Patient Medical Home Implementation Working Group

The Patient Medical Home Implementation Working Group has been meeting since early spring 2018 and the discussions and decision-making have been robust and collaborative. Here is what the team has been up to:

1. Incubator model
As of July 2018, two clinics, Qualicum Beach Medical Centre and the Fern Tree Clinic, submitted their application to participate in the incubator model. Happily, both clinics indicated a willingness and desire to work collaboratively to establish a clinic incubator in Oceanside.
These clinics will develop in-depth understanding of their current clinical and business models, including analysis of their office and record systems and their patient panels.
Together they will develop a plan to shift toward the PMH model, taking into account clinic, physician and human resources needs and opportunities. ODFP staff and independent contractors will assist PMH physicians with resources and mentoring to develop a PMH implementation plan and execution.
The goal is to have this be an ‘incubator model’ and its results readily available for other Oceanside clinics who would be interested in implementing Patient Medical Home into their future practices.
2. Physician networks
Network supports are systems focused on care and/or common practices currently supported by the Oceanside family practice community. Tools and resources will be explored to support initial networks of care (outlined by ODFP members) and be used as a foundation for the development of future networks as they emerge.
Relevant community data and a recent member survey were used to determine network selection. A member event scheduled for the end of September will assist in identifying and prioritizing physician-supported networks going forward.

3. Physician/Practitioner support
This project is designed to allow all practitioners, whether or not they are directly involved in other PMH development work, to access programs and resources that will support a shift to the PMH model when the timing is appropriate.
In partnership with the Physician Support Program, ODFP will provide supports that will allow practices to shift their delivery of care by attending CMEs focused upon PMH development. PSP will also assist practitioners by delivering Understanding your Patient Panel modules and in-house one-on-one supports to all interested Oceanside practitioners.

Port Alberni Discussions

Dear Oceanside Division members;

The Oceanside Division of Family Practice Board of Directors is pleased to report that we have started the process of discussing potential partnership with Port Alberni family doctors. In the late summer of 2018, the Board began a conversation between the Port Alberni family doctors, Doctors of BC and ODFP to explore the opportunity of aligning as one Division.

We are at the very beginning of these discussions and we wanted our members to be informed at the start. It is hoped that this future partnership would offer potential for increased organizational strength and sustainability along with program and service efficiencies and scalability, to include the potential of increased influence of local family doctors gained through information and knowledge sharing and the strengthening regional partnerships.
This trend is happening within divisions across the province.
This is a very exciting opportunity for both organizations, our members and our staff. Our greatest assets have always been our members and our communities, and by joining forces, we can make a huge increase in the quality of those assets.

Should we go ahead, this would be an alliance of two highly compatible organizations. Both organizations hold similar Vancouver Island values and community patient focus.

The ODFP Board is optimistic that with deeper exploration of our commonalities and good planning that this opportunity will enhance both organizations going forward. We are committed to communicating with our membership at every step of these negotiations. We anticipate hosting a member meeting regarding this subject in October. Please watch your newsletter for more information.

If you have any feedback or questions do not hesitate to contact Evelyn Clark, our Executive Director, at 250-703-6159 or eclark@divisonsbc.ca.

Sincerely

Drs. Clair Biglow and Gina Bell
Co-chairs
Oceanside Division of Family Practice

Oceanside Community Need for Increased Psychiatry Support.

Dear Primary Care Provider,

Situation:

Dr. Saffy has now reached an unmanageable state of capacity and there is an urgent need for a temporary plan to be created.
• There is no capacity for Dr. Saffy to accept responsibility for or see referred patients who are not known to her.
• Dr. Saffy will continue to see her patients who have previously been referred by Primary Care Providers when they are currently active with her.
We ask your patience while we are actively engaged in solutions to the Oceanside Community need for increased psychiatry support. Our plan and the current clinical solutions to support your patients are outlined below.

Physician support:

The OHC leadership team, Dr. Saffy, Geo 2 Director and Medical Directors, and the Department of Psychiatry have met and are actively engaged in seeking solutions.
• There is a current posting for a second fulltime psychiatrist to work out of the OHC.
• We are working with the Department of Psychiatry leadership on other innovative solutions.
OHC MHSU/Out Patient Psychiatry Program Support
Please continue to send referrals for your patients to the OHC Mental Health Substance Use program and Outpatient Psychiatry.
• These referrals are triaged weekly to ensure that the psychiatry program is aware of those with high needs and to suggest other programs that your patients may benefit from participating in. We have many valuable services/ programs at OHC.
• The program will continue to keep you informed about any program recommendations for your referred patients.
• Mental Health Walk-In is open to anyone of all ages, 10:00 – 19:00, Monday-Friday. Walk-in Counselling has a no appointment, no charge policy.
• Please see our program pamphlets (included) that describe our services. These may be helpful to provide to your patients.
Thank you for your understanding of our situation. We will endeavor to provide support for you and your patients.

