Latest / Morning Medical with Dr. Chow / Virtual Health Care, Blood Transfusion Policies, and Men's Mental Health Initiatives

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Virtual Health Care, Blood Transfusion Policies, and Men's Mental Health Initiatives · Morning Medical with Dr. Chow

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Hello and welcome to Morning Medical with Dr.
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Chow.
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I’m your host, Dr.
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Chi-Ming Chow.
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Today, we're diving into some of the latest medical news and insights from around the
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world.
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We’ll be discussing topics ranging from virtual health care to mental health initiatives using
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all-terrain vehicles.
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But first, let’s talk about a recent study that questions the effectiveness of virtual health
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care in Canada.
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A new study published in the journal BMC Primary Care has raised concerns about the
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current state of virtual health care in Canada.
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Despite its proliferation during and after the pandemic, virtual care isn't delivering on its
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promise to free up doctors' time as many had initially hoped.
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This research, which analyzed the experiences of health care professionals in Alberta,
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Ontario, and Nova Scotia, found that the lack of available physicians remains a significant
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barrier to access.
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Myles Leslie, a co-author of the study and a researcher at the University of Calgary’s
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School of Public Policy, explains that virtual care often involves doctors speaking to
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patients by phone.
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These calls take up the same amount of time in a doctor’s day as in-person visits, which means
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that without an increase in the number of available doctors, the situation for the
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roughly seventeen percent of Canadians without a primary care physician remains largely
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unchanged.
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The study highlights that while virtual care provides convenience, especially for those in
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rural areas, it isn't as effective as it could be due to existing payment models that favor
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face-to-face consultations.
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Family physician Dr.
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Christine Leulo points out that doctors are financially incentivized to see patients in
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person, as the current fee-for-service billing codes require doctors to see the ‘whites of the
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eyes’ to bill for services.
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Although there’s no longer a cap on the number of calls she can bill for, complex calls that
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take more time still earn the same amount as simpler ones.
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Moreover, the study suggests a potential solution: shifting funding models away from the
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traditional ‘eyeball-to-eyeball’ requirement.
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Some clinics in Alberta are already exploring new compensation models that encourage
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physicians to take on more patients outside of regular hours.
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Leslie believes a cultural shift is necessary to integrate more health care team members,
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such as nurses and pharmacists, into the virtual care framework.
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Expanding beyond phone calls to include secure messaging and video calls could also enhance
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the effectiveness of virtual care.
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Despite the challenges, there are positive signs.
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Many respondents in the study noted improved efficiency with the expansion of virtual care.
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Dr.
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Leulo’s patients have responded positively in satisfaction surveys, finding virtual care
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particularly useful for follow-ups and check-ins.
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As we continue to adapt to the evolving landscape of health care, it’s clear that while
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virtual care holds promise, there’s still work to be done to fully realize its potential.
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In a significant update from the Jehovah's Witnesses, the organization has modified its
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long-standing policy on blood transfusions, a topic that's often been a point of contention
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both within and outside the religious community.
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The leadership now allows members to choose whether to have their own blood drawn and
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stored in advance for medical procedures like scheduled surgeries that might involve
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significant blood loss.
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This change, however, maintains their prohibition against receiving transfusions of
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blood from others.
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This policy shift is described by the Governing Body of Jehovah's Witnesses as a
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"clarification" of their teachings.
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It was announced after what they called extensive prayer and consideration.
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Gerrit Lösch, a member of the Governing Body, explained in a video statement that each member
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must decide individually how their own blood will be used in medical care.
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This includes the decision to allow their blood to be removed, stored, and possibly reinfused
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during surgery.
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While this change might seem modest to some, it marks a notable shift in the organization's
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approach to medical treatment.
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The Jehovah's Witnesses have long interpreted biblical passages as requiring abstention from
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blood, applying this principle not just to dietary laws but also to blood transfusions.
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Their teachings have historically led to a refusal of both donating and storing blood for
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transfusions, as stated in their publication, The Watchtower, back in 2000.
