Just Medicine

In this episode, Dr. Kona Williams, a Cree and Mohawk forensic pathologist and coroner based in Sudbury, Ontario, talks to host Sandra about what forensic pathology is (and isn’t). They also discuss death investigation systems, why some communities in so-called Canada are left waiting years for answers about their loved ones’ deaths, and what needs to happen to ensure health care is more equitable for all – including those who are no longer living.Resources:- Watch Dr. Williams’ TedX talk entitled “Investigating Indigenous deaths: Looking beyond the pathological diagnosis”, on how the social, structural, and colonial determinants of health factor into her work in death investigation.- For additional context on Murdered and Missing Indigenous Women and Girls (MMIWG), read the final report of the National Inquiry, and this news story: McCue, D. (2019, Jun 10). MMIWG report missed chance to change how deaths are investigated, says Indigenous forensic pathologist. CBC News. https://www.cbc.ca/radio/checkup/mmiwg-report-missed-chance-to-change-how-deaths-are-investigated-says-indigenous-forensic-pathologist-1.5167987- Read about the Goudge Inquiry, mentioned by Dr. Williams, which prompted a change in death investigation systems in Canada: Eggerston, L. (2008, Nov 4). Goudge: “Systemic failings” in Ontario coroner’s office. CMAJ, 179(10), 995. https://www.cmaj.ca/content/179/10/995- Learn more about the Canadian Association of Forensic Medicine on their website, and familiarize yourself with what’s happening at the Centre of Forensic Sciences in North York, Ontario.- Have a listen to relevant past episodes, eg. ⁠⁠⁠on the structural determinants of health⁠⁠⁠, trauma-informed care, and ⁠realizing the Truth and Reconciliation Commission’s health-related calls to action⁠.Credits:Additional music by Aleksey Voronin⁠, used under the ⁠⁠⁠⁠Pixabay content license⁠⁠⁠⁠.Survey:To help us make the best possible podcast, please consider filling out ⁠⁠⁠⁠this short, anonymous survey⁠⁠⁠⁠ after listening.

In this episode, host Sandra speaks to Dr. Gbolahan (GB) Olarewaju, a public health resident physician, academic activist, and past and inaugural chair of the Black Medical Students’ Association of Canada. They discuss how decades of discriminatory policies and practices have thrown up obstacles to the medical profession for Black folks – and how the efforts of Black learners and trainees and their allies are righting these wrongs.Tune in as we delve into the history of medical violence against Black communities, and the role we all play in dismantling structural barriers to health and the health professions. Resources:Learn more about the history of medical violence against Black communities in Harriet A. Washington’s 2008 book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present.Familiarize yourself with the concept of race correction with this primer from the Canada-US Coalition to End "Race Correction" in Health Care and in Vyas, D. A., Eisenstein, L. G., and Jones, D. S. (2020). Hidden in plain sight — Reconsidering the use of race correction in clinical algorithms. NEJM, 383. 874-882.Review some papers about the health impacts of a demographically diverse health care workforce:Marrast, L. M., Zallman, L., Woolhandler, S. et al. (2014). Minority physicians’ role in the care of underserved patients. JAMA Internal Medicine, 174(2). 289-291.Greenwood, B. N., Hardeman, R. R., Huang, L., and Sojourner, A. (2020). Physician-patient racial concordance and disparities in birthing mortality. PNAS, 117(35), 21194-21200.Snyder, J. E., Upton, R. D., Hassett, T. C. et al. (2023). Black representation in the primary care physician workforce and its association with population life expectancy and mortality rates in the US. JAMA Network Open, 6(4). E236687.Watch Dr. GB’s keynote, “Progress and Protection: Intersectional Vigilance and Justice in Research and Advocacy”, given at 2024’s The Summit Conference.Read ‘The End of Diversity’ (2019) by Rinaldo Walcott, a critique of the language often used around equity and diversity, and a meditation on what true transformative change and structural justice could look like.Check out this list of Canadian anti-racism resources.Have a listen to relevant past episodes, eg. ⁠⁠on the structural determinants of health⁠⁠, and realizing the Truth and Reconciliation Commission’s health-related calls to action.Credits:Additional music by ScovinieBeatz, used under the ⁠⁠Pixabay content license⁠⁠.Survey:To help us make the best possible podcast, please consider filling out ⁠⁠this short, anonymous survey⁠⁠ after listening.

Climate change is presenting a big problem for health, with significant implications for equity. As medical trainees, when it comes to addressing the health impacts of climate change in our patients, it can be hard to know where to even start. In this episode, our guest Dr. Melissa Lem – a family physician, environmental advocate, and the president of the Canadian Association of Physicians for the Environment (CAPE) – shares ideas on how to integrate considerations about planetary health into medical practice.Resources:- Ready to get involved in climate action? Check out CAPE, the Canadian Coalition for Green Health Care, and EnviroMed at the University of British Columbia's Faculty of Medicine.- Dive into some of the health research and recommendations around time spent in nature at the website of PaRx⁠, Canada’s evidence-based nature prescription initiative.- Consult inhalerguide.ca (or BCinhalers.ca for folks practicing in BC) to learn more about the carbon footprint of and coverage for different asthma and COPD inhalers.Credits:Additional music by ⁠LP-Studio-music, used under the ⁠⁠Pixabay content license⁠⁠.

