Medicine Canada

Over the next five years, every patient treated at Canada’s largest cancer centre will have the opportunity to undergo genomic testing to see if major hereditary health risks lurk in their DNA.

The Princess Margaret Cancer Centre in Toronto announced Thursday that it would become the first Canadian hospital to join a cross-border collaboration involving 15 hospitals in the United States and Helix, Inc., a private American genomics company, that together plan to sequence the exomes of 1.6 million patients.

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Nearly 1,000 Canadians with multiple myeloma and their caregivers have e-mailed elected officials asking that pricing talks resume for a cutting-edge immunotherapy that Health Canada approved nearly three years ago but which still isn’t available in this country.

The letter writers are pleading with the pan-Canadian Pharmaceutical Alliance, the organization that negotiates confidential discounts on drug prices on behalf of provinces and territories, to cut a deal for Carvykti, a bespoke, one-time-only infusion for the aggressive blood cancer.

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When the OHIP claim for a newborn dying at a Toronto-area hospital was rejected, Dr. Jane Healey faced a difficult choice: forgo her pay or ask the grieving parents to go stand in line at Service Ontario.

The baby died of a genetic condition after 10 days, Healey said. In the end, she decided against bothering the family.

“That means that we aren't remunerated for some of that very difficult, highly emotional work that stays with you,” she told CBC Toronto.

And, Healey says she isn’t alone.

OHIP billing issues have become a sticking point for physicians as they work to finalize a new compensation deal with the province. Last month, an arbitrator directed the two sides to come up with solutions quickly.

Over 99 per cent of claims are paid automatically as submitted, “reflecting the system's productivity,” said Health Minister Sylvia Jones's spokesperson, Ema Popovic.

That’s true, the Ontario Medical Association acknowledges. But there are over 200 million claims that get processed every year — meaning about 1.16 million claims are rejected annually.

The absence of any standards and regulations is becoming increasingly problematic. At least 70 per cent of clinical trials are now being done in the community, outside of health-care institutions and their in-house REBs.

In response to the movement of trials into the community where they aren’t covered by institutional REBs, it’s reasonable to assume that the number of for-profit REBs has grown, although there are no definite estimates of their number. Drug companies pay these for-profit REBs a fee to review their trials.

It was nearly two years ago when an oncologist first told Jas Velic that his best hope of surviving aggressive blood cancer was CAR-T therapy, a cutting-edge treatment that would genetically alter some of his own white blood cells to attack his cancer.

Unlike the punishing regimen of weekly chemotherapy keeping the 43-year-old father of two alive, CAR-T therapy is given as a single infusion.

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Health Canada has for the first time approved a disease-modifying drug for Alzheimer’s disease, a watershed moment that offers hope for patients but does not guarantee that the complex and expensive intravenous therapy will be widely available in this country.

The federal regulator on Friday granted a conditional authorization for lecanemab, an antibody drug that can slow the progression of the disease for some people with mild cognitive impairment or early-stage dementia owing to Alzheimer’s.

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Doctors should discourage teenagers from dieting because it can be dangerous to their physical and mental health, according to new advice from a panel of Canadian pediatricians.

In its first statement on adolescent dieting in more than 20 years, the Canadian Paediatric Society advised physicians who care for children to instead promote a “health at every size” approach that focuses on how adolescents exercise, eat, sleep and socialize, rather than how much they weigh.

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The new NL Health Services facility is in the former Costco building at 28 Stavanger Drive in St. John's. (Laura Howells/CBC)

A new health-care facility in the former Costco building in St. John's is opening this week, offering several outpatient services that were relocated from city hospitals.

“It’s been several years, but it’s exciting to see that now, Tuesday, we’re going to have patients walking through the door,” said Kim Pike, clinical planner with Capital Planning and Engineering.

“We have a beautiful space here that patients can easily navigate.”

The two-story Unity Health Centre at 28 Stavanger Drive was open for public tours on Sunday, with dozens of people arriving for a first look. Patients will start coming on Tuesday.

Seats fill the spacious waiting areas on both floors, with brightly coloured signage for the different clinics. The centre has free parking, large murals on the walls, and will eventually house a coffee shop and drug store.

Pike says patients will be able to easily get around the new space, and “don't have the maze of our large and intimidating acute care hospital.”

For people accessing health care, she thinks "this is going to be a much calmer and pleasant experience." Patients will have shorter distances to walk, she said, as well as central waiting areas and better signage.

A number of outpatient services from the Health Sciences Centre, the Janeway and St. Clare’s Hospital have moved to the new centre, with more opening later.

Clinics opening Tuesday include the medicine and surgery specialty clinics, eye clinic, bariatric and total joint assessment, plastic surgery outpatient, endocrine, thrombosis, general medicine, cardiac diagnostics, orthopedics, audiology, and X-rays, among others.

More services will open in December, including blood collection, physiotherapy and occupational therapy, ultrasound appointments, pre-admission clinic, and a pain clinic. Two MRI machines will be added to the building in January.

An urgent care centre will also open at the site later this year.

N.L. Health Services is leasing the space, which was a big draw to the area when it housed Costco, before it moved in 2019.

“We’ve repurposed, revitalized an area in the city that was once kind of a desert town,” said Pike.

Radiologists in Canada are sounding the alarm about rising wait times for diagnostic imaging procedures such as MRI and CT scans, saying the holdups hurt patients and the economy.

“When access is delayed, treatment is delayed,” said Alison Harris, president of the Canadian Association of Radiologists, which represents about 3,000 specialists across the country.

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A celebrated Vancouver researcher used fabricated data and hid evidence of infected wounds to falsely claim his patented skin treatment could heal years-old bed sores in a matter of weeks, according to a leaked report.

If these results had been real, a product known as Meshfill would have been "close to miraculous" for people with spinal cord injuries, according to one expert. But investigators say they weren't real, and the public was never informed about an investigation that uncovered numerous examples of misconduct during a clinical trial for the liquid skin substitute.

The Investigative Journalism Foundation (IJF) and CBC News have obtained a 64-page report about University of British Columbia (UBC) plastic surgery professor Aziz Ghahary's actions during a pilot study for Meshfill. It lays out how he presented falsified results to the public on several occasions, violated conflict of interest guidelines and was even accused of bullying by another researcher.

The March 2021 document, which was written by a UBC-appointed investigative committee of three outside experts, says Ghahary "abandoned his scholarly integrity in his pursuit of his attempt to establish that Meshfill should be used as a treatment for chronic pressure ulcer wounds" — also known as bed sores. Despite his public claims of success, none of the pressure wounds in the pilot study had healed and some became infected.

"These false claims gave patients and funders false hope by falsely claiming that Meshfill had quickly healed chronic pressure ulcer wounds. He also potentially endangered the health of future human trial subjects when Dr. Ghahary falsely claimed that there had been no adverse effects during the pilot study," reads the report.

Ghahary left his job at UBC shortly after the investigation was completed in 2021. He'd worked there since 2005.

The lack of public notice about the findings raises some questions for Leigh Turner, director of the Centre for Health Ethics at the University of California, Irvine.

"I think the findings of the report are extremely serious," Turner said. "I would hope that this is a really relatively extreme example of violation of scholarly integrity. But there presumably are other cases and there presumably are other investigative reports that are not seeing the light of day. That's a problem."

UBC spokesperson Matthew Ramsey said he could only confirm that Ghahary's employment at the university ended in 2021.

"Privacy law prevents UBC from commenting on allegations of scholarly integrity you've raised related to Dr. Ghahary’s research at UBC," Ramsey wrote in an email.

"Scholarly integrity investigation reports contain personal information that UBC, as a public body, is required to protect from disclosure under FIPPA [the Freedom of Information and Protection of Privacy Act]. UBC does not have the legal authority to publish/share this type of personal information."

[Tarek Elneweihi, a lawyer who represents Ghahary] noted that Ghahary is now 83 years old and is completely retired from research work.

Meshfill never reached the market in Canada and should not be confused with the cosmetic procedure advertised online.

