September

Better together. You will often hear me repeat these are two words when I’m communicating with our members. Quite simply it means that when we are united as a profession and working together, we really can make a meaningful difference. You have probably also seen the two words associated with our Doctors of BC logo (Better. Together.). That’s because they form the foundation of the work we do with and for our members.

Over the years hundreds of millions of tax dollars have been spent on over 300 government health care task forces and commissions; 25 years ago BC’s Royal Commission on Health Care and Costs (the Seaton Commission) made its recommendations for health reform. Ministers of health, deputy ministers, and health bureaucrats across Canada embraced and implemented many of the BC proposals, including the following: “The commission recommends that the Ministry of Health and the BCMA give priority to the joint development of a program to limit the number of physicians.”

Recently our profession has faced a number of controversial issues—physician-assisted dying, narcotic prescribing for nonmalignant pain, and the use of medicinal marijuana to name a few. I’m not an expert on any of these issues so naturally I will tell you how things are.

First, thank you for a very important and well-written article [BCMJ 2016;58:203-209].I took a look at the four recent studies that were discussed in the “How much exercise is enough?” section and wonder if you can shed light on something. The clearest U-curve is found in the study on Copenhagen joggers.[1,2] The study on runners in Texas[3] also showed a U curve though it was less striking.

References

We would like to thank Dr Fox for his comments. The studies mentioned are population cohort studies looking at a wide range of individuals with varying activity and fitness levels. The Taiwan study[1] attempted to define the minimal amount of exercise required and looked at all comers in a standard medical screening program. They did demonstrate that higher levels of moderate or vigorous activity conferred no additional health benefits and, thus, more of a reverse J-shaped curve than a U-shaped curve.

References