Sincerely,

Cheryl Rikley, RN, BSN, MA
Manager, CHS/ MHSU /DEC / Telehealth

Cc: Division of Family Practice; Dr Drew Digney, Medical Director of OHC; Shelley Gallant, Director, Integrated Community Services Nanaimo & Oceanside; Dr Samantha Saffy, Psychiatrist, OHC; Carly Tripe, RN Intake Clinician

GP Liver Forum

I would like to invite you to participate in the first GP Liver Forum, to be held on the morning of Saturday October 20 2018 at the Four Season’s Hotel in Vancouver.

The program consists of plenary sessions and workshops to provide best practices in liver disease. The meeting will aim to provide an approach to the evaluation of elevated liver enzymes, abnormal liver imaging as well as to provide further understanding and practical approaches to common liver diseases including Fatty liver disease, viral hepatitis and cirrhosis.  

The Forum is awaiting accreditation as a group learning activity (Section 1) as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada.

Please click here to Register and for more Information. There is no charge for this meeting. 

I look forward to seeing you there.

Alnoor Ramji on behalf of the GP Liver Forum organizing committee.

Alnoor Ramji MD FRCP(C)
Clinical Associate Professor of Medicine
Gastroenterology and Hepatology
Division of Gastroenterology
University Of British Columbia
770-1190 Hornby St.
Vancouver, BC. V6Z 2K5
Tel: (604) 688-6332 ext 225  

Fax: (604) 689-2004

Trauma-Informed Care

Trauma-informed care
Better care for everyone

Eva Purkey MD MPH CCFP FCFP

Rupa Patel MD CCFP FCFP

Susan P. Phillips MD CCFP FCFP

Without realizing that the past is constantly determining their present actions, they avoid learning anything about their history. They continue to live in their repressed childhood situation, ignoring the fact that it no longer exists. They are continuing to fear and avoid dangers that, although once real, have not been real for a long time.
Alice Miller1

Although physicians are adept at seeing the illnesses that emerge, we often fail to consider how external forces shape what hides inside the body. Among the
most common and yet least visible of these are adverse childhood experiences (ACEs), particularly childhood neglect and abuse. Adverse childhood experiences work their way into the physical body, increasing allostatic load, inflammation, dysfunction, and ultimately disease.

Max is a burly, tattooed man. He visits frequently com- plaining of pain and claims you are doing nothing for him. When he appears at the office your heart sinks. Max has 2 kids and he is very close to one son. This relationship motivated him to end his criminal activities. Unfortunately, he has chronic pain that started in his back, spread to his arms and legs, and now is everywhere. No treatment has been effective. He has become a loner, experiences anxiety and insomnia, and cannot maintain functional relationships.
After struggling with his care for months, you finally take the time to ask him about his life. He is surprised, as he has never been asked about his upbringing. He was abused as a child, left home at age 14, lived on the streets, and worked as a labourer before joining street gangs.

After this conversation, your rapport changes dramatically. You start to talk about the link between chronic pain and childhood trauma. He is open to this conversation and gradually visits less often, although you still see him regularly. When he visits, you listen to him with care, and when you discuss the need to wean him off the narcotics he has been prescribed, he is willing to participate despite his persistent pain. Now you both smile when you greet each other, and you are surprised to discover that you look forward to seeing him.

