Over the last few months, a few new members have joined our Board, and few have changed roles. Our Board is working hard to represent our members and ensure your priorities are being addressed by Doctors Manitoba.
A couple of months ago, new members joined the Board for our rural Medical Districts. This includes:
Dr. Carina Kaiserjoins the board as the representative for Brandon. Raised and trained in South Africa, Dr. Kaiser has extensive experience working in addictions and palliative care. Dr. Kaiser started the Methadone Clinic in Brandon making her the first physician to prescribe methadone to patients outside of Winnipeg. During her time on the board she hopes to advocate for family physicians and hospitalists. Among her many hobbies and extracurricular activities, Dr. Kaiser enjoys cross-fit and is an avid reader.
Dr. Chukwuma (Chuck) Abararepresents Manitoba’s Northern district. Dr. Abara is passionate about addressing health inequities and improving access to healthcare for minority and racialized groups in Northern communities. He is the Physician Champion for the Northern hub of the Physician Health and Wellness Community of Practice and he has a strong interest in improving physician health and wellness for all members. Dr. Abara earned his medical degree in Nigeria in 2008 and organized free medical outreach programs for the community as Medical Lead at the Ancilla Hospital.
Dr. Bittoo Malik is a diagnostic radiologist in Dauphin and represents the Parkland District. Originally from the area, Dr. Malik returned home to develop and advance the diagnostic imaging program at Dauphin Hospital. She is an advocate and champion for health equity, particularly as it applies to Manitoba’s rural communities. In her spare time, Dr. Malik enjoys outdoor activities such as gardening, kayaking and skiing.
On our Board executive, Dr. Michael Boroditsky is now the President-Elect for 2022 – 2023. Dr. Candace Bradshaw is our current President, and Dr. Kristjan Thompson is our Past President. Joining them on the executive is Honourary TreasurerDr. Randy Guzman and Honourary Secretary,Dr. Nichelle Desilets.
Dr. Alon Altman re-joins the Board as the new representative for Health Sciences Centre, a space vacated by Dr. Boroditsky when he became President-Elect. Dr. Altman’s strong interest in undergraduate and postgraduate education and research has led to his involvement in multiple university, national and international committees.
The Directors representing our partner organizations have also changed:
Dr. Kurt Skakum, a Psychiatrist and Assistant Dean PGME at the Max Rady College of Medicine, has taken on the role representing the University Medical Group. With experience as the PARIM board representative during residency and on the Psychiatry Block negotiations committee, Dr. Skakum will work to prioritize support for University GFT members. He is a new cottage owner and has been honing his fishing and navigation skills.
Dr. Rachel Bethune, a PGY‑3 Resident in Pediatrics, is the PARIM representative on the board. Dr. Bethune studied for her undergrad at Queen’s (with an exchange in Grenoble, France!) and has since been making her way across the prairies with her MPH in Saskatoon and Medical School in Calgary. She is honoured to represent over 600 Manitoba residents in her time on the board. She is also passionate about working with children across the spectrum of care in the community, hospital, and Northern Manitoba. Outside work, Dr. Bethune loves spending time outdoors camping, hiking, downhill skiing and rock climbing.
Ms. Rachel Wang is a third year medical student, the current Vice Stick External Senior, and the MMSA representative on the board. Ms. Wang was born in Beijing and immigrated to Canada when she was 9 years old. She received her undergraduate degree in Microbiology from UM and hopes to one day work in pediatric surgery. When she is not studying, Ms. Wang enjoys improving her tennis skills, playing the violin, and exploring new sushi restaurants.
Public Health posts weekly COVID-19 Surveillance Reports on Thursdays. This week’s report covers the week ending August 10 and shows “increased activity” . Highlights include:
Severe outcomes from COVID-19 increased compared to the previous week. There were 57 hospital admissions, up from 53 the week before. This includes 12ICU admissions, up from 7 the previous week. Weekly hospital admissions last peaked at 264 the week ending April 16.
There were 6 deaths recorded, up from 1 the previous week. There have now been 2,079 deaths related to COVID-19.
There were 347 lab-confirmed cases reported in Manitoba over the week, up from from 257 the previous week. The test positivity rate was 20.8%, up from 17.9%.
The updated wastewater surveillance dashboard for the city of Winnipeg continues to show lower levels of COVID-19 circulating, with all three wastewater testing locations showing decline in viral load in the most recent week, ending August 4. Wastewater surveillance data is now available for Brandon, though it is very new with data only going back to June 2022. The most recent data shows a decline.
