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Tag: Doctors

Health Advice
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‘You are still overweight’: how a doctor’s health advice triggered Sarah’s eating disorder | Health

Sarah Cox was admitted to hospital and placed on a feeding tube because she was malnourished, yet hospital staff discharged her with a weight loss plan. “I was told: ‘You’re still overweight, you still need to lose weight.’”

Cox says her eating disorder began after she was told by her GP to lose weight and that her body mass index (BMI) was too high at every appointment she attended throughout 2018-19, despite displaying no indicators of poor health such as blood test abnormalities or high or low blood pressure.

Cox remembers raising concerns with her GP about the diet after she passed out multiple times and being told: “You are still overweight. You need to ramp it up, not ramp it down.”

In 2020 Cox developed atypical anorexia, an eating disorder with all the same symptoms as anorexia except the person never becomes clinically underweight. Between 2020 and 2021, Cox was admitted to hospital more than 10 times.

Experts in diet and nutrition say cases such as Cox’s reveal why health, not weight loss, needs to be the focus of public health messaging, but that dietary guidelines from government bodies are doing the opposite – contributing to eating disorder risk.

Cox says when she was treated by one of the chief psychiatrists in eating disorders for Queensland, he told her she would never have developed a disorder if medical professionals had not put so much pressure on her to lose weight.

Dr Fiona Willer, a dietitian and lecturer at the Queensland University of Technology, says the primary risk of developing an eating disorder comes from trying to change one’s weight, yet it is a message reinforced by some doctors and health departments. “Everyone’s saying, ‘if you’re larger-bodied, you should try to be smaller-bodied’.”

The National Eating Disorders Strategy,

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Health Advice
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WATCH: New long COVID guidance aims to help doctors identify mental health symptoms

As millions of Americans seek answers about long COVID, a recent advisory from the Substance Abuse and Mental Health Services Administration (SAMHSA) is giving physicians better guidance on how to identify mental health symptoms that may stem from the condition.

These new guidelines, released in June, as part of the Biden’s administrations action plan for long COVID research, provide a framework that can help physicians, patients, and providers to better understand the mental health symptoms — anxiety, fatigue, obsessive compulsive disorder and post traumatic stress disorder (PTSD), among others — associated with long COVID.

“They validate and create categories for these conditions, and then provide some kind of guidance about how to manage them,” said Dr. Serena S. Spudich, a professor of neurology at Yale School of Medicine.

“We are really focused on continuing to prioritize the treatment, the identification and treatment of people who have long COVID, particularly who are dealing with these mental and behavioral health symptoms, because they can be very debilitating and people with long COVID need help now,” said Molly Sanborn, a Public Health Analyst at SAMHSA.

PBS NewsHour digital anchor Nicole Ellis spoke with public health analyst Molly Sanborn and Dr. Serena S. Spudich about long COVID’S impact on mental health. Watch the conversation in the player above.

Dr. Spudich said that the symptoms of long COVID can be characterized as what was traditionally thought of as psychiatric or psychological, and then there are others that are neurological. In most cases, she says, these conditions are overlapping — for instance, depression and brain fog.

READ MORE: What the latest research tells us about long COVID’s most common symptoms

In an October 2021, meta-analysis of COVID-19 survivors, published in the Journal of the American Medical Association (JAMA), about one in three survivors were diagnosed

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Department Health
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Emergency Department Doctors Call for More Resources to Address Youth Mental Health Crisis

There has been a significant increase in emergency department visits by children and youth experiencing mental and behavioral health emergencies.

The American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association on Wednesday issued a joint policy statement calling for more support to help U.S. emergency departments (EDs) deal with the influx of children and young adults they see who are experiencing mental health crises.

The statement cites studies that found there has been an increase in emergency department visits by children and youth with mental and behavioral health emergencies, as well as the increased prevalence of depression and suicide in children, adolescents, and young adults. It also mentions the increased suicide rates in Black school-aged children, which is about two times higher compared to White children.

According to the paper, the communities dealing with these issues often don’t have adequate resources to provide treatment. When this happens, hospital emergency departments become the safety nets for those requiring acute and subacute mental and behavioral health care.

The statement also says that children and youth with intellectual disabilities, autism spectrum disorders, behavioral dysregulation, immigrant children, children on welfare, youth in the juvenile justice system, and lesbian, gay, bisexual, queer, transgender or questioning (LGBTQ+) youth may have additional challenges, which must be addressed.

“Because of the diversity of the populations and the high prevalence of trauma and adversity among ED patients, organizations/ED leadership should provide resources for physicians, PAs, NPs, and nurses about trauma-informed relational care as a universal approach to care,” the paper says.

The statement lists a multitude of recommendations to address the problems, such as:

  • Developing emergency department transfer protocols
  • Using telehealth to identify and divert low-acuity patients
  • Activating existing mental health mobile crisis teams to respond to schools and other locations
  • Training ED
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Department Health
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Emergency room doctors beg for help treating children with mental health illnesses

Three influential groups of pediatricians and emergency medicine providers are pleading for more support and resources as the number of children and teenagers with mental health concerns overwhelm emergency departments nationwide.

“The scope of this problem is really great,” said Dr. Mohsen Saidinejad, a professor of emergency medicine and pediatrics at the David Geffen School of Medicine at the University of California, Los Angeles. “But our ability to solve it is not there.”

Saidinejad is the lead author of a joint policy statement from the American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association released Wednesday. The groups are calling for local communities to increase access to mental health services before emergency care is needed.

Every year, approximately half a million children with mental or behavioral health conditions are evaluated in emergency departments, according to the AAP. That number increased over the past decade, experts said.

Dr. Willough Jenkins, medical director of emergency and consultation liaison psychiatry at Rady Children’s Hospital in San Diego, is on the front line of the surge.

Silhouette of Little girl sitting on bed
Every year, about half a million children with mental or behavioral health conditions are seen in emergency rooms, according to the American Academy of Pediatrics.Annie Otzen / Getty Images

She said that the number of kids seeking psychiatric emergency care in her ER has grown from approximately 30 a month in recent years to 30 a day.

“The volume is astronomical, and I don’t know that people fully understand how many people are struggling,” said Jenkins, who was not involved with the new policy statement.

Jenkins said that children as young as six are coming in, often talking about suicide.

“This crisis is only getting worse,” she said. “It’s not getting better.”

A nationwide mental health problem

The call for help

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Health Care
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Converting doctor’s offices to premium clinics could spawn a new health-care crisis

News that a Calgary medical clinic has solicited “member” fees from its patients will no doubt shock many Albertans, regardless of their ability to pay for enhanced care.

But the believers in an equitable, fully public health care system should understand this challenging reality: some Alberta clinics have been charging patients thousands for premium services since well before Premier Danielle Smith’s tenure.

The trend predates UCP predecessor Jason Kenney. And the NDP’s Rachel Notley. In fact, you can go back five premiers into the Tory dynasty, to the latter days of Ralph Klein in 2006, to find a government and health ministry reckoning with a new private health clinic offering a boutique or “concierge” service for willing residents.

And similar clinics have existed in other provinces like Ontario, Quebec and British Columbia.

But there’s something that seems to set the Marda Loop Clinic apart, that many Albertans will reasonably find unsettling.

What appears to be different or novel in this case is that Marda Loop is an existing clinic that’s switching over to premium-pay service.

A ‘transformative’ model

Dr. Sally Talbot-Jones’ clinic in an inner-city southwest Calgary neighbourhood recently sent existing patients a letter about what it called a “transformative health care initiative.” It offered reduced wait times, longer appointments and an array of other perks, through membership that costs up to $4,800 for families.

Clinic patients who opt not to become paid members could still receive care from their doctor, but only one day a week.

The long-controversial but long-sanctioned Copeman Healthcare Centre chain of private clinics set up as new operations seeking a new list of patients. For patients at Marda Loop, the doctor and clinic they’d relied on for years transformed beneath their feet.

The switch from a public doctor’s clinic to a (mostly) private boutique seems

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Health Care
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Murray Mandryk: Sask. doctors may be exploring once unthinkable moves

Saskatchewan doctors opting to leave is what’s now wrong with our health-care system — why we can’t seem to find a GP or specialist.

Published Jun 19, 2023  •  Last updated 2 days ago  •  3 minute read

nn
Some Saskatchewan doctors may be looking a solutions to inadequate compensation patients might like even less than long wait times.

There was an uncomfortableness in the conversation between the patient, his wife and their doctor beyond the usual reasons for uncomfortableness in such settings.

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Health Care
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COLUMN: System is not showing doctors enough respect

‘We need to try everything to cut the costs of health care … Carrying on as we have been doing threatens to bankrupt public finances,’ says columnist

Your car’s water pump is leaking. There are several ways to look how it might be fixed.

You expect to sell the car soon, so you opt for cheap, aftermarket parts, installed by an independent garage. Cash deal.

Perhaps you intend to keep the car for several years, so you insist on original equipment parts, installed by a trusted dealership offering a no-quibble guarantee.

Or maybe you operate a taxi company and need the vehicle on the road tomorrow — time is money, after all! You have the parts installed by a garage which does the work overnight.

You can apply similar logic to Ontario’s health-care system.

A. The employer (the Ontario government) wants nurses working 100 per cent of the time. To achieve this, there must be a “waiting list.” This means delayed procedures: diagnostic MRIs, “elective surgery” such as cataracts and hip replacement, cancer care, etc. But delay may increase the cost of treatment.

B. For the patient, an effective system means timely, rapid treatment, plus skilled, kindly care.

C. Patients do not arrive in hospitals at a steady rate. Sometimes things are “slow,” sometimes frantic. Perhaps hospitals should operate at below full capacity. That would allow them to deal with surges without so-called “hallway medicine” or delays to scheduled treatments and surgeries.

D. “Taxpayers” have a variety of opinions. Some wish to fund hospitals generously so they are available if they need health care. Others believe politicians claiming they can lower taxes but keep services untouched through (never specified) “efficiencies.”

E. Nurses checking intravenous drips or changing wound dressings would like time to sympathize with patients’ nausea or reassuring them

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Health Advice
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Doctors share their in-flight health advice for summer travel

Holidays are great — but travelling can take its toll on your body and mind, particularly when flying long distances.

“When you consider that pressure, temperature and oxygen levels fluctuate in the aircraft, add in the fact that humidity levels are lower than sea level – it’s not surprising flying can upset some of your body’s normal functions,” says Dr Chun Tang, medical director and GP at Pall Mall Medical. “Not forgetting, most people feel varying degrees of stress before take-off too.” 

So, if your summer holiday is set to include a hefty flight, what are some of the key things to think about when it comes to health and wellbeing?

Dehydration 

“Airplanes can dehydrate you because half of the air circulating in the cabin comes from the outside, and when you’re at a higher altitude there is hardly any moisture in the air,” says Tang.

If you want to help mitigate the impact of dehydration while flying, consider what you eat and drink both before and during.

“Eat something light, like a salad and fruit. Avoid salty fast food, especially before flying, as this can cause bloating and dehydration,” suggests Tang. “Many people like to have an alcoholic drink in the departure lounge prior to flying, but you are just dehydrating yourself further. Avoid coffee too and stick to fresh juices and water.

“After you’ve flown, tempting as it is to go and get an alcoholic beverage, keep drinking water to restore hydration.” 

Chun Tang. Picture: Pall Mall Medical/PA Photo
Chun Tang. Picture: Pall Mall Medical/PA Photo

Germs 

Tang explains: “When you fly, you’re exposed to more germs because you’re near others – that’s why it’s common to catch a cold or sniffle following a flight. Your tray table, seatbelt and other surfaces that are frequently touched will also be covered with germs.

“Carry a small

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Department Health
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Health officials won’t publicly admit scale of ‘crisis’ at Surrey Memorial Hospital ER, doctors’ letter says

Dozens of physicians working inside the busiest emergency room in British Columbia have released a scathing letter describing an unrelenting “crisis” at the department, claiming the local health authority has “repeatedly” asked them to keep details of the situation from the public.

The medical professionals at Surrey Memorial Hospital said it’s become necessary to speak out in violation of communications protocol because health-care leaders have not been transparent about the dire reality of overcrowding and inadequate staffing in the facility.

More than 35 emergency physicians at the hospital backed the page-long letter that says patients are suffering and, in some cases, dying in hallways as a result of “steadily worsening” problems.

“We have been repeatedly sounding the alarm to our regional and provincial leaders; these alarms have been ignored,” read the letter dated Friday and obtained by CBC News.

“Additionally, these conditions have been poorly and incompletely communicated to the public. We feel that patients and the public deserve honesty. Fraser Health has repeatedly told ER physicians to not openly discuss our ‘challenges’ with the public.”

CBC News is withholding the physicians’ identities as they fear professional repercussions for releasing the letter.

A glass building is pictured against a blue sky with thin cloud.
Surrey Memorial Hospital pictured on March 6. (Ben Nelms/CBC)

“It’s scary, and we know we’re going to get blowback on this. All we want to do is go to work and look after our patients in a reasonable way — and we feel like there’s an incomplete truth that’s been told,” one physician said in an interview.

“When a patient comes into the emergency department, and they see how busy it is, they see patients in hallways and corridors, there’s a natural feeling that the emergency department is failing — and, truly, the emergency department is failing,” they added.

“But the failure is not because of your frontline

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Health Care
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Why is a cottage country ER closing? Doctors say they’re baffled

It’s a good-sized letter in a small-sized newspaper — about eight paragraphs in all, long enough to catch your eye as you turn the page, but easy enough to miss if you’re in a hurry.

It’s a farewell lament, of sorts, to a community that’s about to lose its emergency department.

Beginning “To the Minden Community,” it’s written by a doctor representing a group of physicians who will no longer be providing their services there to the people they believe are being failed.

The letter, which appeared in this week’s The Highlander, which serves the Haliburton Highlands, is also a snapshot of the kind of debate that’s roiling communities across this country, as cash- and resource-strapped health-care systems struggle to provide adequate levels of care to local patients.

“As physicians of the Minden emergency department, we would like to express our sincere appreciation and support to the wonderful community we have had the privilege of serving for the past 28 years. It has been an honour to provide emergency medical care to you, our adopted neighbours, friends and community members during some of your most vulnerable moments,” writes Dr. Dennis Fiddler on behalf of the Minden Physician Group.

“It is with a heavy heart that we must inform you that the decision to close the Minden ED was not ours to make. Despite our best efforts and unwavering commitment to the community, circumstances beyond our control have led to this challenging decision by Haliburton Highlands Health Services (HHHS).”

The closure, announced last month by the HHHS board, is just one example of the ongoing strains Ontario’s health-care system is facing. In a news release, the board said Minden emergency services would be “brought together” with those at the Haliburton Hospital, about 25 kilometres away, on June 1.

The decision

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