Evidence for the long-term effects of ACEs is convincing and extensive. For some, childhood experiences marked by abuse lead to addiction, mental health challenges, cardiovascular disease, respiratory disease, and cancer.2-4 Others adapt and even thrive.  We cannot rewrite the histories of patients, but as health care providers, we might be able to help them develop resiliency, improving function and well-being.
Imagine 3 patients, each with a limp. One has a splinter in his foot, the second has sciatica, and the third had a knee replacement 6 weeks ago. Without identifying the cause of each limp there will be no cure. Even if there is no cure, physicians look for the cause, recognizing that we can help with improving function only by understanding the cause. In the same fashion, we should look for causes of anxiety, addiction, chronic pain, teen pregnancy, and cardiovascular disease. Many of the conditions we treat and screen for routinely can   be linked to remote ACEs. In our research  article  in this issue of Canadian Family Physician on page 204— in which we  examine  the  primary  care  experiences of women who have a history of traumatic childhood experiences and chronic disease—we propose that it is critical that family physicians ask their patients about childhood experiences in the same way they ask about other risk factors for ill health (eg, family history, sub- stance abuse).5 Although one’s past cannot be changed, we can read the script to identify causes, understand patients’ experiences, and intervene appropriately.
What does “reading the script” mean? This brings us to applying trauma-informed care to family medicine. The 5 principles of trauma-informed care guide clinicians in caring for complex patients who are often survivors of ACEs, who are neglected or shunned, and who might be labeled as difficult, borderline, or chronic pain patients. The trauma-informed care model offers a clear, compassionate, and rewarding approach.

Applying the principles

The relevant literature explains that trauma-informed care has 5 principles.6-11 Ideally, delivering such care involves the entire health care system, from receptionists to nurses, from physicians to learners and other allied health professionals. Trauma-informed care is not trauma-specific care; it does not propose to heal the trauma nor even to address it directly. It does not imply that family doctors need to be trauma specialists. Here we present the principles of trauma-informed care followed by a description of how to apply them.

Trauma awareness and acknowledgment
Step 1. Bear witness to the patient’s experience of trauma: This is a fundamental step and can be therapeutic on its own. In some ways, it is the easiest step, and in some ways, it is the one that most deeply threatens to
undermine the physician’s worldview. This step involves bearing witness to the patient’s experience of trauma, not in all its terrible detail but in its general outlines, while acknowledging the persistent and ongoing effect of this trauma on all facets of the person’s life. It involves identifying for the patient that the violence and abuse they had experienced led to coping strategies that might have once been necessary for survival, but that are often mal- adaptive once these threats no longer exist. Bearing wit- ness offers an opportunity for clinicians to ensure that patients do not feel responsible for their neglect or abuse. Adverse childhood experiences are not their fault. The guilt and shame that often accompany these experiences need to be acknowledged and, most important, validated as relevant to current health and coping strategies. Understanding the connection between these past experiences and current functioning can be life changing.

Safety and trustworthiness
Step 2. Help patients feel they are in a safe space and recognize their need for physical and emotional safety: This step has 2 components, and although the step appears straightforward it is often hard to achieve. The first component is fundamental to the structure and delivery of care. Consistency and predictability in the procedure of care is essential.  Consider that anxiety might easily be triggered in a patient living with ACEs. Perhaps appointments could be scheduled for this patient at times when the waiting room is not full, which would minimize time spent in the waiting room and accommodate last-minute cancellations.  A survivor of ACEs is supremely sensitive to nonverbal communication. A rushed, harried, or patronizing physician can undo a great deal of progress toward regaining a sense of safety. A safe and predictable relationship with a health care provider can be a critical component of this step.
The second component involves recognizing the need for the physical and emotional safety of a person with a history of ACEs. There are many factors that can affect one’s sense of safety, such as financial instability, involvement with child protection agencies, and insecure housing issues. These circumstances all diminish one’s ability to feel calm, secure, and safe. For example, if a patient living with anxiety had a father who was an abusive alcoholic, that patient’s anxiety might be triggered by a drunk partner even if he or she is never abusive; living with this current partner is not a safe space for this patient and will undermine treatment of anxiety.

Choice, control, and collaboration
Step 3. Include patients in the healing process: Here we are seeking to actively involve patients in their own healing process using informed choice. By presenting both positive and negative choices (including the option to not engage in care), we can begin to override the passivity   or deferral to authority that is typically used as a means
of self-preservation by survivors of trauma. Physicians should seek to develop truly collaborative relationships with such patients, despite the initial added time required to do so. This will encourage the patient to move toward more active engagement in health care, rather than passivity or dependence. This step helps overcome the “no- show” problem (ie, the patient who habitually misses specialist appointments; the one who  has  no  intention of going but does not dare to disagree with the proposed referral) or, similarly, the “failure-to-change” dilemma (ie, the patient who does not modify behavior despite his  or her apparent repeated commitments to do so). Active involvement helps patients avoid feeling they have failed yet again. A more collaborative approach might also elicit the reasons behind their reticence, resulting in better and more effective care.

Strengths-based and skills-building care
Step 4. Believe in the patient’s strength and resilience: Here the physician is called upon to shift from seeing the patient as a victim with symptoms and pathology, to a person with tremendous strength and resilience who has survived serious ACEs. Supporting a patient’s evolution from passive victim to active, motivated participant is one the most rewarding aspects of a health care provider’s work. This might be the first time someone has highlighted these strengths to a patient. One of the fundamental experiences of abuse is disempowerment, and even the most benevolent paternalism (often inherent in the medical system) recreates a cycle   of helplessness from which a person must emerge. If a physician truly believes in a patient’s strength and resilience, then this belief can be conveyed, and the patient will be encouraged to move on, albeit slowly and with setbacks at times.

Cultural, historical, and gender issues
Step 5. Incorporate processes that are sensitive to a patient’s culture, ethnicity, and personal and social identity: Understandably, in addition to the issues of ACEs, there are groups who have experienced and continue to experience more systemic abuse based on their race, culture, gender identity, biological sex, or sexual orientation. This sometimes leads to intergenerational transmission of both trauma and shame that must be recognized. Demonstrating a sensitivity to group marginalization will augment the effectiveness of a trauma-informed care approach.

Conclusion
Trauma-informed care has already been accepted in fields such as addiction and mental health, child protection, and the penal system. However, this approach is essential for family medicine given our breadth of practice and connection to community. As family physicians, we already recognize that the relationship between
physician and patient is a key component of care. The principles of trauma-informed care provide guidance for physicians who might be unsure of how to approach the difficult topics of ACEs that are central to a person’s health and identity. Physicians are susceptible to our society’s collective denial of child abuse and neglect. As physicians we are morally called to provide compassionate and healing care to the survivors of such trauma. We propose that ACEs are a key determinant—a root cause—of many of the pathologic conditions we treat on a daily basis. Viewing patients through a trauma- informed lens can lead to considerable patient healing and much greater professional satisfaction. 
Dr Purkey is Assistant Professor and Director of Global Health in the Department of Family Medicine at Queen’s University in Kingston, Ont. Dr Patel is Assistant Professor in the Department of Family Medicine at Queen’s University and practises clinically
at Kingston Community Health Centres. Dr Phillips is Professor in the Department of Family Medicine at Queen’s University.
Competing interests
None declared
Correspondence
Dr Eva Purkey; e-mail eva.purkey@dfm.queensu.ca
The opinions expressed in commentaries are those of the authors. Publication does not imply endorsement by the College of Family Physicians of Canada.

References
1. Miller A. The drama of the gifted child. The search for the true self. New York, NY: Basic Books; 1997.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998;14(4):245-58
1. Felitti VJ, Anda RF. The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behavior: implications for healthcare. In: Lanius RA, Vermetten E, Pain C, editors. The impact of early life trauma on health and disease. The hidden epidemic. Cambridge, UK: Cambridge University Press; 2010. p. 77-87.
2. Keeshin BR, Cronholm PF, Strawn JR. Physiologic changes associated with violence and abuse exposure: an examination of related medical conditions. Trauma Violence Abuse 2012;13(1):41-56. Epub 2011 Dec 19.
3. Purkey E, Patel R, Beckett T, Mathieu F. Understanding the primary care experiences of women with a history of childhood trauma and chronic disease. Trauma- informed care approach. Can Fam Physician 2018;64:204-11.
4. Ardino V. Trauma-informed care: is cultural competence a viable solution for efficient policy strategies? Clin Neuropsychiatry 2014;11(1):45-51.
5. Covington SS. Women and addiction: a trauma-informed approach. J Psychoactive Drugs 2008;(Suppl 5):377-85.
6. Trauma matters. Guidelines for trauma-informed practices in women’s substance
use services. Toronto, ON: Jean Tweed Centre; 2013. Available from: http://jeantweed. com/wp-content/themes/JTC/pdfs/Trauma%20Matters%20online%20version%20 August%202013.pdf. Accessed 2018 Jan 22.
7. Trauma-informed. The trauma toolkit. 2nd ed. Winnipeg, MB: Klinic Community Health Centre; 2013. Available from: http://trauma-informed.ca/wp-content/ uploads/2013/10/Trauma-informed_Toolkit.pdf. Accessed 2018 Jan 22.
8. Substance Abuse and Mental Health Services Administration. SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS publication no. 14- 4884. Rockville, MD: Substance Abuse and Mental Health Services Administration;
2014. Available from: https://store.samhsa.gov/shin/content/SMA14-4884/SMA14- 4884.pdf. Accessed 2018 Jan 22.
9. Trauma-Informed Project Team. Trauma-informed practice guide. Vancouver, BC: BC Provincial Mental Health and Substance Use Planning Council; 2013. Available from: http://bccewh.bc.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf. Accessed 2018 Jan 22.