More than 50 per cent of the Ontarians who were on an official waiting list for a family doctor at the start of the year now have a medical provider, according to the provincial government, which has promised to spend $2.1-billion to combat a long-running shortage of reliable primary care.

There were approximately 235,000 people on Ontario’s Health Care Connect list on Jan.1. Half of those patients have since been added to the roster of a family doctor or nurse practitioner, Health Minister Sylvia Jones said in a statement Wednesday.

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Ontario will give patients access to select new cancer drugs early as part of a pilot project that would make these medicines available whether or not public health plans have finalized price negotiations with the drug manufacturers.

At the same time, the pan-Canadian Pharmaceutical Alliance (pCPA), the national body that represents all public insurance plans, says it will try to speed up price negotiations so they are finished earlier, possibly eliminating the need for Ontario’s pilot project.

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Health Canada is touting the major uptake of its public dental insurance program, but data shows that nearly half of the 5.2 million eligible patients have yet to see a dentist.

Of the Canadians approved for coverage, 2.8 million have been to a dental clinic, Health Canada says. And to date, those visits have cost taxpayers $3.37 billion.

The new data comes six months after the Canadian Dental Care Plan expanded significantly to cover 18- to 64-year-olds. So far, 1.8 million people in this newest cohort are approved for the plan. A quarter of them have actually used it so far.

Health Minister Marjorie Michel says having people enrolled is the first step.

"It's still a new program," Michel said Thursday at a news conference at a community centre in Ottawa. "To have people enrolled in the program is key for them to have the opportunity to go."

"It's like, you can go to your doctor, and you don't feel the need to go tomorrow morning, but you still can go to the doctor. It's just the same."

Health Canada also now says close to 100 per cent of active dentists, denturists and independent dental hygienists are treating patients through the program. It's a significant milestone considering initial uptake from dentists was low.

The national insurance program subsidizes the cost of dental care for Canadian residents with a family net income below $90,000 if they don't have access to a private insurance plan.

The program helps pay for a range of dental work, including cleanings, fillings and dentures. Health Canada says that on average, each patient has had $800 in expenses covered per year.

Local hospitals saved $1.66 million after 48 residents moved into Dunn House, says doctor

When Dr. Andrew Boozary and his team at Toronto's University Health Network looked deeper into the issue, they discovered that about 100 patients accounted for more than 4,500 emergency department visits in one year.

A month-long hospital stay costs the public health system more than $60,000, he said, compared to $15,000 a month to keep a person in a provincial jail and about $6,000 to house someone in a shelter.

There had to be a better way, he thought.

Boozary and the hospital network teamed up with Fred Victor, a non-profit housing and social services organization led by a kindred spirit, CEO Keith Hambly.

A four-storey building was erected on a parking lot UHN owned next to its rehabilitation hospital on a quiet residential street in Toronto's west end. It features 51 units where residents sign long-term leases and have access to doctors, nurses, social workers and a whole host of health and social supports.

Residents began moving into Dunn House in the Parkdale neighbourhood a year ago. Now, Miles and 50 other people, many of whom came off the street or from emergency shelters, call the place home.

The Ontario government says its plan to fund new primary care clinics across the province is paying dividends, with nearly 100,000 patients on the official waiting list for a family doctor having recently found a new medical provider.

Ontario Health Minister Sylvia Jones said the number of people registered on Health Care Connect has fallen by 42 per cent since the Progressive Conservative government began a concerted effort to expand access to primary care in a province where 2.5 million people did not have a family doctor as of September, 2023.

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It was late June, and the largest hospital in the Northwest Territories was running out of options for keeping its emergency department open through the summer.

There were nine shifts in July and 38 in August and early September during which no ER doctor was scheduled to work at Yellowknife’s Stanton Territorial Hospital, a facility that serves all of the NWT and western Nunavut.

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At Canada’s largest research hospital network, nurses get a lesson on how to protect themselves from violence

The patient’s name is Rowan, and he is not happy to be held in a hospital against his will.

Rowan was admitted to an inpatient psychiatry unit for bizarre behaviour and paranoia after coming in off the streets to receive IV antibiotics for a leg wound.

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