The walk-in or urgent care clinic that you visited just once is obliged to be your “medical home” if that’s what you need and want, according to new standards set by the College of Physicians and Surgeons of BC.
Formerly, there was an expectation that such clinics became your primary care clinic of record after three visits.
Under beefed-up guidelines, walk-in clinics will be held to the same high standard as those where patients book appointments. That means doctors at walk-in clinics must keep excellent medical records, contact patients with lab or other diagnostic test results, send copies of reports to other doctors who need them, offer to be the primary-care clinic for patients who need a regular place to go, and schedule periodic screening and prevention checkups.
Dr. Heidi Oetter, CEO and registrar of the College, said professional standards and guidelines were updated with stronger language to let doctors and patients know there aren’t different standards of care for traditional medical clinics and walk-in clinics.
If patients have no other place to go, then walk-in clinic doctors must offer to be the patient’s primary care physician through a “verbal invitation.” They can no longer consider a patient’s visit as a one-off, she said,.
Oetter said the College hears regular complaints from the public that walk in clinics “cherry pick” the easiest cases. But even patients with complex or chronic illnesses should be able to depend on walk-in clinics for continuing care, she said. If it’s not offered, patients should feel comfortable demanding “what they need.”
The College also expects every walk-in clinic to have a medical director who is a doctor, not a business person, so the College can communicate “doctor to doctor.” The medical director must ensure compliance with College standards. Doctors at such clinics can’t delegate followup of medical care and lab tests to staff who are non-physicians.
The College is also insisting walk-in clinics provide after-hours coverage and have access to PharmaNet so they know what prescriptions patients are taking. Oetter said the latter rule arose after investigations which found evidence of prescription fraud throughout the Lower Mainland. One person got more than 250 prescriptions, from multiple physicians, and filled them at 34 different pharmacies from 2007 to 2013. The College found fault with 46 physicians who had deficient prescribing practices.
“This case serves to remind physicians of the important role they play in mitigating this public health problem, which starts with prescribing medication to patients according to current prescribing standards and principles. This includes taking the time to conduct an appropriate exam, asking the right questions, and checking the patient’s PharmaNet profile before issuing a prescription — especially for a narcotic.”
Dr. Chris Watt, a family doctor who owns three walk-in clinics in Vancouver and Victoria, said he agrees with the College’s goals of high quality care, but worries that an unintended consequence of the rule changes may be the retirement of older doctors at walk-in clinics. The new guidelines make the establishment of a doctor-patient relationship an automatic process, removing autonomy from doctors. Older doctors who’ve given up their practices but work part-time in walk-in clinics are a “rich source of manpower” — but they may just decide it’s too much of a burden to continue working, Watt said.
Dr. Charles Webb, the new president of Doctors of BC, said the College’s new standards are welcome and will improve the level of patient care.
How night sweats is actually a sign of obstructive sleep apnea and why it happens.
Everyone wants to fall asleep easy, rest well and wake up refreshed. In reality, that’s not always the case. Many people suffer from night sweats and just assume it’s a normal thing and nothing is wrong. A lot of time females will just chalk it up to menopause. However, there are many other factors that can cause your body to sweat at night time. A big one being Obstructive Sleep Apnea. When we stop breathing in the night our oxygen levels go down and our body is thrusted into the “fight-or-flight” response also known as acute stress response. This activates the sympathetic nervous system causing an increase in heart rate, constriction of blood vessels, and sweating. This may be the biggest reason you are struggling to sleep at night. Once treated majority of people never sweat at night again and get the rest they need. Come get checked for sleep apnea today at Can sleep for free at one of our many locations. Feel free to call us at 1-844-SLEEP40 or check out the website at http://www.cansleep.ca/.
Nimbus and Viva Care Medical Group Health form strategic partnership to offer cannabis access via telehealth to patients.
VANCOUVER, BC – April 12, 2019 – Nimbus, an information technology healthcare provider in the cannabis industry, and Viva Care Medical Group, a chain of clinics in BC, today announced a strategic partnership to integrate Nimbus’ telehealth offerings within Viva Care clinics and their online presence. This strategic partnership promises to improve access to medical cannabis education and authorizations to patients.
Nimbus (a telehealth provider based out of Vancouver, BC) will be bringing it’s secure and state of the art telehealth and education platform to Viva Care patients who are interested in accessing medical cannabis.
“Many family physicians are not yet comfortable with authorizing medical cannabis prescriptions for their patients,” states Nimbus CEO, David Pham. “As we work to help educate physicians, we will concurrently offer telehealth prescribing so that patients can access the medicine they need.” A survey of physicians in June 2018 by MD Analytics found that only 32% of physicians approved of cannabis legalization.
“Securing this exclusive agreement with Viva Care, a leading health clinic with over 10 locations in British Columbia, will allow for Nimbus to supply an industry leading telehealth solution that meets the growing demand for medicinal cannabis as an alternative and effective treatment offered to patients”, said David Pham, CEO of Nimbus.” Viva Care is also a telehealth care system that relieves patients of the need to travel around to find a suitable physicianand get speedy and continuous care. We look forward to building on this partnership.”
About Nimbus:
Nimbus is a telehealth system that caters to patients by connecting themto health care professionals and physicians. Patients are prescribed medical cannabis treatment to manage their symptoms. Nimbus also aims to educate patients, the general public, and physicians about the benefits and effective usage of medical and recreational marijuana. To learn more about all that Nimbus has to offer, you can visit our official website at www.getnimbus.com.
September is Alzheimer’s Awareness month. This disease affects half a million Canadians directly and also their families and friends. It can be difficult to watch a loved one suffer from Alzheimers. While it affects many people, more awareness is needed.
What is Alzheimers and how is it different from dementia?
In this video, the difference between Alzheimers and dementia is explained:
What services are available for people with Alzheimers and their families?
The Alzheimer’s Society of Canada has a list of great resources like First Link, a service that connects families with support and referrals. They also have information on MedicaAlert, something that can be helpful to identify and return patients who have wandered off. Their SafelyHome partnershiphas valuable tips to help in these situations as well as information on how to order a MedicAlert bracelet.
How can you tell if a loved one is struggling?
The Alzheimer’s Society of Canada has a list of ten signsthat someone may be impacted by Alzheimers. Watching for these signs can be really helpful to ensure that friends and family get the treatment and attention they need as soon as possible. There is also a difference between dementia and normal aging and that’s important to keep in mind. If you’re wondering how to tell the difference, this is a resourceyou can consult.
Self-Care for Caregivers
If you have a loved one who has Alzheimers, you may find that their care takes a toll on you. While you naturally want to care for your friend or family member, you also want to make sure that you are taking care of yourself. In the midst of caretaking responsibilities, it’s crucial to make sure that you are getting adequate nutrition, fluids, rest and time for yourself.
Checking in with yourself on how much stress you are really under by reviewing these ten warning signs of stressfrom the Alzheimer’s Society of Canada. It’s also really key not to feel like you have to do this alone. Ask for help if you need it, from family, friends or your family member’s health care team. Feeling supported can make all the difference during a difficult time and a sense of isolation can have a negative effect on your mental health as a caregiver.
The reality is that caring for aging relatives can come with complicated feelings and that these feelings are completely normal. It is helpful, however, to have someone to talk to about these feelings. Look for a support group in your area or online to connect with other caregivers who are going through the same things you are for peer advice. Talking to a professional can be a good idea too. Wellin5’s counsellors would be happy to support you as you navigate the realities of caring for an aging relative with Alzheimers, dementia or any other health condition that affects the lives of those around them. Your family member’s needs need to be addressed, but so do yours and you deserve to have people on your team helping you also. Reach out and book an appointmentif you need someone to talk to who can give you the advice and support you need.
Cancer-preventing Nishi system
In my practice with cancer patients, an essential element of treatment was always Nishi therapeutic system. It’s not as impressive as complex radiation equipment and other sophisticated hardware supporting surgical teams in modern operating rooms, but it brings good results nevertheless. I’m going to present a few examples of successful use of Nishi system (records of professor Watanabe), to let you see for yourself.
• K. Majra, 76 years, was diagnosed with lung cancer in August 1958. He didn’t consent to a surgery. Another test in a Tokyo hospital confirmed the diagnosis. He was treated in hospital for two months, which caused general weakening, gradual loss of appetite, and severe difficulties with breathing. An X-ray picture done in the second month of his hospital stay showed the same dark spot on the lungs and an enlarged one in the heart area. This last one was a side effect of pharmaceuticals that interfered with blood and lymph circulation. Breathing became almost impossible. There seemed to be no options, even a surgery would give no chances. He was checked out of hospital in December. Some relative suggested trying Nishi system. He used the following routines every day:
2. Alternating hot and cold showers
3. Drinking beverage prepared from dactyl palm leaves, very rich in vitamin C (2qt /2L a day)
4. Performing a set of exercises designed by Dr. Nishi
After a month, his appetite increased, his physical strength returned, breathing became easier, and his mood improved. The dark spot on his lungs, as big as a chicken egg, started shrinking. A year later (November 1959) the patient was completely healthy. He decided to use cancer- preventing Nishi system till the end of his life.
• T. Jumiki, 69 years old, after a thorough examination in hospital was found to have stomach cancer. A surgery was recommended, and he refused consent. He decided to go through Nishi system therapy.
A month of therapy decreased nausea and took care of the feeling of discomfort in the stomach. A year later in a letter, he reported that he felt well. He was thankful for the therapy that cured his stomach cancer without surgery.
• Iszizuko, 61 years old, in the summer 1958 started experiencing pain in his abdomen while having his meals. His stools were dark because of blood mixed with the feces. Doctors in an Osaka hospital diagnosed colon cancer. He refused a surgery and checked into another hospital where he learned Nishi system therapy, which eventually led him to full recovery.
• Masapugu, 68 years old, lost his ability to speak and was diagnosed with throat cancer by doctors in Osaka. Isotope radiation therapy didn’t bring any improvement. He checked into a hospital for Nishi system therapy in November 1958. He had unhealthy habits – smoking up to forty cigarettes a day and eating a lot of sweets. These habits caused even more irritation in the affected area of his throat. Two months of therapy brought significant improvement and his voice became normal. He was able to check out of the hospital and continue the therapy on his own. In 1962, he sent a letter thanking the hospital for help in his full return to health.
• Gojono Sato, 49 years old, suffered heavy bleeding from uterus for five years due to uterus cancer. She checked into a hospital for eight months to undergo Nishi system therapy. The first results were noticed at the end of the second month: her physical condition improved and heavy bleeding carried out chunks of dead tissue. She checked out of the hospital at that time and continued the therapy at home with some help in the form of telephone consultations. Bleedings with chunks of dead tissue happened on three more occasions. Examinations after completed therapy confirmed her return to good health. The doctor who first recommended surgery was amazed at her recovery and said: “You are very lucky. The diagnosis was probably wrong.”
These were cases from 40 years ago. Nishi system therapy is however successfully used in Japan even today for cancer treatment. Starting in 1990, many alternative medicine clinics in Russia started using it in their practice.
I have been using it, along with my co-workers, since 1986, with some modifications (to account for different climate, food products, etc.) I didn’t keep statistics because the patients had medical records anyway, but I kept letters from my patients reporting results of their therapy done at home. I’ll summarize some cases here: Natalia D., 44 years old, was diagnosed in 1986 with uterus cancer, which had also spread to her breast. Her doctor first pressed for a quick surgery. She was in bad shape, with grayish skin complexion, bent posture, and an unpleasant odor from her mouth. Faced with her hesitation, the doctor agreed to delay the surgery for eight weeks. He understood the 44-year-old woman’s shock at the prospect of loosing her reproductive organs and breasts. Natalia kept working but her husband took over her house chores (it’s important to have support and understanding of loved ones in times of health crisis). She went through therapy involving aerobics twice a day; drinking tea brewed from blackcurrant leaves, raspberry, and wild rose; taking alternating hot and cold showers; and performing a set of exercises from Nishi system. She also cleansed her large intestine using enemas and limited her diet to raw fruits, nuts, bran, rice, hot cereals with cooked vegetables, carrot juice, and beet juice.
Three weeks later, her skin was covered with red spots and her vagina excreted “terrible filth.” It was a sign that her body started cleaning itself. Then she went through a seven-day fast. She only drank water, adding a teaspoon of apple cider vinegar and a teaspoon of honey to each glass in order to maintain adequate supply of minerals and vitamins. After a fast, the body needs an adjustment period of equal length before regular diet can be re-introduced. For the next seven days, she only drank freshly squeezed juices from five kinds of fruits and vegetables of different colors, and ate only fruits and vegetables. In her later diet, she paid attention to correct combination of food products. She fearfully went back to see her doctor when the eight-week period was up. After the examination, not able to hide his disbelief, the doctor said, “I can’t believe my eyes, haw did you do it?” After hearing the story of her quick and effective therapy, he exclaimed: “I have to tell everybody about it.” I got her letter a year after the end of the therapy. She felt healthy, continued working, and enjoyed her life.
In matters dealing with health, some of us are lazy (please take no offence) and some diligent. The lazy ones expect others to help them. They believe that taking care of their health is the responsibility of physicians. The diligent ones want to help themselves by discovering the real causes of their diseases but they do not always know how to do it. My books are intended mainly for the diligent people. The lazy ones should reflect on the old Eastern wisdom: “Nobody does anything for you without satisfying their own needs before yours.”
Modern medicine uses three basic methods in treating cancer: chemotherapy, radiation, and surgery. As I said before, these methods are limited to treating symptoms. The right approach is to identify and target causes. According to our present knowledge, the main cause of tumors is inability of our body’s defenses to effectively deal with cancer cells. This is where prevention and treatment should be focused.