Welcome back to Just Medicine! In this episode, we explore the often overlooked vulnerabilities in pediatric health care with our excellent guest, Dr. Amarens Matthiesen, a Certified Child Life Specialist. She discusses the importance of including children in healthcare decision-making and how this looks in practice. Please tune in for a thought-provoking conversation on equity and agency in the pediatric care setting.

We are back with another episode! In this podcast, I spoke with Bryan Becker, who is presently working in peer support at the RAAC clinic at St.Pauls Hospital. RAAC stands for rapid access addiction clinic: this service provides addiction medicine assessments for any substance use issue, including alcohol. It serves to maximize treatment support for clients, provide training and distribution of Take Home Naloxone, offer harm reduction services and to facilitate referrals to substance use services. Support Workers like Bryan are individuals with lived experience of mental illness or substance use who have graduated from a Peer Support Worker Training Program. These individuals work on a contracted basis under the supervision of Rehabilitation staff with clients who access Vancouver Mental Health and Substance Use programs and services. On his own time, Bryan enjoys BMX, the beach, 3rd Beach drum circle, movies, reading and helping others. I am so honoured to have had the chance to speak with Bryan, and I hope everyone listening takes away as much as I did from the stories and advice that he shares.

We are back with another episode! I had the pleasure of speaking with Dr. Elise Jackson, who recently completed her Addictions Medicine Fellowship following an internal medicine residency at UBC. We speak about the protocols surrounding substance use while in hospital, as well as how the importance of hospitalization as a touchpoint for future care coordination. We also delve into the personal difficulties physicians and other HCP can face while caring for populations with complex needs.

We are back again with another episode! I had the pleasure of speaking with Dr. Victoria Weaver, one of the only dual infectious diseases and addictions medicine specialists in Canada. She shares her insights on the treatment of infectious diseases in patients with concurrent substance use. In particular, we discussed the challenges that arise in ID treatment, disease severity and continuity of care. Additionally, we delved into the ethical dilemmas that often arise in this line of work and the importance of multidisciplinary healthcare teams to this specific population.

We are back again with another episode! I had the pleasure of speaking with Dr. Mary Kestler, an infectious diseases specialist with particular expertise in HIV, TB, Global Health and Tropical Medicine. She shares her insights on HIV care in urban settings, amidst their unique challenges and opportunities. We also delve into the intersection of HIV care with substance use, gender, and sexual orientation, as well as the social stigmatization that can affect these marginalized groups.

We are back with another episode! I had the pleasure of chatting with Dr Tribesty Nguyen who is a public health resident physician. He has many years of experience in social justice, health equity, health policy, and political advocacy, particularly with 2SLGBTQ+, refugee, and racialized communities. He is here with us to share about the nuances of providing care for GBTQ+ men and how to take a sexual history for this population. If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

We are back with another episode! I had the pleasure of chatting with Dr Fraser Black and Ashley Mollison who are experts on the complexities of delivering palliative care for a vulnerable population. In this episode, we also discuss what drew Dr Black and Ashley to this line of work and why it is so rewarding. For details on PORT, refer to: https://www.equityinpalliativecare.com/port For details on research about PORT as well as the ways in which approaches to palliative care are defined, understood, provided, received, and supported, refer to https://palliativeapproaches.uvic.ca If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

We’re back baby! For part three of our Reproductive Health series, I had the pleasure of chatting with Dr. Sheila Curran on the complexities of rural pregnancy care. While pregnancy itself isn’t exactly a “walk in the park,” navigating pregnancy for those who live in rural locations comes with its own particular challenges. In this episode, we address both the practical (ex. financial) implications of rural pregnancy, as well as more nuanced topics such as the cultural implications of travelling for healthcare. If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

In this final episode of a 2-part series on Medical Assistance in Dying (MAiD) for mental health, I had a conversation with Dr. Derryck Smith where we explored the positive outcomes anticipated from this legislation. Join us as Dr. Smith shares his personal encounters with MAiD and why he believes this reform is pivotal in restoring human rights and empowering individuals suffering from treatment refractory psychiatric conditions. For more information on MAiD in Canada, check out the link below: ⁠https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html⁠

In this first episode of a 2-part series on Medical Assistance in Dying (MAiD) for mental health, I chatted with Dr. Diane McIntosh on the equity considerations that follow the legalization of MAiD for psychiatric conditions. Listen in as Dr. McIntosh shares her expertise and perspective on this issue, discussing the disproportionate impact MAiD might have on vulnerable populations, how a lack of access to care might drive individuals to seek MAiD, and some of the health equity concerns that are raised by the law. For more information on MAiD in Canada, check out the link below: https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html