BCPRA education course for GPs

Issue: BCMJ, vol. 52, No. 9, November 2010, Pages 473-474 News

It is estimated that up to 8% of British Columbians have potentially significant chronic kidney disease (CKD). Many of these patients are also affected by heart disease and diabetes as CKD increases the normal risk of cardiac morbidity by 10 times. Fully 40% of patients on dialysis also have diabetes. 

The ability of GPs to manage care for patients with chronic conditions often depends on effective communication and exchange of knowledge with specialist colleagues. The BCMA and Ministry of Health Services have highlighted the importance of effective physician-to-physician communication through recent updates to fee schedules that facilitate inter-provider contact. Strategic alignment of compensation with point-of-care health care processes provides appropriate in­centives to enhance interaction among participating physicians and represents a philosophical shift toward a shared care model.[1]

Shared care refers to a set of ideas designed to facilitate collaboration between GPs and specialists. The benefits are thought to include reduced patient wait times for specialist care by minimizing the amount of primary care provided by specialists, a de­crease in inappropriate consultations, less duplication of testing and fewer un­necessary prescriptions, and increased communication and knowledge ex­change between specialists and GPs. 

Shared care also seeks to open ongoing dialogue between specialists and GPs to more effectively define roles and mutual expectations and en­sure that patients do not “fall through the cracks.”

In support of shared care, the Bri­tish Columbia Provincial Renal Agency (BCPRA) has developed a program to engage GPs and neph­rologists to­ward improving care for patients with kidney disease. Within this program, one initiative has focused on studying wait times for outpatient nephrology assessment, while a second is aimed at providing opportunities for GPs to up­grade their knowledge of nephrology care. 

These initiatives are timely in view of the epidemic prevalence of CKD, which is estimated to affect more than 2 million Canadians.[2] The Table shows the projected CKD prevalence figures for BC by health authority.

While the projected total out­patient demand of approximately 360000 patients may include some non-progressers who do not need to see a nephrologist, the most conservative estimate of true outpatient CKD demand suggests close to 200000 British Columbians live with high-risk CKD stage 3 to 4. At the same time, BC has only about 50 full-time nephrologists. It is clear that provision of effective early CKD care by primary care physicians is needed to optimize outcomes for these patients.

To help GPs manage the increasing number of CKD patients in their practices, the BCPRA has developed a nephrology curriculum with objectives derived from a formal survey of GP’s educational needs. The first annual GP nephrology course has been approved by the College of Family Physicians of Canada for 6.5 Mainpro-1 CME credits. It will be held Saturday, 22 January 2010 at the Wosk Centre for Dialogue in downtown Van­couver. More in­formation is available at www.bcrenalagency.ca/default.htm.
—Michael Schachter, MD


1. Hickman M, Drummond N, Grinshaw J. A taxonomy of shared care for chronic disease. J Public Health Med. 1994;16:447-454.
2. Stigant C, Stevens L, Levin A. Nephrology: 4. Strategies for the care of adults with chronic kidney disease. CMAJ 2003;168:1553-1560.
3. Coresh J, Selvin E, Stevens LA. Prevalence of chronic kidney disease in the United States. JAMA 2007;298:2038-2047.

Michael Schachter, MD,. BCPRA education course for GPs . BCMJ, Vol. 52, No. 9, November, 2010, Page(s) 473-474 - News.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply