BCMJ maintains strong reader support

Wave 2 of the BCMJ readership study was completed in January (Wave 1 was completed in 2001). Results are consistent with 2001, with the Journal receiving very strong physician support:

• Almost all members (90%) continue to feel the BCMJ is a useful source of information and forum to discuss organized medicine in BC; three-quarters feel it is a useful source to keep them up-to-date with new services and procedures in BC.
• The BCMJ and CMAJ are still the most read publications (90% and 82% respectively).
• Almost all readers feel that both the clinical content and the general content of the BCMJ has either stayed the same or improved over the past few years. 
• Half of the readers continue to be regular readers (read all 10 issues per year).
• Almost all readers continue to feel there is something they like about the BCMJ—with most common mentions related to BC/local focus and editorials.

The study also identified a few areas that require attention, which the BCMJ Editorial Board and staff will tackle over the coming months. These are:

Readers would like fewer enclosures coming along with the Journal.

When asked an open-ended question about what they would like less of, respondents said they would like to see fewer enclosures in the polybag the Journal is mailed in. This poses a dilemma, since the reason the BCMJ accepts advertisements is to reduce the cost of the publication (advertising revenues cut the cost of the Journal to members by about half). The Journal must strike a balance between cost savings and disturbing readers with an abundance of enclosures.

There is very low traffic to the BCMJ web site, despite a slight increase in reliance on the web for information in general.

Is having an online version of the Journal important given the limited interest? If so, there is a need to:

• Increase awareness of the web site.
• Generate ways to increase usage.
• Ensure optimal usability/functionality of the site.

There is a decrease in agreement on the Journal being useful for CME.

When asked an open-ended question about what they would like more of, survey respondents gave a wide variety of answers, but the overall theme related to having more clinical content. The BCMJ continues to serve an audience split in two: about half of the readers are specialists and half are family or general practitioners, and both waves of the survey revealed that specialists would like more relevant clinical content. This poses another dilemma for the Journal, since what is relevant to one specialist is probably not to another, nor to our generalist readers.

Despite these challenges, we are gratified to learn that the BCMJ continues to be a popular, well-read, and solid source of information for physicians.

Readership survey figure

—Jay Draper
BCMJ Managing Editor

The telephone survey was completed by Ipsos-ASI and is accurate within +/- 6.9%, 19 times out of 20. The full report is available as a PowerPoint presentation (please contact jdraper@bcma.bc.ca to be e-mailed a copy.)

Locum matching service

Physicians looking for locum coverage can now use a new web site developed by the BC Locum Group. www.locums.ca has introduced a service enabling GPs to submit locum job ads online. It is designed to improve their chances of success by giving access to a growing network of over 110 active BC locum physicians who are members of the web site. Locums are e-mailed the job ads directly. The ads are also posted online and are easily searchable by date and location.

GPs are able to submit detailed, descriptive job ads. The ads are designed to streamline the process and minimize negotiations between the physician parties. Resources are provided to educate GPs about the locum market and how to maximize their success in attracting locums.

Although www.locums.ca is primarily a resource site for locum physicians, it is dedicated to finding innovative solutions for GPs struggling to find locum relief to ensure the survival of family medicine. Specialist locums are welcome to use the web site.

For family physicians, currently the cost per ad is $30 for 3 months. For Last Minute Locums (locums starting in the next 30 days), the cost is $10. Additional ad formats are being developed for clinics and organizations; contact info@locums.ca for rates.

Benefits update: Bylaws and building codes—Homeowners beware

If a home is damaged significantly by a fire, the owner can be left with big bills to rebuild the home to new building standards—bills for which the coverage provided by home insurance policies is not enough.

A few years ago, a significant fire loss occurred at a home in Burnaby. It involved a house that was built in the 1940s and structurally was relatively unchanged from that time. The repair cost was in the neighborhood of $160 000 on a replacement cost policy. However, there were undamaged portions of the home that required upgrades in the amount of close to $100 000.

The homeowners could not afford the $100 000 upgrade and did not have any bylaws coverage under their home insurance policy. They could not service a mortgage and therefore were unable to proceed with the repair. Instead, their best option was to accept an actual cash value settlement that did not amount to much more than $85 000. The significance of bylaw coverage cannot be overstated using this example. The fire that occurred in their home dramatically changed their lives.

