July

The optimal management of rectal cancer continues to evolve, and recent studies have addressed the dual pattern of recurrence of the disease: local recurrence within the pelvis and distant metastases. In conjunction with careful preoperative imaging, improved surgical techniques, and accurate pathological staging, significant improvements have been achieved in the results of rectal cancer management.

I appreciate all the hard work done by the BCMA on behalf of all BC physicians, especially during these challenging times. What I don’t appreciate is the seeming unwillingness or inability of some physicians to recognize that medicine has an ever-changing face. Why did the editor MHG, in the opening lines of his recent editorial (BCMJ 2002;44[3]:115) recognize only male physicians, “gentlemen physicians of the BCMA,” as coming to our defence? Is Dr Heidi Oetter not a woman?

Recently, within 24 hours, two disturbing incidents concerning senior citizens and their family physicians came to the attention of this fellow septuagenarian.

One older patient who is the ongoing provider for a family with a mentally handicapped dependant, and who has been affected with ongoing renal failure, told his wife that he had been declared by his ($400 000 + $50 000) GP that he was too old to qualify for dialysis. The anguished wife was later reassured on good authority that age plays no part in the criteria for dialysis.

So where do we go from here? The current duo of health ministers have come to realize that they are as unable to control the economic drivers of health care costs as the past six or seven incumbents. I’m sure that informing the decision-makers that they shouldn’t agree to pay the McEachern arbitration award because they were broke was difficult for the new economic advisers.