th Annual Spring Conference On Integrative Medicine In Women’s Health
Symposia Medicus
925-969-1789
symposia medicus.org
Jan 24-27 2018
Grand Cayman Cayman Islands
2018 Anesthesia Camp, Grand Cayman
destinationCME
773-417-0075
destination cme.com
Jan 26-30 2018
Winter Park Florida
Society For Education In Anesthesia 2018 Workshop On Teaching
Society for Education in Anesthesia
414-389-8614
seahq.org
Jan 29Feb 02 2018
Arosa Switzerland
2nd NSpine Platinum Small Group Educational Event
NSpine
49-36-413116315
nspine.com
Dec 17-20 2018
Miami Florida
Current Topics In Anesthesia
Northwest Seminars
800-222-6927
nwas.com
Feb 19-23 2018
Cancun Mexico
new CE to beInplaced Cardiology At Cancun: Topics Clinical
Cardiology
Mayo Clinic
800-283-6296
go.evvnt. com/150830-0
Feb 22-25 2018
Venice Italy
5th International Conference On Prehypertension, Paragon Group Hypertension & Cardio Metabolic Syndrome
41-22-533-0948
2018.prehy pertension.org
Feb 25Mar 02 2018
Atlanta Georgia
21st Annual Society Of Cardiovascular Anesthesiologists Echo Week
Society of Cardiovascular 855-658-2828 Anesthesiologists
scahq.org
Mar 18-20 2018
Glasgow Scotland
2018 Society For Cardiothoracic Surgery In Great Britain & Ireland Annual Meeting
Society for Cardiothoracic Surgery in Great Britain & Ireland
44-20-78696893
scts.org
Mar 09-11 2018
Pune India
2nd International Diabetes Summit
Chellaram Diabetes Institute
91-20-66839767
cdidiabetes summit.org
Mar 16-18 2018
Shanghai China
2nd Asia Pacific Symposium On Diabetes, Hypertension, Metabolic Syndrome & Pregnancy (DIPAP Greater China 2018)
ComtecMed
972-3-5666166
go.evvnt. com/120522-0
Sep 30Oct 03 2018
Kanagawa (Tokyo) Japan
18th International Society For Pediatric & Adolescent Diabetes Science School For Physicians
K.I.T. Group GmbH
011-49-302460-3210
ispad.org
Dec 01-04 2018
Cape Town South Africa
18th International Congress Of Endocrinology: 53rd Annual Society For Endocrinology, Metabolism & Diabetes Of South Africa Congress
Scatterlings Conference & Events
011-27-21-4222402
ice2018.org
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Just For Canadian doctors Winter 2018
MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/
General & Family Medicine
Gastroenterology
Endocrinology
Emergency Medicine
cme
calendar
cMe
when
where
topic
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contact
website
Jan 08-13 2018
San Diego California
2018 National Association Of EMS Physicians Annual Meeting
National Association Of EMS Physicians
800-228-3677
naemsp.org
Jan 27-28 2018
Las Vegas Nevada
Hospitalist And Emergency Procedures Course
Hospital Procedures Consultants
805-339-0225
hospitalproce dures.org
Feb 27Mar 03 2018
Beaver Creek Colorado
18th Winter Conference On Pediatric Emergencies
Symposia Medicus
925-969-1789
symposiamedi cus.org
Mar 10 2018
Vancouver British Columbia
Ophthalmology Update For Emergency Physicians
University of British Columbia
604-875-5101
ubccpd.ca
Jan 12-13 2018
Abu Dhabi UAE
2018 European Society Of Endocrinology Clinical Update
Imperial College London Diabetes Centre
971-3-746-4848
icldc.ae
Mar 01-03 2018
Dubai UAE
8th Emirates Diabetes & Endocrine Congress (EDEC)
MCI Middle East
971-4-311-6300
edec-uae.com
Mar 11-14 2018
San Diego California
40th Annual Meeting Of The Society For Inherited Metabolic Disorders
Society for Inherited Metabolic Disorders
503-636-9228
simd.org
Jun 13-16 2018
Berlin Germany
49-89-54823462
go.evvnt. com/166212-0
Jan 25-26 2018
Edinburgh Scotland
44-13-12473634
rcpe.ac.uk
Apr 21 2018
EPC 2018 Team new CE to Congress INTERPLAN be placed 22nd Advanced Gastroenterology & Hepatology Royal College of 50th Jubilee Meeting Of The European Pancreatic Club
Course
Physicians of Edinburgh
New York New York
3rd Annual School Of Gastrointestinal Oncology
Physicians’ Education Resource
609-378-3701
gotoper.com
Sep 03-06 2018
Berlin Germany
2018 FoodMicro Conference
MCI Deutschland
011-49-30-204590
foodmicro 2018.com
Jan 21-26 2018
Hokkaido Japan
2018 Winter In Japan Integrated Health Care Conference
Amped Medical Conferences
011-61-40-4855636
ampedmedi calconfer ences.com
Feb 09-10 2018
Miami Florida
2018 Mass Gathering Medicine Summit
American Academy of Event Medicine
info@mass gathering medicine.org
massgather ingmedicine.org
Feb 19-22 2018
Grand Cayman Cayman Islands
2018 Advanced Imaging In The Islands
Duke Radiology
919-684-7228
duke.edu
Mar 01-04 2018
Miami Florida
2018 South Beach Symposium (Dermatology)
South Beach Symposium
904-309-6262
southbeach symposium.org
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Winter 2018 Just For Canadian doctors
23
Hepatology
Hematology
Geriatrics
General & Family Medicine
c Mcmee when calendar where
MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/
topic
sponsor
contact
website
Honolulu Hawaii
15th Hawai’i International Summit On Preventing, Assessing & Treating Trauma Across The Lifespan
Institute on Violence, Abuse & Trauma
858-527-1860
ivatcenters.org
Apr 20-21 2018
Vancouver British Columbia
Canadian Conference On Physician Leadership “Dialogue: A Tool To Lead Action”
Canadian Society of Physician Leaders
613-369-8322 physicianleaders. ca
physicianlead ers.ca
Apr 26-28 2018
Boston Massachusetts
Writing, Publishing, And Social Media For Healthcare Professionals
Global and Continuing Education, Harvard Medical School
617-384-8600
wps.hmscme. com
Jun 07-19 2018
British Isles And French Open Cruise
Topics In Addiction Medicine, Mental Health, Obesity, And Preventive Medicine
Continuing Education, Inc./University at Sea
800-422-0711 See Ad Page 39
continuingedu cation.net
Oct 13-20 2018
Tahiti & Bora Bora
Treatment Considerations In Isolated Communities / Seminar At Sea On The Paul Gauguin
Professional Education Society
877-737-7005 See Ad Page 33
pestravel.com
Oct 21-28 2018
Southern France River Cruise
Medical Symposium Confronting Healthcare Needs / 7-Night Uniworld River Cruise Avignon To Lyon
Professional Education Society
877-737-7005
pestravel.com
Nov 08-11 2018
Miami Florida
19th Annual Fall Scientific Meeting Of Sexual Medicine Society Of North America (SMSNA)
Sexual Medicine Society of North America
952-683-1917
smsna.org
Jan 20Feb 01 2019
Rio to Buenos Aires Cruise
Medical Healthcare Delivery In Challenging Environments / Brazil, Uruguay & Argentina On Regent Explorer
Professional Education Society
877-737-7005
pestravel.com
Dec 14-16
Las Vegas Nevada
888-997-0112
a4m.com
Jan 25-27 2018
Toronto Ontario
2018 Better Breathing
The Lung Association Ontario
416-864-9911
betterbreath ing.ca
May 03-04 2018
Montreal Quebec
La Gériatrie
Université de Montréal
514-343-6790
umontreal.ca
Aug 08-10 2018
Toronto Ontario
14th Global Conference On Ageing
International Federation on Ageing
416-342-1655
ifa2018.com
Jan 19-20 2018
Miami Florida
2018 Highlights Of ASH In North America
Washington University School of Medicine in St. Louis
314-362-6891
wustlcme.highmarksce.com
Mar 28-30 2018
Paris France
38e Congres de la Société Française d’Hématologie
Société Française d’Hématologie
33-1-5727-6736
hematologie.net
Dec 13
Strasbourg France
Hands-on Flexible Endoscopy For Surgeons Advanced Course
Institut de Recherche Contre les Cancers de l’Appareil Digestif
011-33-3-88119090
ircad.fr
Jan 25-26 2018
Edinburgh Scotland
22nd Advanced Gastroenterology And Hepatology Course
Royal College of Physicians of Edinburgh
44-13-12473634
rcpe.ac.uk
Apr 16-19 2018
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Just For Canadian doctors Winter 2018
calendar
cMe
when
where
topic
sponsor
contact
website
Expiry Jan 30 2018
Online
Adult Immunization In Primary Care - Influenza, Meningococcal And Food And Water Borne Travel Illnesses Update
mdBriefcase
416-488-5500
goo.gl/M8Fe5A
Nov 07 2018
Toronto Ontario
5th International HBV Cure Workshop
Virology Education
31-30-230-7142
virology-edu cation.com
Dec 15-16
Brussels Belgium
2017 Annual Congress Of Belgian Society Of Internal Medicine
Belgian Society of Internal Medicine
32-4-7687-4297
bsim.wildapri cot.org
Jan 06 2018
Richmond Virginia
Urological Update & More 2018
Virginia Commonwealth University Health
800-413-2872
vcu.cloud-cme. com
Feb 02 2018
Sherbrooke Quebec
AMU - Atelier Pratique de Techniques Utilisées en Médecine d’Urgence
Université de Sherbrooke
819-564-5350
usherbrooke.ca
Feb 13-17 2018
Atlanta Georgia
2018 Association Of Academic Physiatrists (AAP) Annual Meeting
Association of Academic Physiatrists
410-654-1000
physiatry.org
Mar 12-14 2018
Whistler British Columbia
Medical CBT For Stress And Anxiety: Ten-Minute Techniques For Real Doctors
CBT Canada
877-466-8228 See Ad Page 20
cbt.ca
Mar 19-21 2018
Maui Hawaii
Medical CBT For Stress And Anxiety: Ten-Minute Techniques For Real Doctors
CBT Canada
cbt.ca
May 26-30 2018
Rome Italy
new CE to 16th World Association For Infant Mental Health Worldwide Congresses be placed World Congress & Events
877-466-8228 See Ad Page 20 011-39-6-328121
waimh.org
Jun 22-23 2018
Miami Florida
14th International Regional Stress & Behavior Neuroscience & Biopsychiatry Conference (North America)
International Stress And Behavior Society
240-899-9571
stressandbe havior.com
Jul 22-29 2018
Disney Mediterranean Cruise
Medical CBT For Anxiety
CBT Canada
877-466-8228
cbt.ca
Oct 07-16 2018
Japan Cruise
Medical CBT For Depression: Ten Minute Techniques For Real Doctors
CBT Canada
877-466-8228
cbt.ca
Jan 18-20 2018
Miami Florida
2018 Neurology Update And Stroke Intensive
Miller School of Medicine
305-243-6716
cmetracker.net/ UMI ACME/
Feb 04-06 2018
Whistler British Columbia
10th Canadian Neuromodulation Society Annual Meeting
Canadian Neuromodulation Society
418-649-5844
neuromodula tion.ca
Mar 22 2018
St. Petersburg Florida
Ultrasound Guided Vascular Access
Gulfcoast Ultrasound Institute, Inc
727-363-4500
gcus.com
Mar 24 2018
Toronto Ontario
MSK Spine Tools
MSK Courses of Canada
647-478-3006
mskcourses.net
Neurology
Mental Health
Internal Medicine
cme Infectious & Chronic Diseases
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Pain Management
Oncology & Palliative Care
Obstetrics & Gynecology
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MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/
topic
sponsor
contact
website
Symposia Medicus
800-327-3161
symposiamedi cus.org
Topics In Women’s Health And Healthcare Communication
Continuing Education, Inc./University at Sea
800-422-0711
continuingedu cation.net
Toronto Ontario
21st Annual Women’s Imaging. Advances In Gynaecologic Imaging And First Trimester Ultrasound
University of Toronto
416-586-4800
mountsinai. on.ca
Feb 16-23 2018
Barbados
General Practitioners & Dermatology Symposium On Skin Cancer
CME Travel
877-377-2211
cmetravel.com
Jul 15-29 2018
British Isles Cruise
Symposia On Hospital, Palliative, Primary And Dental Care On The All-Inclusive Crystal Serenity
Professional Education Society
877-737-7005 See Ad Page 33
pestravel.com
Aug 15-18 2018
Sydney Australia
17th World Congress On Cancers Of The Skin
The Skin Care Foundation
wccs2018@ arinex.com.au
wccs2018.com
Feb 16-18 2018
Whistler British Columbia
Neurology & Pain Management For Primary Care
MCE Conferences
888-533-9031
mceconfer ences.com
Feb 16-19 2018
Carlsbad California
The 31st Annual Practicing Physician’s Approach To The Difficult Headache Patient
Diamond Headache Clinic
312-867-9104 See Ad Page 28
dhc-fdn.org
Jul 12-15 2018
Lake Buena Vista Headache Update 2018 Florida
Diamond Headache Clinic
312-867-9104 See Ad Page 28
dhc-fdn.org
Feb 22-25 2018
Orlando Florida
The Conference For Neonatology
Pediatrix Medical Group
800-243-3839 See Ad Page 10
neoconfer ence.com
Feb 20-25 2018
Orlando Florida
Specialty Review In Neonatology
Pediatrix Medical Group
800-243-3839
specialtyre view.com
Jul 31Aug 02 2018
Austin Texas
Innovations Conference
Pediatrix Medical Group
800-243-3839 See Ad Page 10
innovations conference.com
Feb 05-09 2018
Naples Florida
6th Annual Essentials In Primary Care Winter Conference
Continuing Education Company
800-327-4502 See Ad Page 37
cmemeeting.org
Feb 19-23 2018
Maui Hawaii
6th Annual Primary Care Winter Conference
Continuing Education Company
800-327-4502 See Ad Page 37
cmemeeting.org
Mar 26-30 2018
Palm Coast Florida
12th Annual Primary Care Spring Conference Session I (Session II: April 02-06, 2018)
Continuing Education Company
800-327-4502
cmemeeting.org
Sep 30Oct 14 2018
Holy Land & Ancient Kingdoms Cruise
Primary Care And Women’s Health Key Topics And Core Strategies
Continuing Education, Inc./University at Sea
800-422-0711 See Ad Page 39
continuingedu cation.net
Dec 15-16
New York New York
23rd Annual Conference On Challenges In Gynecology
Jan 20Feb 01 2018
Australia and New Zealand Cruise
Feb 23-25 2018
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travel at home
Looking down Red Tree run at Fernie Alpine Resort below Ice skating on the lake at Fairmont Jasper Park Lodge right High above Jasper atop Whistlers Mountain below right The view from the top of Currie Bowl at Fernie Alpine Resort
a tale of two Rockies From west (Fernie) to east (Jasper)‌there are two sides to the Canadian Rockies to discover story by
+ photography Barb Sligl
November/December 2017 Just For Canadian dentists
29
travel at home
T
here’s a dusting of snow over the quiet main street, the sky’s a deep, twilight blue edging into dark night and unlike anything you’d see in the city. Peaks rise high above the quaint buildings, stars start to emerge, the snow seems aglow and ski-jacketed people amble about in search of a warm spot to continue their après-ski. It’s a small-town scene in the mountains after the ski hill shuts down for the day. I’m in Fernie, tucked into the southeastern corner of BC on the west side of the Rockies. But on the other side to the north is another, similar scene. There, the mountain village is Jasper, where the sky may be darker (it’s home to one of the world’s biggest Dark Sky Preserves) and there are more tourists (it’s in a renowned national park, after all) but it’s still under-theradar as far as ski destinations go. Go-to resort towns (ahem, Whistler, Mont Tremblant, Banff’s big three) are an easy pick for getting that ski fix, but venturing farther out of the way makes for a more local vibe (and less lift lines). And I found both on opposite sides of the Rockies. Fernie’s long been known as a skier’s wet dream—deep powder, stellar steeps, five glorious bowls—but because of its location—on the west side of Crow’s Nest Pass, a three-hour drive from Calgary and more than 10 hours from Vancouver—it’s not overrun. And people actually live and work here (mining marmot basin employs a good Number of runs: 86 (30% easy, 30% percentage of the intermediate, 20% advanced, 20% expert) population). That Terrain: 678 hectares (1,675 acres) longest run: 5.6 kilometres (3.5 miles) means year-round Summit elevation: 2,612 metres (8,570 feet) establishments like a Vertical drop: 914 metres (3,000 feet) sushi joint locals happily average snowfall: 4 metres (13 feet) line up for (yes, nigiri skimarmot.com in the mountains, and Yamagoya even has a solarpowered sushi truck, Yama2Go, in warmer months) and a coffee shop that’d fit in the hippest ’hoods of any big city. I walk off the main drag into this coffee spot, The Valley Social, to find a cow skull top The view of Jasper townsite from the top of Jasper Avenue black-diamond run at Marmot Basin middle row from left Buffalo head above the fireplace in the Fairmont Jasper Park Lodge; snowshoeing in Jasper National Park bottom row from left Parks Canada photographer, Ryan Bray, in front of one of his captures of the Dark Sky Preserve; sampling local microbrew from Jasper Brewing Co.
travel at home hanging above a menu etched on planks of wood and a plaid-and-toque-wearing proprietor behind the counter, drawing espressos himself. He tells me how he started his venture with a mobile trailer, bringing good coffee to the good people of Fernie. Demand was such that he opened this bricks-and-mortar place just over a year ago, and now also hosts pop-up multicourse dinners. A few steps away, still on that softly blanketed and hushed main street, I have dinner at The Loaf, where oven-baked pizza and the Shaft are a much-loved thing (the Shaft is described as “the quintessential BC mountain town cocktail,” made of Fernie Alpine coffee, vodka, Kahlua, Number of runs: 142 (30% easy, 40% cream). Afterwards, intermediate, 30% advanced) Terrain: 1,012 hectares (2,500+ acres) I wander about in longest run: 5 kilometres (3 miles) the chill to admire Summit elevation: 2,134 metres (7,000 feet) historic turn-of-theVertical drop: 1,082 metres (3,550 feet) century buildings. average snowfall: 9 metres (30 feet) And, of course, skifernie.com before all of this was the actual skiing. If you’re into skiing, you’ve heard of Fernie (and Calgarians certainly have; here, they’re known as Calfernians). Because those five glorious bowls of white stuff are revelatory. Beneath the looming ridge of rock called the Headwall (yes, it’s skiable, but strictly for those with hardcore skills and absolutely no fear) are the “old” and “new” sides. Local ski guide and instructor Johnny (who runs the Steep and Deep program) takes me to the edge of the old side, along Snake Ridge to where out-of-bounds Fish Bowl beckons to serious powderhounds (avalanche equipment required). We ski the ridge, down Red Tree and into Cedar Bowl, before heading over to the new side and up to the very top of Fernie, where Polar Peak provides vertigoand adrenaline-inducing views and runs. After a killer ski day (in the best sense) of Johnny’s fave runs and tips (slap those skis down the moguls’ side, keep on balls of feet, stay forward!), I have a much-needed Wolf IPA (from Fernie’s own microbrewery) at legendary slope-side bar, the Griz. Named after a rockface high above that looks like Lone Wolf IPA from Fernie Brewing Co. at legendary après-ski spot, the Griz; Lost Boys Café, go-to lunch stop at the top of Timber Bowl in Fernie middle Twilight in downtown Fernie with view of the Headwall bottom row from left The Valley Social coffee house in Fernie; Steep-and-Deep instructor, Johnny, surveys his domain from the top of Currie Bowl and across from Polar Peak top row from left
travel at home said bear, it’s also known for beer-lubricated table sliding…in the nude. I forgo the table slide and instead tackle another bowl, the Knob, some 600 kilometres northeast of here, across the Continental Divide, at Marmot Basin in Jasper National Park. With the highest base elevation in Canada, Marmot is far above
Marmot Basin Snow School instructor Jezz’s office below Skiing down from Polar Peak at Fernie Alpine Resort
Jasper village, reached via a twisty 20km road that’s a bit of a trek itself (there’s a bus or cab service…really). Despite Jasper’s renown, Marmot is little-known, largely serving a local and Edmonton market. Read: no crowds. Ever. And wow skiing. My guide, Jezz (lead instructor with the ski school and Ski Instructor Training program), takes me down Elevator Chutes
32
(sweet tree run), Show-off (one of his faves), Milkrun (more in the trees), Grizzly Glades (another “griz,” this one a bumpy tree run)…and on and on. We never encounter anything resembling a lift line, and my quads are on fire by the end of the day. Thankfully, again, this town has lively après-ski and even better, “In Jasper you can
days, I also snowshoe, hike along a frozen waterfall, watch fireworks and practise yoga (okay, this is indoors, but part of the Lolë Wellness Weekend, one of the Jasper in January events, like those fireworks). I also try some night photography in this Dark Sky Preserve (public workshops take place during the annual Dark Sky Festival), which is documented beautifully by a resident Parks Canada photographer. My snowshoeing session is one of many free activities that Parks Canada offers, and in the hour or so I’m in the woods, I come across numerous tracks (wolf?!) and concave formations (curled-up and napping elk!) in the snow. Then I cross paths with other creatures—a young (and local!) family out on cross-country skis for their weekly loop through the forest. After my calorie-burning foray in the forest, I stop in at Jasper Brewing Co. (the first brewery in a national park) for Jasper the Bear ale (another thing named after a bear). I sample other funky spots like Coco’s Cafe to fuel-up with an apropos Groomers Breakfast and Snowdome to caffeine-up while others do their laundry (yes, it’s a laundromatcum-café and it’s wonderfully For more on what to see and weird and right). do in Jasper go to jasper.travel, There’s a ravedand for info on the Alberta side about sushi of the Rockies: travelalberta. place too, as I’ve com. For more on Fernie go to come to expect tourismfernie.com, and for of these two info on the BC side of the Rockies: hellobc.com. not-so-surprisingly sophisticated small ski towns. This one’s hidden away in the lower level of the Fairmont Jasper Park Lodge and just as hard to get into (Oka Sushi is a one-man operation with just 12 seats). But my most off-beat experience in this mountain village is The Den in the bowels of Whistler’s Inn. A can’t-miss, Jezz insists when he tells me about this “attraction.” I buy my token at the front desk (a mere $3), make my way to the basement and insert the coin into a turnstile to enter a dark diorama of forest creatures. Or more accurately, some 100 taxidermied animals—cougars, biggo to a bar and actually sit next to a local,” horned rams, eagles, elk, grizzlies—that are says Jezz. “Try do that in Banff.” Jasper prides strangely arresting, grotesque yet beautiful. I itself on this difference and its independent can’t imagine seeing anything of the kind— spirit; this a town where McDonald’s tried to so unabashedly quirky—in a larger ski-resort make a go of it and only lasted six months. town. And that’s the joy of these two But, being a national park and UNESCO sides of the Rockies, because these smallWorld Heritage Site, there are the inevitable and-sweet ski towns still make space for tourists, which also means plenty of non-ski- authenticity…with a little bit of eccentricity. ing activities—even in winter. Over a couple And a lot of great skiing.
Just For Canadian doctors Winter 2018
if you go
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China, Tibet & the Yangtze River Tour with A&K Healthcare in the Far East—Medicine for the Masses Beijing | Xian | Chengdu | Lhasa | Yangtze River Cruise | Shanghai
May 21 - June 6, 2018
British Isles Cruise on Crystal Serenity Symposia on Hospital, Palliative, Primary and Dental Care
England | Channel Islands | Ireland | Northern Ireland | Scotland | Netherlands | Belgium
July 15 - 29, 2018
Portugal & Douro River Cruise on AMA Waterways Current Medical/Dental Health Issues Lisbon | Porto | Salamanca | Vineyards & Port Tasting | Dramatic Landscapes
September 8 - 18, 2018
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Joint Medical/Dental Symposium Confronting Heathcare Needs 7-Night Cruise Exploring Southern France on the Rhône and Saône Rivers
October 21 - 28, 2018
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Medical/Dental Healthcare Delivery in Challenging Environments 12-Night All-Inclusive Luxury Cruise Exploring Brazil, Uruguay and Argentina
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April 26 - May 8, 2019
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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 is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.