This article has been peer reviewed. Can Fam Physician 2018;64:170-2 Cet article se trouve aussi en français à la page 173.

Residential Care Refresher

Registration is now open for the upcoming 2nd Residential Care Refresher Conference, taking place Oct 19 – 21, 2018. Bring your family and enjoy the amenities at our new location - Predator Ridge Resort in Vernon, BC!

Residential Care Refresher

To view brochure please click here.

Oct 19-21 (Fri-Sun) | Predator Ridge Resort | Vernon BC

Target audience: family physicians, geriatric psychiatrists, nurse managers, nurse practitioners, allied health, social workers, pharmacists, administrators/managers, recreational therapists, occupational therapists, anyone involved with and interested in residential care
Up to 15.25 Mainpro+/MOC Section 1

Highlights:
o Prevention of ER Transfers
o Integrating a Palliative Approach – Lessons Learned
o Traumatic Brain Injury in Long Term Care
o Alcohol Misuse
o Behavioural & Psychological Symptoms in Dementia: A Challenging Case
o End Stage Parkinson's: Advanced Symptoms & Treating Side Effects

To register please click here.

Friday night Keynote Dinner Presentation:

o Using Managed Risk to Deliver Patient-Centred Care
Dr. Keren Brown Wilson, Founder and Senior Advisor, Concepts in Community Living

UBC CPD
Division of Continuing Professional Development
Faculty of Medicine
The University of British Columbia
City Square, East Tower, Suite 200
555 W 12th Ave, Vancouver BC V5Z 3X7
T 604.675.3777 | F 604.675.3778
ubccpd.ca | @UBCCPD | Facebook | LinkedIn

SI Division of Gastroenterology - Education Evening for Referring Physicians

OCTOBER 18, 2018 SI DIVISION OF GASTROENTEROLOGY
Education Evening for Referring Physicians
SI Division of Gastroenterology, GI Central Access and Triage, Enhanced Primary Care Pathways, Gastroenterology Subspecialist Clinics and Colon Screening Program overviews.

Date: Thursday, October 18, 2018

Location: Delta Ocean Pointe Resort Arbutus Room A

Time:

5:30-9:00pm

5:30 Reg/dinner

6:00 Program Start

Menu –Buffet
please let us know if you have any dietary requirements

RSVP By Friday, October 5, 2018 limited seating pre- registration required

DIVISION OF GASTROENTEROLGY
GI Central Access and Triage

RSVP to:
si_gicat@outlook.com

19th Annual WorkSafeBC Physician Education Conference

Physicians are invited to learn, share, and network at this WorkSafeBC-hosted conference, coming to the Inn at Laurel Point in Victoria, B.C. Delegates can expect a full day of discussion, dialogue, and workshops relating to the physicians’ role in work-related injuries and the latest protocols in patient care.

Saturday, October 20, 2018
Conference cost

On or before Oct. 1:
$179 + GST for physicians
$89.50 + GST for students and residents

After Oct. 1:
$199 + GST for physicians
$99.50 + GST for students and residents
Reduced rates available for students and residents

To Register click here

For more information click here

Plenary sessions:

• Pain and Suffering: A Psychiatric Perspective on Management
• Seeing Stars: Neuro-Ophthalmology and the Concussed Patient
• Cannabis in the Workplace

Workshops

• Help Your Depressed Patient
• Neck, Elbow, and Knee Examinations
• Occupational Respiratory Illness
• Skill Development in Difficult Conversations
• Evidence Based Approach to Head Trauma and Concussion
• Imaging: Risks, Benefits, and Interpretation
• Managing a Mental Health Claim with WorkSafeBC
• Neuro-Ophthalmology and the Concussed Patient
• Short snapper topics
• Occupational Contact Dermatitis
• Triangular Fibrocartilage Complex and Distal Biceps Tendon Ruptures

Obstetrics Update for Family Physicians

26th Obstetrics Update for Family Physicians | Thu-Fri, Oct 25-26, 2018

For more information please click here. 

