2001

Daily, we hear of physicians leaving practices in our community, both to retire, go abroad, go south to greener pastures, or even to abandon the profession for other endeavors. Politicians, who are elected for very short terms in the grand scheme of things (how many health ministers have we had during my practice lifetime?), seem to be ignoring this very high wastage rate.

The press do report high-profile defections. However one gets the sense that they are insensitive to the continued loss of medical talent from the province.

I would like to warn other physicians in the province who have had distressed patients presenting to their offices clutching lab results that suggest mercury poisoning or other heavy metal poisoning. These tests will have been ordered by a naturopath or physician interested in chelation. The patient will typically bring in urine testing results performed by a laboratory in Chicago where the mercury levels are right off the scale provided in the lab report.

I read in the June 23 issue of the Vancouver Sun that yet another nail has been driven into the coffin of the art of obstetrics. (“Hospitals adopt cesareans for breech babies,” and “Natural breech births abandoned by Vancouver hospitals because of higher risk.”)

Did the reported study compare cesarean section to vaginal delivery of only properly selected cases of breech presentation managed by skilled and experienced obstetricians? If not, the results have little meaning.

Hospitals are not honoring the social contract between them and BC’s surgeons. As long as anyone can remember, it was understood that surgeons worked at a hospital and provided coverage of the emergency department 24 hours a day, 365 days a year. In return for this they were able to work at the hospital and were able to have elective OR time and access to emergency OR time for urgent and emergent patients.

As practising physicians, we make ethical decisions every day, sometimes without even realizing it. This special issue is designed not only to help resolve ethical dilemmas and prevent potential problems from arising, but also to bring this ever-present factor to the foreground.