Seroprevalence in Manitoba
While there are over-the-counter tests that can determine if you have an IGG antibody or an IGM antibody response, Derek Stein, a scientist at Cadham Lab, says the test won’t tell you how many of those antibodies you do have. Broad testing of blood taken for various reasons across the province can determine Manitoba’s seroprevalence. The data collected to date tells us that the total cumulative rate for COVID-19 antibodies in Manitoba is 82 per cent, meaning 4 out of 5 Manitobans have either been infected by COVID or exposed to it since the beginning of the pandemic with the largest COVID-19 antibody rate is in those aged 20 – 39 years old. Antibody responses vary from person to person based on many factors like sex, age or existing medical conditions. Read the whole story here.
Vaccine now eligible to all kids age 6 month and up
Late last week, we learned that the health system is canceling over 100 surgical slates in September, citing a lack of anesthesiologist coverage as the cause. These are “baseline” slates, meaning their loss will add to the massive pandemic backlog, impacting at least 300 patients.
The internal memo, sent out last Thursday, instructed staff at all five Winnipeg hospitals and the Pan-Am Clinic to cancel 106 surgical slates in total for the month of September. Health-care facilities plan to schedule procedures that do not require anesthesia in place of the surgeries that can no longer be accommodated.
Doctors Manitoba President, Dr. Candace Bradshaw called the cancellations a “completely predictable and avoidable outcome and a huge setback for the health system when we’re already trying to deal with a massive pandemic backlog of surgeries and diagnostic tests.” According to CIHI, Manitoba has the 7th lowest number of anesthesiologists per capita in the country, and after 2+ years of pandemic disruptions, burnout and uncertainty, the current situation should be no surprise.
Diagnostic Backlog Call for Proposals Due
In related news, the Request for Supply Arrangements (RFSA) for diagnostic testing closes tomorrow, August 12. You can read more here about this opportunity, and how to access the RFSA requirements and instructions. We have learned that the government plans to repeat the call for both surgical and diagnostic capacity every quarter. Any physicians who missed an opportunity to apply in this initial round can expect the next round to come shortly.
Rural Health Challenges
Rural and Northern hospitals continue to struggle with service disruptions, and we continue to track rural ER closures at RuralCare.ca.
ERs continue to have gaps in physician coverage across the province:
In the Prairie Mountain Region, the ERs continue to be closed in Treherne, Shoal Lake, and Melita. Many other ERs continue to have reduced hours of operation. This includes recent reduced operating hours in Roblin, Souris and Ste. Rose, as well as Grandview. In Grandview, local physician Dr. Jacobi Elliott has worked to extend hours on weekends at the medical clinic to fill the void, but it is relying on community members volunteering to cover reception duties.
In the Interlake-Eastern Region, Teulon ER remains closed. The ERs in Eriksdale and Arborg have no physician coverage most days this month, and the Beausejour and Pinawa ERs have significant gaps in coverage as well.
In the Southern Health Region, services continue to appear stabilized, albeit with reduced hours in several communities.
In the Northern Health Region, the summer-long closure of the ER continues in Leaf Rapids.
Inpatient services are also being affected. In Lynn Lake, all inpatient beds have been closed for the summer with patients transferred to Flin Flon. We have also learned that Prairie Mountain Health has issued an all call to cover shifts at Brandon Regional Health Centre, the largest hospital outside of Winnipeg, for its medicine units. If the shifts can’t be covered, the hospital may have to close medical admissions for up to two weeks as a result.
We have been continuing our efforts to raise awareness about rural and Northern health care disruptions. Most recently this includes targeted outreach including to farm families and to the business community.
Starting your practice is a major milestone for young physicians, and this milestone has only become more complex during COVID-19. We’re here to help you navigate this transition in your journey as a physician. This webinar is intended for physicians in their first five years of practice, residents who are approaching the end of their residency, and physicians who have recently relocated their practice to Manitoba. These annual sessions will cover:
What Doctors Manitoba offers you
Benefit, rebates and insurance options for physicians
After registering, you will receive a confirmation email containing information about joining the meeting. If you have specific questions, you can send them in advance to PracticeAdvice@doctorsmanitoba.ca or ask them live during our webinar.
Practice Opportunities
Doctors Manitoba maintains a list of practice opportunities across the province. Right now, there are over 50 opportunities posted, such as:
The College of Physicians & Surgeons of Manitoba (CPSM) is looking to hire a Medical Consultant for a Quality Improvement Program. The ideal applicant will have excellent verbal and written communication skills, experience with applying and evaluating physician risk rubrics and a problem-solving approach that incorporates a client centered approach.
Strategies for physicians facing reduced cash flow
MD Financial has three strategies for physicians facing reduced cash flow. Are you thinking about cutting back your hours, halting your practice for a while, or retiring early? Here are three financial planning strategies to help prepare for a reduced level of income. Read More
Pride in Winnipegosis
Winnipegosis held its first ever Pride event last weekend. Dr. Alison Carleton was on the planning committee and her wife, Cyndie Blythe, was the president. The event, which included face painting, a parade, a dinner and a drag show, proved to be a great success and had many people from outside the community in attendance.
