Item: More and more family doctors are turning to AI scribes to reduce their workload. Many physicians in the article state time saving is the main driver for adopting these scribes.
My thoughts: I’m piloting an AI scribe right now with my Health Team. It can reduce the number of hours spent on paperwork. However, one does need to review the note dictated to ensure it’s accurate (a few examples of mistakes so far). The notes also tend to be wordier than my own notes. Finally, it’s really important to review the examination section of the notes – as the scribe has no way of knowing what a patient “looks like” and it’s up to you to ensure accuracy.
There are of course some privacy concerns. That’s why I like the fact that the scribe I’m using is not integrated into my Electronic record. That way the patients name/date of birth/health card/other identifying information does not get sent into the ether when the scribe generates a note.
My hope is the government settles on one scribe (after appropriate vetting) and pays for all physicians to use it. This will have significant positive benefits for health care.
Item: Ontario Liberal Party Leader Bonnie Crombie has launched her first campaign ad. She blames current Conservative Premier Doug Ford for the shortage of Family Physicians.
My thoughts: It’s a bit rich for the Liberals to blame the current government for the doctor shortage when most of the problems with family medicine began during their tenure. But, just as federal/national elections are won based on the cost of living/inflation (the big reason why Trump won), provincial elections in Canada are often lost based on how the current government is managing health care. And this truly is Doug Ford’s Achilles heel.
I know it seems like Ford’s handlers have him convinced that he can win a third term if only he calls an early election. But the blunt reality is that an early election call will be viewed as cynical even by people who will vote for him. Similarly the $200 Ontario “rebate” cheques are going to be viewed as a bribe.
Will Ford win a third term? I don’t know. But I doubt it will be as easy as he or his handlers think. He really needs to take some significant steps between now and the spring on health care. If only some would give him advice, and on more than one occasion.
Item: We’ve all heard about the rise in measles cases across the country and in the U.S. It seems that now Whooping Cough is also on the rise.
My thoughts: Jeez. Get vaccinated and get your kids vaccinated already people.
Item: On that note, it seems very few adults in the United States are getting updated Covid/Flu and RSV vaccines, even in high risk populations like nursing homes.
My thoughts: Life expectancy in the United States continues to fall. These two articles are not unrelated.
Item: Microplastics have now been found in the human brain.
My thoughts: Not nearly enough attention is being paid to this story. There are significant red flags for the harm that microplastics can do to human health including increasing the risk of dementia/heart disease/stroke and reducing fertility and sexual function. While it’s true that most of the studies raising alarm have been in labs or in animal models that don’t give a complete picture of the effect on humans, there are just too many concerns to ignore. We need an urgent review of microplastics (along with a review of all the processed garbage in the North American diet).
Item: A great article in the Annals of Family Medicine shows that when your doctor is away, there is LESS downstream use of ER and associated health care costs if you see a doctor in the same group practice than in a walk in clinic.
My thoughts: This is yet another reason why expansion of scope of allied health professionals is a bad idea. Rather than getting your care fragmented between health care workers who don’t have your full health history – the ideal is to support your family doctor to make sure whoever is covering can see that information, to give you better care. And on that note….
Item: Ontario is going to allow the further expansion of scope of nurse practitioners. PEI is going to allow physiotherapists to order X-rays.
My thoughts: Go read the article from Annals of Family Medicine above. This move (to expand scope) will eventually be shown to have been a big mistake.
Item: Excellent (and unusual for the Trillium – ungated) article on the aging population of family physicians in Ontario and what it could mean for the future.
My thoughts: None of this is surprising. Four of the five doctors in my clinic are late 50s or older. We are heading for a real problem if we don’t immediately support family medicine now.
Item: I somehow missed this but it seems that Australia just had its worst flu season on record.
My thoughts: I wrote this in 2017 warning that our health care system couldn’t handle a bad flu season. The situation is worse now. I don’t know what the flu season will be like, but if it’s a bad one we will see a proliferation of horror stories about health care. At the risk of sounding like a broken record – get your flu shot people. Keep yourself safe.
That’s it for this week. I’m away next week. Might have a blog later on a specific issue that is making Ontario an undesirable location to practice medicine. Back in two weeks with more snippets.
justanoldcountrydoctor 