Municipal governments have passed bylaw legislation aimed at improving the construction of buildings within their boundaries. A review of many of the building regulation bylaws of cities and municipalities across our province demonstrates that most of the local governments have set a percentage for damage to the home, such as 75%, as the threshold when bylaws will be enforced. Through these bylaws and adherence to the Provincial Building Code, they make certain that new construction adheres to certain standards. This benefits society as a whole in terms of standard of living and safety.

Municipalities haven’t stopped at new construction and have implemented bylaws that require certain current-day building code standards to be met when repairing a structure damaged by peril, usually fire. The adherence and the enforcement of these bylaws create unique challenges to the homeowner.

Most replacement-cost homeowners’ insurance policies contain bylaws exclusions that exclude all losses or increased costs of repair due to the operation of any law regulating the zoning, demolition, repair, or reconstruction of buildings. Some insurers will add an endorsement to the policy that provides limited coverage, usually in the $10 000 to $15 000 range. The problem is that this limit may be inadequate given the bylaws exposure on an individual home, especially if it was built prior to 1970.

To further complicate matters, bylaws and building codes are constantly changing, which makes it difficult for a homeowner to know what the potential cost of rebuilding will be to comply with current codes following a fire loss. The best insurance protection is offered by purchasing a policy which includes a high bylaw coverage limit or even unlimited bylaws coverage. Having your home damaged by fire is bad enough. Finding out that your home insurance policy will not provide sufficient funds to rebuild the home to modern standards is not something a homeowner wants to find out after the fact.

Homeowner products, which include unlimited bylaws coverage, are available through the BCMA Home and Office Insurance Program, an insurance program designed exclusively for BCMA members.

The Mardon Group is located at 3080 Cambie Street, Vancouver, BC. For more information, please contact them at 604 877-7762 or visit their web site at www.mardongroupinsurance.com.

—Sandie Braid, CEBS
BCMA Benefits Department

HIV clinical trails enrolling patients

If you have HIV-positive patients, the following information on clinical trials now enrolling patients may be helpful. For details, visit the Canadian HIV Trials Network web site (www.hivnet.ubc.ca) or call 1 800 661-4664.

Strategies for management of ART (SMART) (CTN 190)

This study evaluates the risks and benefits of two treatment strategies: a viral load strategy and a CD4 strategy. Participants with a CD4 count above 350 cells/mm3, on HIV treatment or not, are assigned to either the GO group or the WAIT group. In the GO group, treatment is initiated or changed if viral load is not suppressed. In the WAIT group, participants start treatment whenever their CD4 count declines below 250, and stop treatment whenever their CD4 count is above 350. Sites: Multiple sites.

3TC or no 3TC for HIV with 3TC resistance (CTN 189)

This treatment strategy study compares the effects of continuing or discontinuing 3TC treatment in the presence of HIV with 3TC resistance for persons who are on a regimen that includes at least three other anti-HIV drugs. Participants are randomly assigned to either continue their 3TC 150 mg twice daily or 300 mg once daily as part of their current therapy or discontinue 3TC while remaining on the rest of their current therapy. Sites: Multiple sites.

Rosiglitazone effect on blood vessels (CTN 178)

This study examines the effect of rosiglitazone on the progression of atherosclerosis through improvements of sugar and fat metabolism. Participants must have elevated blood fat levels, have been on two or more anti-HIV drugs for at least the previous 12 months, and be unlikely to change anti-HIV therapy during the study. Site: Vancouver.

DAVE: D4T or abacavir plus vitamin enhancement (CTN 169)

This study aims to determine the best way to treat people on d4T with high levels of lactic acid. Switching from d4T to abacavir will be assessed. Adding riboflavin and thiamine will also be assessed. Sites: Toronto, Vancouver, Whitby.

OPTIMA: Options with antiretrovirals (CTN 167)

Volunteers with advanced HIV disease, and in whom regimens that have included all three classes of antiretroviral drugs have failed, are randomly assigned to an intended antiretroviral drug-free period of at least 3 months or to a non-drug-free period, and are randomly assigned to receive either standard ART or mega-ART. Sites: Multiple sites.

Early versus delayed pneumococcal vaccination (CTN 147)

This study aims to determine whether people who are HIV-positive respond better to a vaccine for pneumonia-related disease when they are immunized immediately, or when immunization is delayed until the immune system has improved to a certain level. The study also compares the effectiveness of 23-valent vaccine and heptavalent vaccine. Participants must have a CD4 count below 200. Sites: Multiple sites.

Permits for designated parking for people with disabilities

Why should you know about the laws enforcing designated parking for people with disabilities? Because as a physician, you are a critical partner in the proper distribution and use of these permits. SPARC BC (Social Planning and Research Council) is the issuer of over 84000 permits in the province. We rely soley on your certification as a physician that the individual you are recommending, a person with a significant mobility disability, meets the criteria for receiving the privilege of access to these specially designated parking spaces.

Designated accessible parking is a way of ensuring that people with impaired mobility, whether temporary or permanent, enjoy equal participation in our community. These permits are needed so people with disabilities can access their recreation, employment, civic involvement—even their appointments with you! Unlawful use of the limited designated accessible parking spaces often means that people with disabilities must sit and wait for a space to become available—or simply go home.

Your diagnosis determines the applicant’s eligibility and qualification for a parking permit and the type of permit this person will receive. We issue two types of parking permits: permanent (valid for 3 years and renewable thereafter) and temporary (valid for a maximum of 1 year and not renewable).

Eligible conditions

Only persons with visible or invisible impairments affecting their ability to walk are eligible for a parking permit. The applicant must meet the following criteria:

• The applicant’s disability classifies as neurological, musculoskeletal, cardiovascular, respiratory, or other disability 
• Given the applicant’s disability, he or she cannot walk 100 metres
• The applicant requires the use of the following mobility aid: manual wheelchair, motorized wheelchair, motorized scooter, walking aid (such as cane, walker, crutches, other)

Ineligible conditions

Persons who have sensory impairments, arm injuries, and or sun sensitivities are not eligible. Neither is a person who has a mental health related diagnosis, unless he or she also has a specific mobility impairment.

SPARC BC’s parking permit application forms are available either by contacting our office at 604 718-7744 or by downloading it from www.sparc.bc.ca. The form has one section that must be completed by the applicant’s doctor. Please contact us if you have any questions at 604 718-7744 or emeses@sparc.bc.ca.

—Betty So, Project Coordinator

Family Practice Physicians are Invited to Submit an Expression of Interest to Establish a Family Practice Group in the New Ambulatory Care Centre at Vancouver Hospital

The Family Practice Department of Vancouver Hospital, the UBC Department of Family Practice and Vancouver Coastal Health are developing an innovative family practice clinic in the new Ambulatory Care Centre now under development at Vancouver Hospital. The clinic will provide a setting for a group practice of approximately six family physicians interested in teaching and innovation within one of the most modern medical facilities in Canada. This opportunity will be of particular interest to an existing multiphysician practice or smaller practices willing to form a group with others.

The purpose of this initiative is to create a clinic that applies innovative family practice services within the context of a large teaching hospital and using primarily fee-for-service practice. The Family Practice Group will link with Vancouver Coastal Health service delivery programs. Vancouver Coastal Health, through its Primary Health Care Network, will provide a variety of supports to help the practice implement best practices in primary health care, including the use of information technology and multidisciplinary practice. Provision has been made in the clinic for the integration of disciplines other than medicine and space for academic activities. There will be opportunities to receive sessional payments for specifically negotiated services.

A small group of family physicians affiliated with the Vancouver Hospital Department of Family Practice have defined some of the characteristics of the Family Practice Group that is being sought. These include:

• Commitment to relocating their practice before the end of 2006.
• Commitment to contributing to a multiyear lease for the clinic at market rates.
• Willingness to operate under a blended payment model of remuneration that will include fee-for-service but potentially alternative payment mechanisms for components of the practice.
• Commitment to continuous care of patients.
• Willingness to teach medical students and/or residents.
• Interested or experienced in use of information technology or electronic medical records.
• Interest in working in a multidisciplinary team setting.

Family practice groups or individual physicians who are interested in pursuing this opportunity should send a short letter describing their existing practice including number of physicians, full-time equivalency of physicians, and characteristics of existing patient population served by the practice. The letter should also describe the reason the practice is interested in pursuing a new practice setting and confirm the willingness to relocate their practice in 2006. The letter should be submitted no later than 15 June 2005 to:

Attention: Winnie Price
Ambulatory Care Clinic Project
Vancouver Coastal Health
11th Floor, 601 West Broadway
Vancouver, BC V5Z 4C2
E-mail: Winnie.Price@vch.ca
Fax: 604 875-4388

For further information please contact Dr Norm Stanley at 604 875-4460 or at Norm.Stanley@vch.ca.

Sandie Braid, CEBS, Jay Draper. Pulsimeter. BCMJ, Vol. 47, No. 4, May, 2005, Page(s) 173 - 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

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