CIHI Podcast on Mental Health in Canada
The Canadian Institute for Health Information’s (CIHI) Canadian Health Information Podcast (CHIP) has released a new episode on child and youth mental health in Canada. The episode covers how mental health experts in Canada have been helping youth deal with the effects of the COVID-19 pandemic. Host Avis Favaro is joined by CIHI’s manager of Health System Analytics, Liudmila Husak, Chris Daken of Fredericton N.B., and Dr. Chris Wilkes, the division head for child and adolescent psychiatry for Alberta Health Services and the University of Calgary.
Doctors Manitoba, MMSA, PARIM, PGME and UGME Student Affairs are excited to be moving into year two of the Medical Learner Mentorship Program. Recruitment for participants is ongoing and no mentoring experience is necessary. Residents and Practicing Physicians are invited to participate. The program offers a variety of supports for participant including complimentary training through CMA-Joule! Learn more about the program and register to participate.
Fantastic Physicians
Dr. Ken Hahlweg was recognized by Premier Heather Stefanson and Health Minister Audrey Gordon in honour of his act of bravery last fall during the attack at Seven Oaks Hospital. Last Year, Dr. Candace Bradshaw presented Dr. Hahlweg with a Special Doctors Manitoba Award for Bravery. You can read that story here.
In a recent Winnipeg Free Press story, Dr. Hahlweg reflected on the incident and recently meeting the victim of the attack, who he says is recovering well. He also noted he has been recovering from the incident, including by using Physician Health services available through Doctors Manitoba.
Congratulations to Dr. Vanessa Poliquin who has accepted the position of department head for obstetrics, gynecology and reproductive sciences and provincial specialty lead – women’s health. Dr. Poliquin was most recently section head of obstetrics at Health Sciences Centre Winnipeg and associate professor of obstetrics, gynecology and reproductive sciences at the Max Rady College of Medicine, Rady Faulty of Health Sciences. She also has experience at the Aboriginal Health and Wellness Centre, Klinic Community Health Centre and Interlake Regional Health Authority. She has a bachelor of health sciences from McMaster University, doctor of medicine from the University of Western Ontario, and masters of science (epidemiology) from the London School of Hygiene and Tropical Medicine. She completed both her residency in obstetrics and gynecology and a fellowship in reproductive infectious diseases at UM. Dr. Poliquin’s term will be Aug. 1, 2022 – July 31, 2027.
Congratulations to Dr. Paul Ratana who has accepted a five-year term position as head of the department of emergency medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, pending board approval, and provincial specialty lead – emergency medicine at Shared Health. Dr. Ratana was director, remediation at the Max Rady College of Medicine from 2013 – 2016, and medical director of the Emergency Medicine Program at St. Boniface Hospital from 2018 – 2022. Most recently he was Emergency Medicine Specialty Lead at the Winnipeg Regional Health Authority from 2020 – 2022, where he coordinated COVID-19 pandemic planning across three urgent care facilities and two emergency departments. Dr. Ratana has a bachelor of laws from the University of Victoria (1999), a master of laws from York University (2003) and 1n 2012, he received an emergency medicine fellowship from the Royal College of Physicians and Surgeons of Canada and UM. Dr. Ratana’s term will run Aug. 1, 2022 – July 31, 2027.
Health System Updates
Monkeypox Vaccine Update
Last week Manitoba Health introduced eligibility for the monkeypox vaccine so people who may be at higher risk of being exposed can be immunized as a preventative measure. Until now, only those who may have been exposed to monkeypox were eligible. To date, there are no confirmed cases have been detected in Manitoba. In Canada and around the world, at this time infections have been primarily reported among people who self-identify as belonging to the gay, bisexual and other men who have sex with men (gbMSM) community. These individuals are now eligible for a preventative vaccination if they also meet at least one of a specific set of criteria.
The initial appointments for this vaccine were quickly booked, but earlier today Manitoba Health confirmed more doses are arriving soon and appointments have reopened. Immunization for eligible people can be booked at a limited number of locations using the online booking tool.
People who do not have internet access can call Health Links-Info Santé at 204−788−8200 or toll-free 1−888−315−9257 to book an appointment. If the appointments in the online system are not easily accessible, individuals can contact their local public health office to discuss other options. A list can be found here.
The clinical standard was developed in collaboration with adult and pediatric clinicians, endorsed by the Chronic and Complex Medicine & Rehabilitation Provincial Clinical Team and approved by the Provincial Clinical Leadership Team. This evidence-informed standard aligns with Diabetes Canada Clinical Practice Guidelines. This standard ensures that patients consistently receive safe, effective, and appropriate prescription of Insulin Pump therapy. Questions regarding this standard can be directed to the Provincial Clinical Service Lead for Chronic and Complex Medicine & Rehabilitation at SHIntegrationQuality@sharedhealthmb.ca. Read more here.
