It is now more than 12 years since the long-acting beta agonists (LABAs) became available in Canada for the management of asthma. When these medications, which include salmeterol (Serevent) and formoterol (Oxese), were first assessed by Pharmacare, they were made available for physicians (other than respirologists and allergists) only with Special Authority approval. At that time, the reason given for this restriction by Pharmacare was that there were not sufficient data to approve full coverage.
Linnus Pauling won two Nobel Prizes, but at the end of a remarkable life—a life highlighted by worldwide recognition of his significant scientific advancements and the kind of insight that usually results in a Mensa invitation—he blew it. I’m not sure if he was just off the mark a bit with the biochemical underpinnings of his vitamin C theory or was merely demonstrating the mild dementia of aging the rest of us mere mortals can look forward to.
In my June BCMJ article, I introduced my patient Bob. He had been rear-ended in a motor vehicle collision, and I reviewed existing medical literature for evidence to develop an initial treatment plan. At the outset, Bob and his lawyer had requested magnetic resonance imaging (MRI) scans of his head and neck. This article deals with MRI requests. I will revisit the Official Disability Guidelines (ODG) for evidence to direct the appropriate use of MRI.
Thank you to Dr Lloyd Oppel for stimulating me to respond to and put into context his very one-sided article entitled “Reality check needed for CME credits” (BCMJ 2007;49[3]:109), which included a partial, out-of-context reference to the workshops I have been presenting to doctors for the past 15 years.