Location: Vancouver Marriott Pinnacle Downtown Hotel, Vancouver BC
Target audience: family physicians, midwives, nurse practitioners who provide maternity care, residents & medical students
Credits: Up to 13.00 Mainpro+ credits
Highlights: Designed to meet the needs of a busy practitioner - no matter where you work!  Suitable even if you don’t attend births!
Thu Oct 25 - Updates to intrapartum maternity care
Fri Oct 26 - Updates to early pregnancy, postpartum, and newborn care
To register please click here.

If you have any questions, please don’t hesitate to contact me.  Thank you!

Regards,
Cherie
_______________________________
Cherie Yiu
UBC CPD Conference Associate
Division of Continuing Professional Development
Faculty of Medicine | The University of British Columbia
City Square East Tower
Suite 200 - 555 West 12th Avenue, Vancouver BC V5Z 3X7
T 604.875.4111 x24604 | F 604.675.3778
ubccpd.ca | @UBCCPD | Facebook | cherie.y@ubc.ca

Oceanside Hospice Society

The Oceanside Hospice Society serves individuals and families experiencing end-of-life, care-giving and bereavement in the area stretching from Deep Bay to Nanoose, and west to Errington and Whiskey Creek
OHS currently delivers the following services to the community:

 Medical Equipment Loan Program
 One to One Client Support Services
 One to One Grief Support
 Grief Support Groups
 Grief Walking Groups
 Self Care Fridays
 Caregiver Respite and Companioning
 Palliative Vigil Team
 Lending Library
 Community Networking , Education and Training
 Advance Care Planning Guidance

We strive to provide links in the continuum of care by supporting care giving at home, in hospital or the palliative care unit at Trillium and at community care facilities.

Please contact us at 250.752.6227 or visit www.oceansidehospice.com for further information.

Medical Assistance In Dying

 Date: 25 August 24, 2018

I am writing to you in my position as Island Health executive lead for MAID on behalf of Rosanne Beuthin, Island Health MAID coordinator and myself.

MAID has been a legal option in the spectrum of end of life care for more than two years. In that time on Vancouver Island we have privileged nearly 40 physicians to be prescribers. More than 250 family physicians on Vancouver Island have completed assessments in patients who have gone on to have an assisted death. MAID now accounts for approximately 4% of all deaths on Vancouver Island.

We have privileged prescribers in communities from Port Hardy to urban Victoria. Some communities have a good number of prescribers; others have few or none. When we look at the map across the island we noticed that Parksville/Oceanside is the largest community that has no local active prescribers at the moment. There are some prescribers in neighboring towns (Nanaimo, Port Alberni, Courtenay) who have been willing to travel to Parksville/Oceanside however we have to recognize that having local prescribers would be an advantage to the local population. The program to subsidize travel for MAID prescribers was set up last November and was originally to last for 1 year. Part of the program was there to enable local physicians to become prescribers by being mentored by experienced prescribers. We will be applying to have the program extended beyond this November, however we have to recognize that travel subsidies will not be there indefinitely.

To date there have been 17 MAID deaths in Parksville and 16 in Qualicum.

In order to discuss the provision of MAID in Parksville/Oceanside Rosanne Beuthin and I would like to offer to come to one of your meetings, or to attend an ad hoc meeting, to present on MAID provision on Vancouver Island. If we do so we would probably be doing it in the company of Dr Marie-Claire Hopwood. If it is possible we would also like to meet any interested nurse practitioners in the area. On Vancouver Island we have recently enabled MAID provision as part of the scope of practice for suitably trained nurse practitioners.

We look forward to your response to this offer.

Thank you

Dr. W. David Robertson

Executive Medical Director
Geography 3 – Pharmacy Services, Laboratory Medicine and Medical Imaging
Phone:  250-737-2030 Ext 44108
Cell:  250-715-8277   | william.robertson@viha.ca
Administrative Assistant: Carolyn Jenkinson 27635
Web: viha.ca| Facebook | Twitter | Flickr | Youtube

Bone Health of Women Living and Aging with HIV

Bone Health of Women Living and Aging with HIV

Register by clicking here. 