Language Access Interpreter Service
Shared Health’s Language Access Interpreter Services offers interpretation in over 200 languages for patients seeking health-care in Manitoba. Their services are available 24/7, either face-to-face, remotely (video conference, conference call) or on-demand over the phone. The service is free to patients seeing their family physician in Winnipeg. Outside of city limits, there is a fee associated with accessing the program. For physicians accessing the service through a hospital, the health region in which the hospital is located may be able to provide some support for the associated costs. To book an interpreter, please call (204) 788‑8585. Click here to learn more about this service and here for Tips for Working with Professional Interpreters.
Reminder to Register for Flu Shot Program by August 15
If you want to offer the flu shot this upcoming season, you must register with Manitoba Health by Monday, August 15. You can learn more about how to register here. Manitoba Health has introduced an improved and more equitable Flu Vaccine Distribution model after Doctors Manitoba successfully advocated for changes based on concerns raised by physicians. Learn more about the changes here.
Southern Manitoba First Nations Advocating for New Health Authority
Awareness walks are planned in nine communities to bring attention to health inequities for First Nations Peoples in Southern Manitoba, and to advocate for the creation of a new health authority. The Southern Chiefs’ Organization (SCO), which represents 34 First Nations, has been advocating for a more independent health system for their people for several years. They recently announced they are working with the provincial and federal governments on the initiative. Read more about the initiative here.
WRHA trying to expand Home is Best policy
The Winnipeg Regional Health Authority is planning to expand its “Home is Best” policy, which aims to support individuals waiting for PCH placement at home rather than in hospital. Currently, the majority of PCH-bound patients are transferred from hospital rather than from their own home. The 60/40 project, outlined in an internal memo, sets the goal that 60% of PCH admissions should be coming from the community and 40% from hospital. Traditionally, those proportions have been reversed and has led to hospital beds being “blocked” for weeks by patients awaiting placement. Concerns have been raised that home care does not have additional capacity to successfully support more individuals at home. Read more here.
UM adds third intake for nursing program
The University of Manitoba will be adding a third intake of students into its nursing program this upcoming year. Currently, the College of Nursing accepts two 120-student intakes per year, one in September and one in January. This coming May (2023), a third intake will be accepted to increase the number of nurses graduating in Manitoba. Read more here. Health Minister Audrey Gordon said the initiative will “directly provide additional nurses into Manitoba’s healthcare system at a time when we need them the most.”
Health Canada Drug Exceptions Consultation
Health Canada has launched an initial consultation to gather input from health care providers, industry, and other stakeholders about exceptions to the Prescription Drug List. Exceptions are intended for when a drug meets one or more of the prescription drug principles and factors, but a health and safety rationale for easier access outweighs the benefits of the prescription requirements.
This consultation is now open and will close on November 29, 2022. You can access the consultation here.
At this early stage, Health Canada would like to gather initial input about which existing exceptions are still needed and why, as well as any possible impacts that could occur if drugs that are currently considered exceptions were to be added to the Prescription Drug List.
The information gathered from this consultation will:
Help to confirm which exceptions are still needed
Inform updated health and safety rationales for existing exceptions
This work aims to ensure that exceptions to the Prescription Drug List meet the needs of patients, caregivers and the modern health care system. If you have any questions or concerns please contact policy_bureau_enquiries@hc-sc.gc.ca
National Young Caregiver Project Needs Participants
To best support young caregivers and their families during recovery from COVID-19, the Young Caregiver Project is inviting young caregivers and families with young caregivers to participate in their study.
They are looking for:
Young caregivers and family members to “understand young caregivers’ and their families’ responses to restrictions, isolation, closures and reopenings.”
Community leaders/allies to “understand how we can best support young caregivers and their families through pandemic recovery and beyond.”
Service providers to “learn more about what service providers have done to support young caregivers and their families through pandemic recovery and beyond.”
Policy/Decision makers to “learn about the experiences and challenges of decision/policy makers during the COVID-19 pandemic.”
Free, On-Demand (self-led) Modules (for all physicians)
*Click on links below to register. You do not need to be a CMA member, you just need to have a complimentary cma.ca account. Click here to create an account and contact pli@cma.ca to set up your CMAID*
Additional practice management resources (e.g. checklists, interview questions, staffing, evaluating practice opportunities, etc.) are also available online (scroll to the bottom).
Cognitive Behavioural Therapy with mindfulness (CBTm) for Physicians & Medical Learners
Cognitive Behavioural Therapy with Mindfulness (CBTm) for Physicians and Medical Learners is a set of courses designed to offer education and skills training in evidence-based self-management strategies to support the mental wellbeing of physicians and medical learners, delivered in a supportive peer environment.