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Despite the update, many former members and critics argue that the change does not go far
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enough.
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They point out that the prohibition on receiving others' blood remains, which can be
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critical in emergencies or for treating conditions like cancer where multiple
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transfusions might be necessary.
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Mitch Melin, a former member, expressed that while the change has value, it falls short of
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granting full freedom of conscience in life-saving scenarios.
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In terms of medical practice, the use of a patient's own blood, known as autologous blood
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donation, is a well-established procedure.
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It involves collecting and storing a patient's blood before surgery, with the option to
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transfuse it back if needed.
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This method reduces the risks associated with blood transfusions from other donors, such as
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allergic reactions or infectious diseases.
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However, it can make a person anemic, so it's not without its own concerns.
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The organization remains firm in its core belief regarding the sanctity of blood, and
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many medical providers have respected the healthcare directives of Jehovah's Witnesses
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members.
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While the policy shift does offer a degree of flexibility, it highlights the ongoing tension
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between religious beliefs and medical necessity.
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As medical technologies and methods continue to evolve, it's possible that further adaptations
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may occur in the future.
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Dr.
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Wendy Troxel, a licensed clinical psychologist and senior behavioral scientist at RAND in
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Utah, recently discussed the common issue of feeling tired even after getting the
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recommended eight hours of sleep.
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This is a concern for many people who wake up feeling groggy despite thinking they're getting
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enough rest.
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Dr.
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Troxel emphasizes the important distinction between the quantity of sleep and the quality
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of sleep, noting that about one in three adults experiences non-restorative sleep quality.
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She identifies several factors that contribute to poor sleep quality.
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These include the consumption of alcohol, which is a major disruptor, and caffeine intake,
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especially if consumed late in the day.
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Stress and worry can also fragment sleep, as can the use of phones right before bedtime.
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These factors can lead to a night of sleep that doesn't leave you feeling refreshed.
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Dr.
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Troxel also addresses the belief that women need more sleep than men.
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Research suggests that women may need a bit more sleep—about ten to fifteen extra minutes
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per night.
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However, women's sleep quality often suffers more than men's, particularly due to
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non-restorative sleep.
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Women are also more likely to experience insomnia, with their risk for sleep
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disturbances increasing significantly during the menopausal transition.
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The idea that some people might feel better with less sleep is also challenged by Dr.
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Troxel.
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She explains that this isn't an indication that they need less sleep.
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Instead, it's likely that their bodies aren't accustomed to getting the recommended seven to
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nine hours.
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Laboratory studies have shown that sleep deprivation can impair judgment, meaning those
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who believe they function well on less sleep may not be aware of the cognitive and
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performance impacts.
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Dr.
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Troxel suggests that those who get less than the recommended amount should gradually
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increase their sleep time.
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Adding about fifteen minutes each night can help the body adjust to a healthier circadian
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rhythm, and benefits can be seen when sleep is increased in small increments.
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For better quality sleep, maintaining a healthy lifestyle and a consistent sleep-wake schedule
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is crucial.
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Eating a nutritious diet and avoiding foods that cause indigestion or an upset stomach late
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in the evening can improve sleep quality.
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Dr.
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Troxel advises against going to bed either starving or overly full.
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Exercise is another key component of quality sleep.
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It promotes better sleep, and in turn, sleep can enhance exercise quality.
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However, vigorous physical activity should be avoided close to bedtime, as it can be
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stimulating and potentially disruptive to sleep.
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Dr.
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Troxel notes that exercising earlier in the day is preferable, particularly for those who are
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naturally morning people.
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She also cautions against "sleep-shaming" individuals for following their natural
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sleep-wake cycles.
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Cultural trends can sometimes undermine our biological sleep-wake patterns, which are
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largely beyond our control.
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Dr.
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Troxel emphasizes the importance of respecting individual differences in sleep patterns and
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habits.
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Cassandra Lee, a dedicated nurse practitioner, is preparing for a significant move from
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Kentucky to Vancouver Island, British Columbia.
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She is one of over four hundred health care professionals from the United States who have
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accepted positions in British Columbia following a targeted recruitment campaign by
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the province.
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This initiative, launched last year, aimed to attract medical workers disenchanted with the
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current political climate in the United States.
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For Lee, the decision to relocate is driven by a desire for greater support and stability.
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She was initially inspired by a video on social media from Tod Maffin, a resident of Nanaimo,
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who has been actively encouraging health care professionals to consider relocating to
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Canadian communities.
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After conducting her own research, Lee found that British Columbia offered a relatively
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straightforward process for recognizing her nursing credentials, which further motivated
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her move.
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Lee's motivations are deeply personal.
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As a former military member, there is an underlying concern that ongoing global
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conflicts might draw her back into active duty, a prospect she wishes to avoid.
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Additionally, she is deeply concerned about her son, who identifies as part of the 2SLGBTQ+
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community.
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The political environment in the United States, particularly following an executive order by
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former President Donald Trump that restricts sex recognition to male and female only, has
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heightened her fears for his safety.
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Moreover, the pervasive presence of Immigration and Customs Enforcement personnel in American
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communities has added to Lee's sense of insecurity.
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Despite being a white American, she has experienced random stops by ICE, which has made
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her empathize with the daily fears faced by her patients and friends of color.
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These experiences have been pivotal in her decision to reassess her life in the United
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States.
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Although leaving her established life and lucrative job in Kentucky is not an easy
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choice, Lee believes the move to Canada will be beneficial in the long run.
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She acknowledges the emotional difficulty of leaving her patients behind but is confident
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that her colleagues will continue to provide excellent care.
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Lee mentions the importance of prioritizing her own well-being and that of her family, likening
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it to the airplane safety advice of securing your own oxygen mask before assisting others.
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Lee is optimistic about her new life in Nanaimo, where she will start her new job in
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mid-August.
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She has visited Vancouver Island several times and feels that it will be an ideal environment
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for her and her son, who both enjoy outdoor activities.
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While her son has not yet visited, Lee is certain he will appreciate the natural beauty
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and lifestyle that the island offers.
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Allergy season can be a challenging time for many, especially when trees, grass, and other
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pollens are in full swing, causing symptoms like runny noses, itchy eyes, and sneezing.
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Where you live, what you are allergic to, and your lifestyle can all influence the severity
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of your allergies.
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Experts point out that climate change is exacerbating these issues, leading to longer
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and more intense allergy seasons.
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However, they also note that treatments for seasonal allergies have improved significantly
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over the last decade.
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The Asthma and Allergy Foundation of America has released its annual ranking of the most
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challenging cities for allergy sufferers.
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This year, the top five 'allergy capitals' are Boise, Idaho; San Diego; Tulsa, Oklahoma;
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Provo, Utah; and Rochester, New York.
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These rankings are based on factors like over-the-counter medicine use, pollen counts,
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and the number of available allergy specialists in each city.
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Pollen, which is a powdery substance produced by seed-producing plants, plays a crucial role
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in plant reproduction but is also a major trigger for allergies.
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Tree pollen is most prevalent in early spring, followed by grasses, and then weeds in the late
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summer and early fall.
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Common tree pollens that cause allergies include birch, cedar, cottonwood, maple, elm,
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oak, and walnut.
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As for grasses, Bermuda, Johnson, rye, and Kentucky bluegrass are known culprits.
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To manage allergies, it is important to track pollen levels.
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The American Academy of Allergy Asthma and Immunology provides a network of counting
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stations across the United States to help track these levels.
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Their website offers real-time updates and email notifications, which can be a valuable
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resource for planning outdoor activities.
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The first step in managing allergies is to avoid exposure to pollen as much as possible.
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Keeping windows closed in both your car and home, even when the weather is pleasant, can
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help.
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Wearing long sleeves when outside can keep pollen off your skin and also offers some sun
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protection.
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Changing clothes and showering daily to remove pollen from your body, including your hair, is
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also recommended.
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If washing your hair every day is not feasible, covering it with a hat or scarf when outside
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can minimize pollen exposure.
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Using saline rinses for your eyes and nose can help remove pollen and alleviate symptoms.
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Masks, which many of us have become accustomed to during the pandemic, can also offer
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protection from inhaling pollen, though they do not help with eye symptoms.
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For symptomatic relief, over-the-counter nasal sprays and allergy pills like Claritin,
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Allegra, and Zyrtec can be effective.
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However, it's important to use nasal sprays correctly to avoid irritation.
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Dr.
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Kathleen May, an allergist, advises angling the nozzle outward toward your ear rather than
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straight up the nose for best results.
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If allergies are significantly impacting your quality of life, it might be time to see an
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allergist.
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They can offer treatments that train your immune system not to overreact to allergens.
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While some home remedies, like eating local honey to build up tolerance to pollen, have
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gained popularity, they are not supported by scientific evidence as the pollen bees collect
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is not the type that typically causes allergies.
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The changing climate is contributing to more severe allergy seasons, with milder winters and
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longer growing seasons allowing pollen to linger in the air longer.
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Last year was recorded as one of the most intense allergy seasons, especially in the
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Southeastern United States.
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Today, we're highlighting a unique approach to men's mental health support happening in
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southeastern Manitoba.
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Cowboys Mud Racing, an organization founded by Ryan Ward and Brian Brown, utilizes all-terrain
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vehicles, commonly known as ATVs, as therapeutic tools to aid men grappling with
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mental health challenges.
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The organization, which started just last June, aims to help men who are struggling with their
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mental health by getting them outside and boosting their confidence on the trails.
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The idea is to provide peer support and a sense of brotherhood through shared experiences in
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nature.
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Ryan Ward, who resides near St-Pierre-Jolys, Manitoba, founded Cowboys Mud Racing after
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overcoming significant personal challenges, including a severe brain injury from a
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motorcycle accident.
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This injury left him unable to walk or talk, but through perseverance and support, he
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regained his abilities and now uses his experiences to help others.
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Ward's journey to recovery involved getting back on ATVs, which became a pivotal part of
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his healing process.
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He applied for a job at Brian Brown's farm, where he initially struggled with getting on a
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quad to navigate the fields.
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With Brown’s support, Ward gradually overcame his difficulties, leading to the birth of
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Cowboys Mud Racing.
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The organization offers more than just ATV rides.
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It's about facing and overcoming fears, building camaraderie, and finding peace in
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nature.
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"When I was out in the bush and riding, nothing else mattered.
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It was just me, the bush, and nature," Ward shared, emphasizing how the activity helps
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focus the mind and provide a sense of peace.
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Brian Brown, who Ward affectionately calls "pops," plays a crucial role in this
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initiative.
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He offers guidance and a listening ear, helping participants to open up about their struggles.
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Brown believes that being outdoors helps people relax and encourages them to express their
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feelings, which is a vital part of mental health recovery.
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Jessica Smith, the director of engagement at Thrive Community Support Circle in Winnipeg,
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acknowledges the importance of peer support for men.
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She mentions that Cowboys Mud Racing helps break down the stigma often associated with
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men's mental health by providing a safe space for men to connect and share their experiences.
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Ward and Brown's efforts have not gone unnoticed.
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Their unique approach to mental health support has garnered interest, and they hope to expand
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Cowboys Mud Racing across Canada and into the United States.
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The organization is founded on the principles of brotherhood and camaraderie, aiming to
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change the narrative around men's mental health.
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As we wrap up today's episode, it's clear that initiatives like Cowboys Mud Racing are vital
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in providing unconventional yet effective support for mental health.
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By combining the thrill of ATV riding with therapeutic conversations, they're making
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significant strides in helping men navigate their mental health journeys.
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Thank you for tuning in to Morning Medical with Dr.
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Chow.
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Join us again tomorrow for more insights and updates from the world of health and medicine.