Peace of mind
The resurgence of the tax-sheltered and untouchable Individual Pension Plan
W
ith punitive taxes on corporate investment income looming on the horizon, many doctors will seek tax shelter in the Individual Pension Plan (IPP). The IPP is a one-person pension plan which operates like a teachers’ pension plan, offering tax-sheltered growth, locked-in savings, creditor proofing and inflation adjusted benefits on payout. Here are the maximum contributions for 2017 your corporation can make in your first year of setting up the IPP. Earnings of $144,500 and service from 1991 are assumed. Age 40: $111,056; age 45: $181,471; age 50: $258,706; age 55: $343,709; age 60: $437,055; and age 62: $476,883. For individuals 40 years or older, can be a source the annual contribution to the IPP is of comfort in this higher than the RRSP contribution. chilly tax climate For instance, the maximum 2018 IPP for physicians contribution for a 55-year-old doctor is $37,666 compared to an RRSP contribution of $26,230. Additional advantages:
The IPP
at your
service
• The company can deduct the interest on funds borrowed to make the contribution. • Actuarial, accounting and administration fees are tax deductible in the company and are not a taxable employment benefit. • If the return on your investment becomes insufficient to fund the IPP benefits, you can top up the IPP. • Upon early retirement the company can make a final contribution, called terminal funding, to increase pension benefits. • You can wait 120 days after the company year-end to make the tax-deductible contribution for the year. • IPP pension income is eligible to be split with spouse at age 50. RRIF income is not eligible for income splitting until age 65. • Ability to roll RRSP into IPP.
34
Just For Canadian doctors Winter 2018
The IPP has some disadvantages: • Since you require the services of an actuary, the administrative expenses are higher than the RRSP. • You cannot make spousal RRSP contributions. • New RRSP room is restricted to $600 per year. • You don’t have the ability to withdraw funds prior to retirement. • You need T4 earnings of about $144,500 in order to maximize the current IPP contribution, very similar to maximizing your RRSP contributions. The actuary prepares a tri-annual valuation of IPP and if there is plan deficit in relation to the prescribed limits, then the company must make up for the shortfall. On the other hand, if your IPP has a surplus, you must reduce your contributions. The funds are locked in and must provide pension income using one of these three options: 1. IPP funds are used to purchase a life annuity, which can be joint with your spouse. 2. Since an IPP does not have to be wound up, the IPP can pay pension benefits directly. 3. IPP funds are transferred directly to an income-paying locked-in retirement plan. This is the most popular option. If the doctor dies after retirement and the IPP funds were transferred to another locked-in retirement plan, the surviving spouse can roll the full value of the plan to his or her own registered plan. The beauty of the IPP is that it gives you peace of mind in the uncertain investment climate; you know what your retirement income will be when you retire. And most importantly, the IPP gives you the comfort of knowing that the money in the IPP grows taxsheltered and untouchable to any new tax measures affecting your investment income in the corporation.
“NO PENSION - NO FEE”
EVER WORKED IN THE UK - BRITISH-BORN OR NOT? YOU COULD QUALIFY FOR A BRITISH STATE PENSION.
As a former Pensions Officer, I have successfully claimed British State Pensions for well over 2,000 pensioners living in Canada, USA, EU and many other countries. This is NOT charity - you paid taxes for it - this is your LEGAL ENTITLEMENT! The sooner you claim, the better the pension you will receive on retirement. Tell us your Date of Birth and how many years you worked in the UK over age 16, and we will advise you in 2 minutes FREE if you can qualify. As your agent, we make the claim - you never even see a Government Pension Claim form! WHAT DO YOU HAVE TO LOSE? YOU’RE NOT AT PENSION AGE YET? If you are contributing to an RRSP now, you already know that the earlier you start, the better pension you receive CALL US TODAY! The British State Pension is payable on top of CPP/OAS, and the top-up rates are only HALF of the top CPP Rate! We claim the absolute lowest cost top-ups for ALL our clients!
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NEW "Single Tier" pensions legislation effective April 6, 2016 In recent years, State Pension Ages have all changed from the original 60th birthday (women) and 65th (men). Anyone reaching SPA after this date will be subject to the very significant changes of this new law. For those reaching SPA before this date, there are entirely different conditions.
DO YOU KNOW YOUR SPA & HOW THIS AFFECTS WHEN YOUR PENSION STARTS AND HOW MUCH IT WILL BE?
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.
