Search

In today’s message you will find:

COVID Update

Public Health now posts weekly COVID-19 Surveillance Reports on Thursdays. This week’s report, which is again showing​“decreased activity,” covers the week ending May 21. Highlights include:

  • Severe outcomes from COVID-19“increased compared to the previous week.” There were 120 hospital admissions, up from 112 the week before, but down from 149 the week prior. This includes 9 ICU admissions, down slightly from 21 the week before. Hospital admissions have trended down the last several weeks, with a modest increase this week. They had peaked most recently at 264 the week ending April 16
  • There were 15 deaths recorded, up from from 6 recorded the previous week but down from 16 the week before. There have now been 1,980 deaths related to COVID-19
  • There were 416 lab-confirmed cases reported in Manitoba over the week, down from 537 the previous week. The test positivity rate was 13%, down from 15.4%

The updated wastewater surveillance dashboard shows generally shows decreasing COVID activity. 

Paxlovid Prescribing Updates 

As of June 1, the centralized referral intake for screening and prescribing Paxlovid within the WRHA will come to an end. Physicians must now prescribe Paxlovid to patients in need, recognizing the extreme time sensitivity to getting that treatment started.

For patients not eligible for Paxlovid, referrals for Remdesivir continue to be received through the centralized referral number found on the Remdesivir Referral Form. Be sure to indicate that Paxlovid has been excluded on the referral fax. Please continue to access resources published on the Shared Health Website Treatment Options for COVID-19 and Community Retail Pharmacies for any additional support.

You can see our recent update here about Paxlovid prescribing, watch a recording of the webinar we hosted here, and see the list of pharmacies dispensing Paxlovid here.

Meanwhile, a reminder has been sent that for solid organ transplant recipients with COVID-19, Transplant Manitoba recommends avoiding Paxlovid due to drug interactions. and instead choosing alternatives such as Remdesivir. Please read the full memo from Dr. Julie Ho, Medical Director with Transplant Manitoba’s Adult Kidney Program

Voluntary COVID RAT Tracking for First Nations People

To improve the availability of quality data for reporting the true impact of COVID-19 on First Nations peoples and assist individuals with the resources necessary to access treatment options, First Nations Health Social Secretariat of Manitoba (FNHSSM) is operating a call center to collect COVID-19 rapid antigen test (RAT) results from those who wish to report their test results to be added to First Nation COVID-19 reports and entered into PHIMS (the medical record containing vaccine and test results for all communicable diseases including COVID). Individuals can call 18336392068 to report their COVID-19 rapid antigen test results. Read the letter from FNHSSM here and download a printable poster for your practice here.

Pride Month

Doctors Manitoba and its members are committed to health equity & inclusion for ALL Manitobans. We recognize that members of the LGBTQ2S+ community continue to face disparities in health, health risk factors, and barriers to health care when compared to heterosexual and cisgender member of society. Board President, Dr. Candace Bradshaw is committed to putting the Doctors Manitoba values of being forward-thinking, committed, human and courageous into action. She believes that, physicians must commit to care for ALL Manitobans and do all we can to create inclusive and safe spaces. This also means a continued commitment to learn about the unique health care needs of LGBTQ2S+ Manitobans.”

We encourage members to continually learn about providing care for the LGBTQ2S+ community. Physicians and medical learners should find ways to support & create safe, inclusive spaces for LGBTQ2S+ physicians, medical learners, colleagues & patients. There are so many ways you can do this!

Join us at Pride Parade & Rally — June 5
Join us on Sunday as we participate in the 2022 Winnipeg PRIDE rally & parade (for the first time in our organization’s 114 year history) to celebrate the diverse community that supports LGBTQ2S+ people. We are proud to demonstrate our support and ongoing work towards allyship with the LGBTQ2S+ community and recognize we should have joined this important celebration years ago. Learn a bit about the history of Pride Month here and here.

The Doctors Manitoba delegation will meet by 10:15am in Memorial park in Aisle G, section 32. Participants will receive a DRMB Pride T‑shirt (sizes range from XS-XXXL). 

→ Register to join us at DRMB​.ca/​Pride.

Pronoun ID Badge Extenders


Words are powerful and using inclusive gender-affirming language is so important when providing health care to people of all genders. Using a person’s correct pronouns and sharing yours fosters an inclusive environment. Introductions with name and pronouns can happen in every setting, not just in LGBTQ2S+* spaces. You can Display & share your pronouns with patients & colleagues with our complimentary pronoun ID badge extenders. Learn about the importance of pronouns & order your ID badge at DRMB​.ca/​p​r​o​nouns

Safe Space Decals
Clinics and medical environments deemed Safe Spaces are important for the comfort, safety and inclusion of patients and staff who identify as members of the LGBTQ2S+ community. Help create these inclusive spaces by ordering complimentary​‘safe space’ decals to display in your practice. You can order up to 5 decals for your practice at DRMB​.ca/​S​a​f​e​Space

LGBTQ2S+ Research
Researchers at UM want to hear from LGBTQ2S+ nurses and doctors about their workplace and educational experiences in a one-on-one interview. Download a PDF here or a social media graphic here. If you are interested in participating or want more information contact Deborah.​mcphail@​umanitoba.​ca

Has the Backlog Peaked?

Earlier this week, we released new estimates on the backlog of surgery and diagnostic tests that has accumulated during the pandemic. It appears the backlog may have peaked, with a slight decrease to 166,903 cases. This is the first time in over a year the backlog has decreased.

While a return to pre-pandemic capacity in most hospitals has helped, all that does is stop the backlog from continuing to grow. In fact, the modest decrease we estimated in this month’s update was only 1.3%, which means it take 72 months, or 6 years, at this rate to clear the backlog. 

As a family physician, I care for patients each and every day who are stuck in the backlog and waiting for a diagnostic test or surgery,” said Dr. Candace Bradshaw, Doctors Manitoba’s new President for 2022 – 23.​“These patients are waiting in pain and at this point there’s not a lot I can tell them to address the uncertainty they face about their wait time.”

That’s why Doctors Manitoba offered a prescription of short-term actions that could be taken now to speed up clearing the backlog. This includes:

  1. Cataract Surgery: Lift the annual cap on the number of cataract surgeries that can be performed each year at Misericordia Health Centre.
  2. Allergy Testing: Remove the limit on in-person appointments and return nurses to outpatient clinics so specialists can catch up and keep up on the backlog.
  3. Mammograms: Increase the volume to catch up on the backlog of breast cancer screening and bring wait times back to pre-pandemic levels.
  4. Complex Lung Function and Respiratory Tests: Remove the restrictions on these testing procedures so they can be offered at more clinics.
  5. Nurse/​Technologist Shortages: A targeted human resource strategy is needed to recruit and retain more nurses and technologists, as the shortage of these skilled staff is the biggest barrier to clearing the backlog. Short-and medium-term actions include addressing high levels of burnout and low morale to retain existing staff, offering special incentives to those willing to take on more shifts rather than mandating overtime, maximizing the use of agency staff, and pursuing aggressive out-of-province recruitment.

This is an initial call to action, and we are inviting physicians to share more ideas to help us get patients the surgeries and tests they need. 

You can learn more in our recent story about the backlog.

Please note: Today the provincial government posted a request for proposals to add more surgical capacity. This is a positive step to help address the backlog. You can view the summary on the Merx contract and tender site, but a subscription is needed to view the full proposal. While proposals for any surgical area will be considered if there is a backlog, the request is specifically looking for the following services:

  • Paediatric dental, ENT and general surgery
  • Cataracts
  • Outpatient spine procedures
  • Adult ENT
  • Adult general surgery
  • Outpatient gynecological procedures
  • Outpatient orthopedic surgery
  • Outpatient plastic surgery
  • Urology
  • Vascular procedures
  • Endoscopy

The Doctors Manitoba team is reviewing this call for proposals and will provide further information and advice next week. A similar request for new diagnostic capacity is expected later this month.

More Audits & More Regulation?

Over a year ago, the responsibility for auditing physician billings was transferred to Manitoba Finance and more auditors were added. We’re aware of dozens of physician audits that have been initiated since the change.

Doctors Manitoba is with you every step of the way in the audit process. Please contact us as soon as possible if you receive an audit notice, as there are time limits to respond. We will help you to prepare your response, and you will help us to gather information to better protect all our members. If you receive an audit notice, or if you have already responded and receive a Preliminary Findings Letter, please contact Allison Crolly (acrolly@​doctorsmanitoba.​ca (204) 9855856) or Andrew Swan (aswan@​doctorsmanitoba.​ca (204) 9855860).

Luckily, physicians still have the right to appeal an audit, thanks to our advocacy against the the legislation proposed a few years ago by the government that would have stripped you of this right. 

While that legislation, also referred to as Bill 10, was ultimately reversed, the government has proposed new regulations that could add new and unnecessary documentation requirements for physicians, adding to your already extensive administrative burden. We’ve heard from many physicians concerned this could add minutes of new documentation to each patient visit, resulting in less time for patient care and risking more physician burnout. 

We don’t yet know if the government will move ahead with the proposed regulations. Many physicians wrote in directly. Our Past President, Dr. Kristjan Thompson, also contacted the government to express physicians’ concerns. You can see his letter here. We are remaining hopeful they will withdraw the regulation, but we are preparing to escalate our advocacy if they do not. We are monitoring this closely, and will be in touch if we need your help to describe in more detail the unnecessary problems these new regulations create.

We’ve also found a partner in pushing back against this new red tape. The Canadian Federation of Independent Businesses has joined our advocacy to stop proposed government regulations that could significantly add to physicians’ administrative burden. 

In a recent letter to the government, CFIB correctly notes that the regulations will create a significant red tape burden for many small business owners who are already subject to robust regulatory requirements.” They go on to explain that the proposed regulatory amendments appear to be a step backward in the province’s commitment to reducing the regulatory burden for small businesses in Manitoba.”

The CFIB recommends, on behalf of the many small business owners in Manitoba who are practicing physicians, optometrists, chiropractors, and dentists, we urge you to reconsider this proposed regulation.”

The move in Manitoba to add administrative burden for physicians runs contrary to what the Auditor General recommended, and it’s a stark contrast to a recent initiative of the Nova Scotia government to reduce the administrative burden on doctors. Through a collaboration with Doctors Nova Scotia, improvements were made to forms and other administrative tasks with a goal to reduce 50,000 hours in administrative burden, which could free up physicians for 150,000 more patient visits. In fact, the initiative in Nova Scotia was recognized earlier this year by CFIB with a Golden Scissor award. This is the kind of initiative that is needed in Manitoba, and Doctors Manitoba and CFIB will work together to pursue an initiative like this here. 

The CFIB exists to be a champion for small businesses and is devoted to creating and supporting an environment where your business can succeed. They have over 95,000 members across Canada, including many physician corporations and medical clinics. In addition to advocacy, CFIB offers specialized business resources, including HR/ compliance support to assist in managing your business and a suite of savings on products and services to help save money. You can learn more about CFIB, or click here to join. 

New Ambulatory Care Clinic at HSC

On May 30, the new Ambulatory Care Clinic added three new clinics: General Internal Medicine, Hypertension, and Respirology. Rheumatology and Neurology opened in April and clinics for Allergy, Cardiology, Dermatology, Endocrinology, Gastroenterology, Hepatology, and Infectious Diseases will open June 27. Find information and updated fax numbers here.

Public Health Bulletin: Reporting of Elevated Blood Lead

Effective May 1, 2022, blood lead levels 50 μg/​L (5 μg/​dL) or greater became reportable to Public Health on an interim basis to assist in the identification of important sources of lead exposure for Manitobans and to inform further actions that may be necessary related to reducing lead exposure. You can find resources to help identify sources of lead exposure here. Read Dr. Brent Roussin’s letter here, download Healthcare Providers Blood Lead Guidance here and an Elevated Blood Lead Level Report Form here.

Newborn Screening Now Includes Spinal Muscular Atrophy

Effective June 1, 2022, all dried blood spots received for newborn screening (NBS) at the Manitoba Newborn Screening Program at Cadham Provincial Laboratory (CPL) will also be screened for Spinal Muscular Atrophy (SMA). The Manitoba newborn approach will be similar to other centres using the Centres for Disease Control (CDC) assay which specifically screens for the exon 7 deletion. If there is no exon 7 target detected, then the blood spot will be sent to a reference centre for quantification of SMN2 gene copies. Any positive screens will also be reconfirmed by requesting a second blood spot. Results will be available by faxed report, and in eChart, and positive screens will also provide the SMN2 gene copy number. Any positives will be immediately referred to Pediatric Neurology for timely assessment and will be coordinated with the infant’s primary care practitioner. Read the communication from Cadham Provincial Lab here and relevant resources will be updated here.

When to Draw your Retirement Income — Advice from MD Financial

Retirement can mean complex financial decisions for physicians with corporate assets. Where should you pull assets from, and in what order, for an efficient and lucrative retirement? Read more

Fantastic Physicians

Congratulations to Dr. Peter Nickerson, on receiving the Dr. John M. Bowman Memorial Winnipeg Rh Institute Foundation Award in recognition of his life altering and life-giving research contributions to the field of transplant immunology medicine. Dr. Nickerson and his team significantly enhance patients’ access to transplants, reduce their risk of rejection, and improve their quality of life for patients all around the world.

Congratulations to Dr. Nadia Marion who won the Penelope Gray-Allen Memorial CJEM Writing Award at this year’s Canadian Association of Emergency Physicians (CAEP) awards. The award recognizes a Humanities in Emergency Medicine article submitted to CJEM.

Beat Stroke. Share FAST.

June is Stroke Month and this year Heart & Stroke is celebrating the dramatic advancements in stroke prevention, awareness, treatment and recovery in Canada over the past several decades. Research breakthroughs, increased awareness and improvements to stroke systems of care in the last 30 years have improved diagnosis and treatment. More still needs to be done as stroke continues to rise due to the aging population and younger people having strokes. And as more people survive stroke, the need for rehabilitation and recovery support increases.

Read more this media backgrounder about stroke advancements that Heart & Stroke has contributed to with our many partners over the past 30 – 40 years in the areas of research (eg. risk factor identification, clot busting drugs, EVT), improving systems of care (eg. stroke strategies, stroke units, telestroke), and awareness, education and support (eg. FAST signs of stroke campaign).

We recently updated our turn-key FAST toolkit for partners so you can help raise awareness around the signs of stroke. Get the toolkit.

ICYMI

Here are some important and popular recent updates, in case you missed them:

Upcoming Events

Join the COVID-19 Immunity Task Force (CITF) on June 23 for The Omicron Tsunami, their 8th Research Results & Implications seminar. Learn more here.

Check out our events calendar for upcoming events for physicians. Here are a few highlights to consider over the next few weeks: