Many women complain that physicians are reluctant to treat menopause with the full range of available therapies, often dismissing symptoms as 'natural' and something to be endured. A review article in CMAJ  finds that physician fears around menopausal hormone therapy and lack of knowledge regarding treatment options often impede patients from receiving treatment. On this episode, Drs. Mojola Omole and Blair Bigham speak with Dr. Iliana Lega, the lead author of the review entitled "A pragmatic approach to the management of menopause." Dr. Lega is a Clinician Scientist and Endocrinologist at Women’s College Hospital in Toronto. She encourages physicians to update their therapeutic understanding of menopause and to initiate conversations with women about the symptoms of perimenopause as they enter their forties. Drs. Omole and Bigham also hear from Janet Ko, the co-founder and president of the Menopause Foundation of Canada. She shares her personal experience of receiving a delayed diagnosis of perimenopause and the impact of hormone replacement therapy on her well-being. Ms. Ko also shares the results of the foundation's study on women's experience receiving care for menopause, and reports that 72 percent of women found medical advice to be unhelpful or only somewhat helpful. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

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X (en français): @JAMC 
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The CMAJ Podcast is produced by PodCraft Productions

Time for a reset: menopause and hormone replacement therapy

CMAJ Podcasts: Exploring the latest in Canadian medicine from coast to coast to coast with your hosts, Drs. Mojola Omole and Blair Bigham. CMAJ Podcasts delves into the scientific and social health advances on the cutting edge of Canadian health care. Episodes include real stories of patients, clinicians, and others who are impacted by our health care system.

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On this episode of the CMAJ Podcast, Dr. Eve Purdy makes it clear what’s at stake when it comes to incivility in medicine. "It's very simple. Incivility kills patients, and that needs to be the single line of every healthcare leader responsible for managing and leading teams.” Dr. Purdy joins Dr. Sarah Kim and hosts, Drs. Blair Bigham and Mojola Omole, for an urgent panel discussion that looks into the deep-seated reasons behind incivility in medical settings. 

Dr. Eve Purdy is an emergency medicine physician and applied anthropologist at Gold Coast Hospital and Health Service in Australia. She focuses on helping healthcare teams perform at their best. Dr. Sarah Kim is a family physician and an assistant professor in the Department of Family and Community Medicine at the University of Toronto. She's also the Medical Education Health Humanities Lead at Temerty Faculty of Medicine, where she researches the intersection of high performance and hierarchical systems.

Together, they explore the structural failures, embedded cultures, and the detrimental role "a few bad actors" can have on the effectiveness of entire teams. The conversation underscores the importance of prioritizing healthy communication practices, cultivating respect within healthcare teams, and the essential role leadership needs to play in combating incivility to safeguard patient care.

The episode begins with a conversation with Dr. Armand Aalamian, a family physician and executive director at the Canadian Medical Protective Association. He is a co-author of the article in CMAJ titled, "Five things to know about…Physician incivility in the health care workplace.” Dr. Aalamian reviews the evidence of the pervasive nature of incivility in health care, its detrimental effects on professional relationships, and its direct correlation to patient outcomes. The discussion not only highlights the problem but also proposes actionable solutions, emphasizing, once again, the role of leadership in fostering a culture of civility.

This episode is structured to arm medical professionals with both an understanding of the causes of incivility and the skills to combat it.

For more information from our sponsor, go to md.ca/EC2024 
 Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ 
X (en français): @JAMC 
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The CMAJ Podcast is produced by PodCraft Productions

Confronting the high stakes of incivility in health care

On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole closely examine anorexia nervosa in male adolescents, a topic that frequently escapes notice. Their discussion highlights the disorder's prevalence, especially among high-risk groups like LGBTQ+ individuals and those from varied racial and ethnic backgrounds. It also underscores the severity of anorexia nervosa in young males and stresses the critical need for early recognition and intervention. This episode features an in-depth conversation with Sterling Renzoni, a fourth-year biochemistry student at Trent University, who shares his personal journey through diagnosis, treatment, and recovery from anorexia nervosa. Sterling's narrative provides valuable insights into the complexities of identifying and treating the disorder in males, highlighting the societal and personal challenges that can impede recognition and care. 
Next, Drs. Omole and Bigham speak with Dr. Basil Kadoura, an adolescent medicine physician at BC Children's Hospital and the lead author of the article in CMAJ entitled, "Anorexia nervosa in adolescent males." He discusses diagnostic challenges, the distinct clinical presentation in males versus females, and the need for tailored approaches for effective treatment. Kadoura's insights contribute to a nuanced understanding of anorexia nervosa's impact on male adolescents and the critical role of healthcare professionals in facilitating early intervention and support.

This episode is structured to provide medical professionals with a deeper understanding of anorexia nervosa in male adolescents, underscoring the need for awareness and specialized care approaches. It serves as a resource for clinicians seeking to enhance their diagnostic and treatment strategies for this often-overlooked condition.

 This podcast has been sponsored by the Yarmouth Region Medical Professional Recruitment Partnership. Click here for more information.


 Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ 
X (en français): @JAMC 
Facebook
Instagram: @CMAJ.ca 

The CMAJ Podcast is produced by PodCraft Productions

Diagnosis and treatment of anorexia nervosa in adolescent males

On this episode, Dr. Blair Bigham and Dr. Mojola Omole explore a clinical case involving a rare infection in a returned traveler, highlighting the critical role of travel history in diagnosing unusual diseases. They discuss the case of a woman in her 60s who presented with fever and ankle pain after returning from India. Initial concerns for septic arthritis led to further investigation when standard treatments failed to alleviate her symptoms. Dr. Mara Waters is the lead author of the clinical case entitled “Melioidosis with septic arthritis in a returning traveller,” published in Canadian Medical Association Journal (CMAJ). She details the steps the infectious diseases team took to ultimately identify the infection as caused by Burkholderia pseudomallei. Dr. Waters, an infectious diseases fellow at the University of Toronto, describes the challenges of diagnosing and treating melioidosis, emphasizing the importance of considering travel history and the evolving geography of infectious diseases. She highlights the broader implications of climate change on the spread of infectious diseases and the interconnectedness of human, animal, and environmental health. 
 Following the case discussion, Dr. Jeffrey Pernica, a specialist in infectious diseases and tropical medicine, offers a refresher on common infections in returning travelers, such as malaria, dengue, and typhoid. He stresses the importance of considering these more prevalent conditions when evaluating a returning traveller with fever, providing practical advice on diagnosis and management. 
 This episode serves as a reminder of the complexities of diagnosing travel-related infections and the need for clinicians to be vigilant about travel history, especially in the context of global travel resurgence and the impacts of climate change on infectious disease patterns. 
 Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ 
X (en français): @JAMC 
Facebook
Instagram: @CMAJ.ca 

The CMAJ Podcast is produced by PodCraft Productions

Diagnosing rare and common infections in returning travellers

On this episode, Dr. Blair Bigham and Dr. Mojola Omole explore two articles in CMAJ focused on the critical importance of trust in the health care system. They speak with Louis Lochhead, who shares his experiences navigating the health care landscape as a caregiver after his wife's serious accident, which resulted in a coma lasting nearly two months. Lochhead highlights the difficulties in building trust with the medical team, pointing to challenges in communication and empathy. He recounts moments where the lack of clear, compassionate communication from health care providers compounded the stress and uncertainty of the situation, leaving him feeling isolated and disconnected from the decision-making process regarding his wife's care. Next, Dr. Omole and Dr. Bigham speak with Dr. François Lamontagne, an intensive care specialist, who offers insights into how health care professionals can better connect with families and build trust, especially when faced with uncertain diagnoses or prognoses. He emphasizes the importance of acknowledging the inherent unpredictability of medicine and the value of being transparent about known facts and areas of ambiguity. Dr. Lamontagne suggests that by engaging in open, honest dialogues that respect the family's perspective and concerns, health care providers can create a more supportive environment that encourages shared decision-making. This approach not only helps in building trust but also empowers families during challenging times, making them feel valued and part of their loved one's care journey.

This podcast has been sponsored by MD Financial Management. Click here for more information.  


 Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ 
X (en français): @JAMC 
Facebook
Instagram: @CMAJ.ca 

The CMAJ Podcast is produced by PodCraft Productions

Building patient trust in health care

On this episode of the CMAJ Podcast, Dr. Catherine Varner, deputy editor of CMAJ, sits in for Dr. Blair Bigham and joins Dr. Mojola Omole to explore two articles published in the journal that highlight troubling findings concerning the treatment of opioid use disorder. They begin with a study that revealed significant gaps in treatment for opioid overdose patients, where only 5.5% received opioid agonist therapy within a week of their hospital visit. This comes five years after the release of guidelines for opioid use disorder management in Canada, which recommended starting opioid agonist therapy, specifically Suboxone, in patients with opioid use disorder. One of the paper’s co-authors, Dr. Jessica Kent-Rice, a PGY5 resident in emergency medicine and toxicology fellow at the University of Toronto, dissects the complexities of treating opioid use disorder in the emergency department and makes a passionate plea for physicians to increase their prescriptions of these life-saving therapies.

 Transitioning to the second article, the hosts examine the presence of xylazine, a veterinary sedative, in the illicit opioid supply. Dubbed the "zombie drug" due to its effects on people's skin and prolonged effects during overdose, xylazine is raising alarm bells among emergency physicians. However, the article's co-author, Dr. Peter Wu, an internist and clinical pharmacology and toxicology physician at the University Health Network in Toronto, advocates for a balanced response. He cautions against excessive concern, noting that treatment continues to revolve around providing supportive care. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X @BlairBigham and @Drmojolaomole

X (in English): @CMAJ 
X (en français): @JAMC 
Facebook
Instagram: @CMAJ.ca 

The CMAJ Podcast is produced by PodCraft Productions

Time for a reset: menopause and hormone replacement therapy

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