By the end of the webinar, participants will be able to:

• Identify some of the medical challenges women living with HIV and aging face
• Outline challenges surrounding bone health for women living with HIV, as well as steps to improve their bone health
• Discuss the experiences of women living with HIV in relation to aging/bone health: In my Hands, Taking Back my Health

SPEAKERS

Dr. Neora Pick, FRCPC
Medical Director, Oak Tree Clinic, BC Women's Hospital & Health Centre
Clinical Professor, Division of Infectious Diseases, Faculty of Medicine, University of British Columbia

Valerie Nicholson
Indigenous Peer Navigator, Positive Living Society of British Columbia
Chair of the Board of Directors, Canadian Aboriginal AIDS Network
Peer Research Associate, Canadian HIV Sexual Reproductive Health Cohort Study

HOST
Dr. Silvia Guillemi
Director, Clinical Education and Training Program, BC Centre for Excellence in HIV/AIDS
Clinical Professor, Department of Family Practice, University of British Columbia

WHERE
Register online by clicking here. 
Webinar ID: 251-422-619

WHEN
Tuesday October 9, 8-9am PDT
CREDIT - 1.0 Mainpro+ credits (College of Family Physicians of Canada, B.C. Chapter)

COST
Free registration

The recorded session will be accessible on the BC-CfE's website at education.cfenet.ubc.ca/webinars.
The HIV/AIDS Webinar Learning Series is a partnership between the BC Centre for Excellence in HIV/AIDS (BC-CfE) and Positive Living BC. The goal of the Series is to empower people living with HIV and to improve their quality of life by providing them and health care providers with up-to-date treatment information related to HIV/AIDS. Sessions bring together experts to share their knowledge and provide a forum for interaction, dialogue and mutual learning.

BC Cancer - Family Practice Oncology Network

ONCOLOGY CME FOR PRIMARY CARE @ THE BC CANCER SUMMIT, NOVEMBER 23-24

Register by clicking here. 

BC Cancer’s Family Practice Oncology Network is hosting two significant CME events from family physicians and primary care providers as part of BC Cancer’s 80th Anniversary Summit, November 23-24 @ the Sheraton Vancouver Wall Centre.
November 23: GPO Case Study Day – for General Practitioners in Oncology and primary care providers keen to tackle prevalent and emerging challenges in cancer care through case-based discussion. Learn with and from your colleagues gaining insight into lung cancer, Non-Hodgkin’s Lymphoma, prostate cancer, cardio-oncology, and radiation complications.
November 24: Family Practice Oncology CME Day – a one-day opportunity for Family Physicians and primary care professionals to learn about new developments and practice changing guidelines in cancer care, plus to build helpful cancer connections. Gain practice-ready insight into the most in-demand topics in cancer care. 

For more informationa nd details please click here  or contact Jennifer via email at: jennifer.wolfe@bccancer.bc.ca.

SURVIVORSHIP CARE POST TREATMENT FOR PROSTATE AND BREAST CANCER, SEPTEMBER 29

Registration and details please click here.  

Hosted by the Vancouver Prostate Cancer Centre’s Prostate Cancer Supportive Care Program, this event at the JW Marriott Parq Vancouver, is geared to all physicians and allied health providers dealing with survivorship issues of breast and prostate cancer patients after initial diagnosis and treatment. The focus will be on how primary care, family physicians, and allied health providers can help recognize and/or mitigate issues of importance relevant to these populations of cancer patients.

Therapeutics Initiative: Bringing Best Evidence to Clinicians

Therapeutics Initiative: Bringing Best Evidence to Clinicians

Oct 27 (Sat) | Surrey Memorial Hospital | Surrey BC
Target audience: family physicians, specialists, pharmacists, nurses/nurse practitioners, and allied health professionals
Up to 7.25 Mainpro+/MOC Section 1 credits
Register:  here
Highlights:
o   Invited guest faculty include Drs. Kay Dickersin, Tom Piscione, and Dee Mangin,
o   Small group case-based workshops promote interaction and facilitate skill building
o   Up-to-day, evidence-based and practical information on prescription drug therapy
Comments from previous years:
"Wonderful speakers and first rate talks. Particularly enjoyed the honesty and scientific data about the drugs and the therapeutics."
"Practical pearls on evidence, guidelines and practice”

Accepting Applications for Rural Physician Grants & Bursaries

Rural Physician Research Grants
The Rural Physician Research Support Project is a new initiative which aims to empower rural physician researchers – or new aspiring researchers – to pursue innovative rural research and knowledge translation projects contributing to advancing rural health in BC. Through this project, rural physician researchers will be able to apply for research grants of up to $10,000 per year to support research activities. To be eligible, applicants must be a physician with experience practicing rural medicine and demonstrable extensive connections to rural communities. The research must be pertaining to health in rural BC.

