Report urges improved access to primary care

A report produced by the College of Family Physicians of Canada and the Canadian Medical Association this week promotes the goal of 95 per cent of the population having a regular family doctor by 2012.

According to a recent public opinion poll for the Canadian Medical Association, coverage currently stands at 82 per cent.

The two medical associations say there are two ways of reaching the ambitious 95 per cent target: increasing the number of physicians practicing in the country, and increasing physician’s capacity to take on more patients.

However, these two measures are unlikely to allow the goal to be reached in time. It says more medical students should be encouraged to choose family medicine. While there has been some movement in this direction, most students still opt to become specialists.

It also recommends the integration of foreign-trained physicians in the workforce, something the provinces are doing. But physicians wanting to immigrate to Canada will not benefit from a new federal-provincial-territorial accord streamlining the recognition of foreign credentials until the end of 2012.

The report largely deals with how to help physicians make their practices run more efficiently and take on more patients – not just urging them to “work harder and longer.”

It says teaching physicians to run a practice from a patient-flow point of view should start in medical school, and there are a number of techniques already being used that are bearing fruit. This includes “advance access” scheduling that leaves a physician’s schedule open for same-day appointments.

Wait times for primary care are an issue, and the reports says measuring these waits should be a priority for governments even though it is difficult to break this information down by the myriad reasons patients have for seeking an appointment.

Team-based care is another approach that is being used to improve patient care, but, as an instrument for improving access, the report says the jury is still out and more research is needed.

The two medical associations say tools to improve the timeliness of referrals to specialists also need to be enhanced. They point out that research undertaken by the Fraser Institute finds that half the total waiting time for care is the interval between when the family physician makes a referral and when the patient is actually seen by the specialist.

They say good professional relationships between family physicians and specialists should be promoted and supported in the health system.

Reference:  Health Edition – December 4, 2009. Volume 13 Issue 48

Federal audit shows progress being made on Electronic Health Records

A report released on November 4, 2009 by the Auditor General of Canda confirmed Canada Health Infoway has “accomplished much in the eight years since its creation.”  The Auditor General concluded that Infoway is making the best use of its funds for Electronic Health Record (EHR) projects, established appropriate governance mechanisms and management controls as well as a risk management strategy.

Reference:

Health care spending in Canada to exceed $180 billion this year

Health care spending in Canada is expected to reach $183.1 billion in 2009, an estimated increase of $9.5 billion, or 5.5%, since 2008, according to new figures released today by the Canadian Institute for Health Information (CIHI). This represents a forecast increase of $241 per Canadian, bringing total health expenditure per capita to an estimated $5,452 this year. The figures are included in CIHI’s report, National Health Expenditure Trends, 1975 to 2009, Canada’s most comprehensive source of information tracking how dollars are spent on health care in this country. The combination of a slowdown in the economy and a continued increase in health care spending resulted in a jump in the proportion of health care expenditure from 10.8% of Canada’s gross domestic product (GDP) in 2008 to an estimated 11.9% in 2009.

 Reference:

Putting tables from Oracle into SAS

If you are interested, the following SAS codes can help you import tables from Oracle into SAS.

 

/*get two tables from Oracle*/
rsubmit;
%macro recent(dsnin1=,dsnout1=,vars=);
proc sql stimer noerrorstop;
%include ‘~/connect.dssp’;
%put &sqlxmsg;

create table &dsnout1 as
select * from connection to ora (
select &vars
from
&dsnin1);
disconnect from ora;
quit;
%mend recent;

options nomlogic nomprint;
%recent(dsnin1=orcale_schma_name1.table_name,dsnout1=new_table_name1,vars=*);
%recent(dsnin1=orcale_schma_name2.table_name,dsnout1=new_table_name2,vars=*);

endrsubmit;

The Canadian Me

So I did my first Toastmasters speech project at our Belmont Blabbers Club today.  The name of the first project is The Ice Breaker.  The goal of The Ice Breaker is for me to introduce myself to my fellow club members and give them some information about me.  I think it went ok.  I couldn’t believe how nervous I was though.  My heart was beating so hard it felt like I was pushing the last mile in this ridiculous 1,000-mile marathon.  The members of the club gave me really positive and constructive feedback.  I love constructive feedback.  While it is nice to know what I have done well, the “better-ifs” are the ones that will really help me to improve my communication skills.  I realized a few things today:

Realization #1 – Always have a title for your speech.  I showed up and was all psyched about getting my first speech project done.  Lyn Coles, our Sgt-At-Arms, asked what the title of my speech was.  I just realized I completely forgot to give my speech a title.  I just assumed that all first speeches were called The Ice Breakers.  Let the lesson to be learned, folks.