Responsible recoup
Endorse
Pain-free recovery from car accidents must go further than a physician’s care
O
uch! I have just paid my auto insurance for another year, and it has gone up another $50. It is now costing me $1,320 and would be closer to $1,900 if I was not able to claim an accident-free status. There are minor variations but basically this is the same across Canada. I thought it was the same in Europe but my brother-in-law in the United Kingdom pays just $264 for a fully comprehensive policy. His son, however, pays $1,600 on account of his age and gender, which is considered a higher risk as per common underwriting practice. This cannot happen in Canada as it is considered age discrimination. I am writing specifically about BC, but it’s my understanding that automobile insurance is fundamentally the same across the country. There are minor variations, such as in Saskatchewan, which has nofault insurance. Insurance premiums would increase even more if it were not for legislation to limit alcohol-impaired driving and now distracted
positivity
and mobility versus extended invalidism
The problem is that once litigation is involved in a claim everything grinds to a halt. It takes about five years to have the claim settled, by which time the patient has become fixed in a pattern of chronic pain and invalidism. These patients come to the office with their pain diaries and a detailed list of every ache and pain that has occurred. This focus on the negative goes against physicians’ inherent practice of encouraging and rewarding rapid recovery. I sometimes wonder if I’m a bit insensitive to these patients— some patients do suffer chronic symptoms and pain—until I was rear-ended by a texting driver and sustained $6,000 worth of car damage and then my wife was also rear-ended by a large, heavy truck. We stayed active and developed negligible symptoms, and both made a rapid recovery. I think some patients are genuinely scared that they have some form of occult injury or are doomed to develop problems later on in life—anxieties that are usually fuelled by well-meaning friends or relatives who “know somebody who was involved in an accident just like yours and ended up paralyzed several years later…” It’s left to the physician to reassure the patient that permanent injury is unlikely, remote complications improbable and early mobility and activity essential—and to never, therefore, impede recovery with a cervical collar (a controversial prescription that can actually make things worse with immobilization). I would like to see the end of contingency billing. I have had several patients over the years who have begun a claim for motor vehicle injuries but later realized that it was not justifiable—yet they were unable to quit the process unless they paid a substantial fee of thousands of dollars. They were trapped. We, as doctors, can do little to change this process on the grand scale. But, one by one, we could urge our patients to agree to a settlement sooner rather than later. Most patients still listen to and heed the advice of their primary care physicians. We need to remind them that the body has a great ability to heal, encourage mobility and provide a positive message that may just save them from becoming chronic invalids.
sudoku 1 easier solution 1 9 8 2 5 6 4 3 7 4 2 7 3 1 9 8 6 5 3 5 6 8 7 4 9 2 1 5 3 9 1 4 2 7 8 6 7 4 2 6 3 8 5 1 9 8 6 1 7 9 5 2 4 3 2 7 3 9 8 1 6 5 4 9 8 4 5 6 3 1 7 2 6 1 5 4 2 7 3 9 8
Puzzle by websudoku.com
36
Just For Canadian doctors Winter 2018
solution from Fall 2017 contest
driving. Some provinces have photo-radar enforcement but this was banned in BC several years ago as a matter of political expedience. There are other steps, major and minor, which could be taken to reduce accidents, and hence insurance costs, and would involve all levels of government and have different levels of efficacy. It would seem logical to have all cars fitted with universalheight bumpers that are impact safe up to 5 km an hour (a very minor bump at a traffic light dented my bumper and resulted in a replacement cost of about $1,000). Road lines made of a durable material that includes reflective elements would prevent them becoming virtually invisible when it rains. More roundabouts would reduce not only the number of accidents but also the severity of injuries. Such things make a difference, like the praiseworthy introduction of universal backup cameras in all vehicles by 2018. But these are small potatoes compared to the main motor (unintentional pun) behind the escalation of insurance costs. That is, the disproportionate remuneration for “pain and suffering” for relatively minor accidents. Of course, adequate compensation is reasonable and justified in the event of serious injuries but one element that precipitated me into retirement was having to write medicolegal reports concerning mostly trivial injuries. These reports take up a great deal of the physician’s time that’s much better spent in dealing with truly sick patients. The last medicolegal report I submitted was billed at $450 an hour and paid without demure. Even at that price it was not worth the time involved.
solution from page 37
It is up to the physician to reassure the patient that permanent injury is unlikely, remote complications improbable and early mobility and activity essential…
sudoku 2 harder solution 4 9 6 8 7 3 1 5 2 2 7 1 6 9 5 4 8 3 5 3 8 4 2 1 9 6 7 3 8 7 2 6 4 5 9 1 9 2 4 1 5 8 7 3 6 1 6 5 9 3 7 8 2 4 6 5 9 7 4 2 3 1 8 8 4 2 3 1 9 6 7 5 7 1 3 5 8 6 2 4 9
Puzzle by websudoku.com
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sudoku Solve puzzle #2 for a chance to win a $50 VISA gift card!
CME Conferences
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.