The complex system I’m going to present here has never undergone scientific scrutiny. It can only be judged based on the testimony of people who suffered from cancer, managed to overcome it, and are now completely healthy. It was never published, but my students and co-workers may have used some elements. Important notice: The system can be used independently of other treatments and medications taken. Its strength is in mobilizing body’s own defenses. The “downside” is the fact that it requires from patients ongoing focus on caring for their health. The system takes more time to show results in serious cases, lighter ones can be dealt with relatively quickly. Those who go through the therapy learn a way to maintain good health for the rest of their lives.
Everyday, thousands of Canadians go to their hospital emergency department with symptoms including heart palpitations, chest pains, shortness of breath, and nausea. Only they are not experiencing a heart attack or stroke; they are in the midst of a terrifying panic attack. The underlying cause of these episodes is anxiety, but unfortunately many people are unaware of how anxiety can affect the body, and believe they are experiencing a life-threatening condition.
It is normal for all of us to feel nervous, worried, or anxious at times. In fact, anxiety is an extremely helpful feeling that in the right amounts, can encourage us, motivate us, and alert us of any possible danger. However, when anxiety passes the point of utility and begins to negatively affect our daily lives, we may be experiencing one of several anxiety disorders.
Here are some of the common signs and symptoms of an anxiety disorder:
-excessive and persistent worry about everyday problems
-excessive worry about being judged or criticized
-fearing the worst possible outcome in every situation
-physical symptoms such as rapid heart rate, muscle tension, difficulty eating, sleep issues
-irritability, restlessness, difficulty concentrating, constantly feeling fatigued
-a change in normal life activities to avoid, or, as a result of anxiety or panic (e.g. change in work attendance, avoiding social situations, missing school)
-low self-esteem or isolation as a result of the above symptoms
Treatment
Typically treatment for anxiety disorders requires one of two methods: pharmacological treatments (medications), OR psychotherapy/ clinical counselling (commonly referred to as “talk therapy”). Medications can be prescribed by your family doctor or psychiatrist, while counselling is usually offered by a Registered Clinical Counsellor (RCC), Registered Social Worker (RSW), or Psychologist (RPsych).
So just what is clinical counselling? Counselling with a registered therapist provides a safe space and opportunity for you to explore behaviours, feelings, thoughts, and relationships that are causing you anxiety or other difficulties in your life. Counselling is also a legitimate source of support during a crisis or difficult time. When you experience a good fit with your therapist, sessions provide you with a greater sense of self-awareness, and an improved relationship with yourself and others. This results in better mental, emotional, and physical health.
Unfortunately, psychological services are not covered under BC’s provincial healthcare plan (MSP). However, some individuals may be able to utilize their Extended Healthcare Benefits (Great West Life, Sunlife, etc.) to pay for a portion of services.
If you believe you are suffering from anxiety or mood difficulties, don’t hesitate to reach out for professional support. Take the brave first step and visit your doctor or speak to a licensed counsellor today!
ARC: Anxiety Relief Centre is a private practice located in Downtown Vancouver that provides counselling and psychotherapy for anxiety disorders, mood issues, relationship difficulties, and many more presenting problems. Visit arccounselling.ca to learn more, check rates, or to book an appointment.
The Viva Care Telehealth solution takes the marriage of face-to-face transactions and online interactions one critical step further, however.
This is our single biggest differentiator and ensures the highest standard of care for patients.
College’s Position
- The decision to end a patient-physician relationship should be based on a thoughtful review of the reasons for doing so and having given the patient reasonable notice of the decision.
- Communicate your decision and the reasons for your decision clearly and non- judgmentally to the patient, preferably in person.
- Follow the initial communication with a registered letter confirming your decision, ensure that the reasons for your decision and a copy of the letter are documented in the medical record.
- Give the patient a reasonable amount of time to find another physician. This time will vary according to the context of the patient’s medical condition and the availability of other physicians to provide care, but a minimum of one month is advised.
- Where possible and reasonable, assist the patient in finding another physician.
- Consider providing the patient with a copy of their medical record without a fee.
Understanding common health concerns and what can be done to prevent or treat them can go a long way towards reducing the stress you feel when it comes to your health and the health of those in your care.
A great resource for this is the Health Link BC website. http://www.healthlinkbc.ca/
With HealthLink BC, British Columbians have trusted health information at their fingertips by phone or web.
On our site, you will find medically-approved information on more than 5,000 health topics, symptoms, medications, and tips for maintaining a healthy lifestyle. You can also search our online Directory to find health services near you.
Call 8-1-1 from anywhere in British Columbia to speak with a nurse any time of the day or night. On weekdays, you can speak to a dietitian about nutrition and healthy eating. At night we have pharmacists available to answer your medication questions.