Realization #2 – Speak with what you used to practice.  If you didn’t practice your speech with your notes, don’t bother bringing them with you to the lectern.  I practiced my speech with what I wrote down.  My plan was to write down the notes in a point form and then glance at them when I presented my speech.  That plan failed miserably.  I think my eyes were actually refused to look at the notes because that’s how unfamiliar I was with those notes.  For the next speech I’m doing, I’m going to practice with the point-form notes.

Realization #3 – Pauses are good to have in a speech.  At some point during the speech today, I was so nervous that I had to stop and think what I just said for a moment.  When I paused to gather myself, I gained more confidence.  I also think when I pause, it is easier to start my next sentence.

Realization #4 – Wow, I need to work on my enunciation!  I tend to mumble when I’m nervous.  I notice this from my daily speaking too.  I mumbled a few times in the speech today, but it was too late for me to go back and say it again.  I think enunciating clearly helps to control the talking speed too.

Ok, enough realizations, here is my speech.

The Canadian Me

I once heard a quote that goes like this, “instead of giving myself reasons why I can’t, I give myself reasons why I can.”  And that’s why I’m here today.  Coming to Canada alone at the age of 18 changed my life entirely.  I think I would’ve been a completely different person if I didn’t come to this country.  In the next five minutes, you won’t find out all about me, but you will get to know my background, what I do for a living, and my passion.

On April 6, 2000, I arrived at the Victoria International Airport with a suitcase as big as me.  My host father, Jim, who was holding a sign that said “Qi Yang”, picked me up from the airport, and that’s how my Canadian life started.  The first year in Victoria was not so good!  I had no friends, was terribly home sick, and couldn’t even communicate in English properly.  I could write no problem, but speaking was always the challenge.  Once I had to describe to my host mother that the power was out and the food in the refrigerator was melting by doing this. [body language follows]  She somehow pieced those together and understood what I meant.  I eventually adjusted to my life in Victoria.  On August 8, 2008, I married my wonderful wife, Anya.  It was the best day of my life!  Now we have a little puppy named Holly, and Holly is supposed to be the “thing” for me to warm-up to the idea of having kids.

I spent a year in the ESL program at UVic and was accepted into the Health Information Science program at the same school.  About a week after getting my bachelor of science in health information, I started working for a pharmaceutical research company called PRA International. At PRA, I joined their Wellness Committee to plan activities for the Wellness Fair and promote healthy working environment.  I also set up workshops to teach co-workers how to use the exercise ball at their cubicles instead of sitting on the chair all day.  I wanted to work for the Ministry of Health because I wanted to take health information more seriously as a profession.  In the past five months in the ministry, I’ve worked on various data requests from the health authorities.  Just recently, I started to take on my own projects.  Working for the province makes me look at health promotion on a much larger scale.  I also work as a Personal Trainer at the university on the side.  I have been training different clients since 2003.  Seeing people being active and healthy is a feeling that no language can describe.

I am passionate about creating a healthy living environment.  I want to be the example to promote population health and preventative care.  I think if we want to make a change in health care with the current challenges we are facing such as aging population, obesity, and waiting lists for anything we do in a health care setting, the first thing we need to tackle is improving primary health care.  In terms of preventative care, take the US for example, studies have shown that nearly 40% of total yearly mortality is from preventable causes of death, such as tobacco smoking, poor diet, and physical inactivity.  We should prevent illness and sickness from happening rather than spending billions of dollars on treatments.  I’m not saying treating is not important, but we should look farther and think outside the box.

In summary, if I hadn’t come to Canada, I would’ve been a completely different person.  Canadian education had made me become a creative and critical thinker.  I still remember after high school, I was giving myself all these reasons why I shouldn’t go to Canada.  Looking back, I’m so glad that I’ve chosen this path and become who I am today.  So, I hope you got to know a little bit about me.  I’m a health informatician, a trainer, a lover, and an Icebreaker.  Thank you.

District 9

Anya and I took Holly and went on an afternoon hike with the Sidhu family around the Thetis Lake.  Holly was all tuckered out, so Anya and I decided to go on a little date.  It felt like putting the kid to bed and going on a sweet dusk cruise.  Anyway, District 9 came to mind, so we went and watched it.  It was pure awesomeness!

Distric 9 is not just a movie.  It is a broadcaster to against racial prejudice.  Wikus Van De Merwe is not just a character.  He is a victim of Apartheid.  The movie has so many layers that it kept me thinking from the beginning to the end.  I even forgot to eat the beef jerky we brought with us!  Now, that tells you something really caught my attention!  The action in the movie was entertaining.  I love it how the alien weapons are always 100 times better than human weapons.  It’s also got that Cloverfield documentary style for a little while, so if you felt dizzy from Cloverfield, be warned.  I wish there was more of that giant mothership action though, but hey, it was in a lot of the scenes.

Ok, seriously, watch District 9.

Does Cross-Training Improve the Triathlete’s Running Performance?

While I was waiting for the bloody ferry to come at the Tsawwassen terminal last Sunday, I picked up Triathlon Magazine CanadaRoy Stevenson had an article, Does Cross-Training Improve the Triathlete’s Running Performance?, in the magazine drew my attention.

In the article, Roy stated “recent research shows that supplementing, or even replacing part of your running program with other forms of exercise might be just what you need to avoid boredom, minimize injuries and take your running to a new level”.  He said substituting some of your running with other cross-training techniques enables you to do extra endurance training with less strain on your running muscles and joints because you’re using the same muscle groups in a different way.  A high-intensity cycling session, for example, helps the runner develop increased lactate tolerance, buffering capacity and fuel resynthesis, without undergoing the high-impact stress on the legs from an interval-training workout.  A triathlete already performing two to three high-intensity run workouts each week cannot add more running workouts at this level.  But extra intense stair climbing or cycling sessions will take him or her to a new level without the added impact trauma caused by high-intensity running.  The key is to do your extra endurance work in low-impact or low-weight-bearing aerobic activities like cycling, stair climbing, swimming, deep-water running, or using the elliptical trainer.  Despite the fact that all these exercises use the legs for propulsion, cross-training appears to defy an important principle of exercise science – specificity.

The principle of specificity states that if you are to improve in a specific sport, you should practice that activity solely and by throwing other similar activities into the mix you confuse your neuromuscular system, retarding your running progress.  This explains why world-class athletes in one endurance sport like Tour de France cyclists are not world-class marathoners.  Although elite cyclists exercise most of the muscle groups used in running, they do it in a very different way.  However, more recently, contradicting research shows that some different activities can actually improve other sports.  Then Mr. Stevenson went on and gave three example studies to support his point of view.  The point is, certain activities such as cycling preserve and maintain running fitness while the runner reduces running.  Nevertheless, swimming shows no correlation with improving running performance.

So my friends, it is possible to improve your running and thus your triathlon running performance, by incorporating or substituting other aerobic activities such as cycling, deep-water running (aquarunning) and stair climbing into your training program.  But the devil’s in the details – make sure you do high intensity cross training, rather than just “junk” time on the cross-training equipment.

The first half of August

Time goes by too quickly.  I never have enough time in a day to finish what I plan to do.  Sometimes I wonder if it’s good to have so many things on the go at one time.  Can’t imagine what it’ll be like to be a father.

Nathan and Shauna got married on August 1st.  It was a beautiful day to get married.  I had a blast by passing out around 10 o’clock in my tent after having three beef burgers, drinking lots of alcoholic beverages, and dancing to numerous songs.

August 8, 2009 marked Anya and I first year wedding anniversary.  I can’t believe it has already been a year since we were married.  08.08.08 felt like it was yesterday.  A lot did happen in this year though.  We got Holly.  We went to Cuba.  We bought our first bed.

We had a really relaxing AnniWillary weekend together.  We made homemade pasta and had yummy dinners, went to Tugwell Creek Meadery for some honey wine tasting, took Holly on lots of walks and hikes, and watched The Ugly Truth.  I enjoyed being married.  The feeling of having a family is indescribable.  We should feel fortunate to have families.

Saw some of my old co-workers from PRA tonight.  My buddy Rob Niewczas is leaving to Edmonton.  His wife, Meredith Niewczas (?), got accepted for a Masters of Population Health program at the University of Alberta.  Rob’s got a sweet job setup so that he can work from home in Ed-town while Meredith does her masters.  I wish I could work from home…sometimes.

I now have a mentor!  The Belmont Babblers Toastmasters Club assigned me its President, Greg MacDonald, as my mentor today during our Toastmasters session.  I’m excited to work with Greg on the new challenges of my career.  I think I’m doing my first speech on the 26th of August.  Stay tuned 🙂

I’m going over to Vancouver this weekend to spend some quality friend times.  I’ll be hanging with my buddy Gabe Wong.  I missed his bachelor party, so we’ll be doing bachelor party related activities like blowing bubbles off his balcony and renting The Wedding Singer to watch…  Michelle Neal’s having a birthday splash on Saturday, and we might be going to a laser concert?

If I could have a power, I wish I could slow the time down…

SAS and Toastmasters

About a couple of weeks ago, I signed up for courses to become a SAS Certified Base Programmer.  I do use SAS at work, but I use SQL more.  I see how powerful SAS can be, so I decided to learn more about the language.  So far, the first course has been fairly basic.  I’m eager to get to the coding part, the juicy part.  Some of the SAS programs I see at work are like novels which produce perfectly comprehensive reports.  Skills man, skillz!  Maybe one day, I’ll be able to write a beautiful script just like the pros do.

Today, I signed up to become a member of Belmont Babblers Toastmasters Club.  My colleague, Leo Siu, mentioned this club to me and took me to a couple of the sessions.  The meeting room was full of energy.  Everybody was a great speaker in there.  The whole hour went by like a minute.  I’ve always wanted to be a good public speaker.  Both of my part time jobs in the past involved with serving customers in a public setting.  I consider myself as a good conversationist, but in terms of giving a speech, I’m the one that’s speechless.  I’m hoping this toastmasters club can really help me to become a better public speaker.

3829 Cumberland Rd

Anya and I went and looked at the house at 3829 Cumberland Rd on July 24.  It was a gorgeous house.  It was a bit expensive, but the house was in a lovely Maplewood neighbourhood.  Right across the street from Playfair Park.  The front and side yard was beautiful!  Sitting in the swing chairs felt like we were out in the woods camping.

I liked the house more than Anya did, but she liked it too.  We gave an offer and they accepted our offer, so off we went to do the whole financing, home inspection, title insurance, etc.  This week has definitely been one of the most stressful weeks in my life.  Anya has been freaking out about our budget because even though we were approved for taking out a huge loan, our budget sheet showed us after all the predicted expenses, we’d end up with only $128 for entertainment.  We wouldn’t be able to affort to have kids in a couple of years.  We wouldn’t be going out to dine and shop like how we can now.  It meant a whole lifestyle change to us.  I wanted this house really badly.  Part of the desire is that I’m eager to be in the real estate market.  It is a buyers’ market right now, and the real estate will take off after 2010 Vancouver Winter Olympics.  The market will have its downs, but in the long run, it’ll go up.  Victoria is a beautiful place, and compared to other wonderful cities around the globe, Victoria’s real estate market is nowhere near its peak.

During this week, it was an emotional roller-coaster ride.  Anya and I would be so happy to own a house one day and would then be completely depressed with how little our spending money would be.  Even with the parents stepping in to help us with the 20% down payment, we would still be in the hole for at least five years, if not more.  Then there are what-ifs!  What if one of us loses our job?  What if Anya’s pregnant and we’d have no money for our kid(s)?  What if Speeper (our little Cabriolet) dies and we have to do major “surgeries” on it or get a new car?  And what if Holly got hit by a flying object and we have to spend $2000 on a new set of teeth for that little mutt?  Okay, maybe not that depressing, but hey, you never know.

Anya tried to contact Saanich and asked to confirm the easements on the property, but she got returned with “seek professional legal advice”.  You think you pay all this tax to this city and one day, you hope maybe the city can be a little helpful on your decisions.  Thanks a lot Saanich!  In the end, we backed out from the offer, on the day all the conditions were supposed to be removed.  Our lawyer, Isabel Weeks-Lambert, played a significant role of analyzing the easements and right of ways of the property for us.  We were so lucky to have Isabel to give us the most honest and helpful advice.

So yes, the house hunt continues.  3829 Cumberland is the furthest we’ve gone in terms of purchasing a house.  It has been a very educational process.  I just hope one of these days we’ll eventually find our house.  Where are you, our dream home?