To apply for this opportunity, please download the application forms here and submit it to apeltonen@rccbc.ca. The deadline for the next round of submissions is Oct 31, 2018.

The Rural Physician Research Support Project is run by the Rural Coordination Centre of BC and supported by the Joint Standing Committee on Rural Issues. For more information about this opportunity contact Adrienne Peltonen at apeltonen@rccbc.ca. Visit www.rccbc.ca for more information about the Rural Coordination Centre of BC.


Rural Physician Leadership Bursaries
The purpose of the Rural Leadership Development Project is to increase opportunities for rural physicians to pursue leadership training and develop the skills and abilities to help bring system improvements that will benefit BC’s rural populations. In addition to access to a formalized leadership program, participants will be offered a mentoring opportunity with a rural leader through UBC CPD’S Rural Physician Mentoring Program. As well, during the course of the training participants will be encouraged to participate as a guest (when invited) in two meetings of groups providing leadership in rural BC (e.g. Joint Standing Committee on Rural Issues, Rural Coordination Centre of BC Core, Rural Issues Committee etc.).

The Rural Leadership Development Project allows rural physicians to access bursaries of up to $15,000 per year to support their participation in leadership training. To be eligible, applicants must have been working in an RSA Community for at least nine months of the past year and have health authority and community support for the training. The next application deadline is Oct 31, 2018.

For more information, please visit the RCCbc website or contact Lisa Hetu at the Rural Education Action Plan at 604-827-4188 or reap@familymed.ubc.ca.


Rural Global Health Partnership Initiative
The Rural Global Health Partnership Initiative (RGHPI) is a new program providing funding to support partnerships between rural BC physicians or medical trainees committed to rural service, and lower resource communities in BC, Canada, and in developing countries. The goals of this initiative are to enhance capacity for generalism in rural BC; to foster reciprocal learning in diverse health systems and community contexts; and to demonstrate how global health (local and international) community partnerships can heighten awareness, create innovative solutions to address healthcare challenges, and lead to improved health outcomes, especially for underserved, marginalized, and indigenous populations.

Through this initiative, rural BC physicians and medical trainees (residents and medical students) with a demonstrated interest in rural medicine and global health can apply for funding to support global health partnership projects. Applicants may apply for grant categories up to $5000 and $10,000. To apply for this opportunity, please download the application forms and submit them to apeltonen@rccbc.ca. The application deadline is Oct 31, 2018.

The Rural Global Health Partnership Initiative is run by the Rural Coordination Centre of BC and supported by the Joint Standing Committee on Rural Issues. For more information contact Adrienne Peltonen at apeltonen@rccbc.ca.


Adrienne Peltonen
Research & Evaluation Coordinator
Rural Coordination Centre of BC (RCCbc)

Therapeutic Initiative Conference

October 25th & 26th, 2018

• Day 1: Mental Health from Childhood to Seniors (0900-1500 hrs)
• Day 2: Applying Evidence in Practice (0830-1415 hrs)

Distinguished Visiting Faculty:
Dr. Dee Ma n gn in, CCFP , McMaster University Kay Dickersin,  PhD,  John Hopkins  University Dr. Tino Piscione, FRCPC, CMPA
Dr. Dale Nicoll, MD, Broadmead Care Society Dr. Trish Snozyk, CCFP, Victoria
Dr. Kehinde Oluyede, FRCPC, Psychiatrist
UBC Tl Faculty:
Aaron M. Tejani (PharmD) Cait O'Sullivan (PharmD)
Dr. Thomas L. Perry, FRCPC Dr. Jessica Otte, CCFP Nanaimo Faculty:
Dr . Kelvin Houghton, CCFP Dr. David Sims, CCFP

This session hos been accredited for 5.0 Moin pro+ credits per day of participation by the College of Family Physicians of Canada. This event is free for oil Nanaimo Division of Family Practice members. A $250 registration fee applies to oil other attendees. Advanced payment required.

EMAIL NANAIMO.DIVISIONSBC.CA TO RSVP BY WEDNESDAY, OCTOBER 17, 2018

Divisions in the News

See what is going on in other divisions around BC:

https://www.divisionsbc.ca/provincial/inthenews