UP TO
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CME CREDITS
OV E R 2 5 Y E A R S O F Q UA L I T Y L I V E C M E 6th Annual Essentials in Primary Care Winter Medical Conference February 5-9, 2018
3rd Annual Clinical Issues in Primary Care Conference May 7-11, 2018
Naples Grande Beach Resort
Fairmont Orchid, Hawaii Resort
6th Annual Primary Care Winter Conference February 19-23, 2018
8th Annual Primary Care Fall Conference October 15-19, 2018
Sheraton Maui Resort & Spa
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12th Annual Primary Care Spring Conference: Session I or II March 26-30, 2018 or April 2-6, 2018
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GOOD LUCK!
sudoku 1 easier solution on page 36
9 8 4 3 1 4 2 4 9 2 3 5 4 8 6 3 5 7 2 9 9 4 8 6 5 4 7 3 9 6 3 7 2 5 3 9
sudoku 2 harder solution in next issue
$50 Visa Gift Card winner: Dr. Andrew Berkshire in Fredericton, NB
7
Big Island of Hawaii
Maui, Hawaii (Ka’anapali Beach)
Maui, Hawaii (Ka’anapali Beach)
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EXPIRES DECEMBER 31, 2018
800-327-4502 | 386-490-8010
www.CMEmeeting.org
Complete schedule available on our website. Educational Sessions 8:00am-12:15pm.
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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 604-681-0456. Entries must be received by February 23, 2018. 3. Prize: $50 VISA 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 affliates are not eligible to participate.
Winter 2018 Just For Canadian doctors
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pa r t i n g s h o t
place to be
on ice
image: Camille Bianchi and Ryder Thalheimer
gs a n i r b Ice or ld w n e w l i fe . . . to
Every winter, when the Red and Assiniboine Rivers freeze at The Forks in Winnipeg, a new world appears. Atop this frozen surface, the visions of creative minds come to life in a series of fantastical warming huts set on the country’s longest public skating trail. One of the winners in this year’s competition is The Trunk, by Camille Bianchi and Ryder Thalheimer of Vancouver, BC, seen here as a rendering (the real thing will be constructed once the ice is thick enough, early in 2018). It’s an inhabitable “tree” made of layers of laminated wood that mimic growth rings. Inside this arboreal structure is an opening to the sky. “The Trunk is inspired by the quiet slowness of growth in the natural world,” say the designers. It stands tall against the flat landscape of the frozen river, a refuge from the elements and place of communion with this most Canadian of experiences. warminghuts.com For more on Winnipeg in winter: tourismwinnipeg.com —B. Sligl
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Just For Canadian doctors Winter 2018
For more information - Call 800-422-0711 or visit www.ContinuingEducation.NET
Outstanding value for your time and resources Combine live, accredited CME and personal renewal time with family & friends Featured Destinations
Topics in Critical Care and Pulmonary Medicine 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 11-Night Japanese Explorer from Tokyo, Japan Celebrity Cruises’ Celebrity Millennium April 15 - 26, 2018
Primary Care and Women’s Health - Key Topics 20 AMA PRA Category 1 Credit(s)™ 20 Contact Hours 14-Night Holy Land & Ancient Kingdoms from Rome Holland America’s ms Prinsendam September 30 - October 14, 2018
March 11, 2018 Preventive Medicine & Preventive Cardiology 20 AMA PRA Category 1 Credit(s)™ 20 Contact Hours 10-Night Panama Canal from Fort Lauderdale Holland America’s ms Zuiderdam
September 1, 2018 Family Medicine: Women’s Health 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 8-Night Norwegian Fjords from Southampton, England Celebrity Cruises’ Celebrity Silhouette
April 11, 2018 Topics in Internal Medicine: 2018 Update 18 AMA PRA Category 1 Credit(s)™ 18 Contact Hours 10-Night Mediterranean Mosaic from Rome Holland America’s ms Koningsdam
October 1, 2018 Dermatology 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 11-Night Mediterranean from Rome Celebrity Cruises’ Celebrity Reflection
May 28, 2018 Internal Medicine: Cardiology 16 AMA PRA Category 1 Credit(s)™ 16 Contact Hours 10-Night Iceland and Ireland from Dublin Celebrity Cruises’ Celebrity Eclipse
October 12, 2018 Topics in Internal Medicine & Critical Care 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 10-Night Italy and Greek Isles from Rome Celebrity Cruises; Celebrity Reflection
June 17, 2018 Family Medicine and Sleep Medicine 12 AMA PRA Category 1 Credit(s)™ 12 Contact Hours 7-Night Western Mediterranean from Barcelona Royal Caribbean’s Symphony of the Seas
November 4, 2018 Topics in Primary Care & Gastroenterology 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Southern Caribbean from San Juan, Puerto Rico Royal Caribbean’s Freedom of the Seas
July 14, 2018 Pediatrics 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Western Mediterranean Rome to Barcelona Celebrity Cruises’ Celebrity Constellation
December 1, 2018 Topics in Family Medicine: 2018 Update 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Hawaiian Islands from Honolulu, Oahu Norwegian Cruise Line’s Pride of America
August 4, 2018 Allergy and Immunology for PCPs 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Hawaii Islands from Honolulu, Oahu Norwegian Cruise Line’s Pride of America
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. Designation: Continuing Education, Inc. designates these live educational activities for a maximum of 14-21 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Course Fees may vary based on number of hours offered. Please visit our web site for current fees and cancellation policies.
Ask about our Guest Travels Free Program We can manage or joint provide/accredit your next association or group meeting Call 800-422-0711 or 727-526-1571 or visit www.ContinuingEducation.NET Florida Seller of Travel Reg. #14337
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