Just Medicine
By Just Medicine Podcast
This podcast is not affiliated with UBC Faculty of Medicine and is not meant to provide medical advice.
Just MedicineJan 12, 2023
12. Migrant Farm Worker Health Part 1: Providing Care for Migrant Farm Workers in British Columbia
Many Canadians may not realize that the apples in their fruit basket or the flowers brought home to family may be there because of the contributions of a migrant farm worker (MFW) to the nation. Despite having such a significant impact on the Canadian agricultural landscape, MFWs face inequities in health care access and delivery across the country. In this two part series, Sebastian Lopez Steven, (UBC MSI 2) engages with healthcare workers that provide care to these individuals in British Columbia. Join us for enlightening conversations regarding the major health issues for MFWs and how to bring care to these individuals in a culturally competent manner.
Episode 1 focuses on a chat with Christelle Kuenzig, a nurse practitioner who provides care for MFWs in the Lower Mainland of British Columbia. We chat with Christelle about a general approach to healthcare provision in this population and what needs to change to ensure equity for MFWs across the province and the country.
Resources for the listener
1. Overview of the Seasonal Agricultural Worker Program (SAWP) as part of the temporary foreign worker framework in Canada: https://www.canada.ca/en/employment-social-development/services/foreign-workers/agricultural/seasonal-agricultural.html
2. Salami, B., Meharali, S., & Salami, A. (2015). The health of temporary foreign workers in Canada: A scoping review. Canadian Journal of Public Health, 106(8), e546–e554. https://doi.org/10.17269/CJPH.106.5182
3. Istiko, S. N., Durham, J., & Elliott, L. (2022). (Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand. International Journal of Environmental Research and Public Health, 19(5). https://doi.org/10.3390/ijerph19052981
11. Reproductive Health Part 3 - Rural Pregnancy Care with Dr. Sheila Curran
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
10. Reproductive Health Part 2 - Cervical Cancer: A Preventable Disease Rooted in Inequity with Dr. Lauren Adolph
We are BACK with an exciting new conversation!!
Did you know that cervical cancer is a preventable disease? In this episode, Dr. Lauren Adolph and I discuss the importance of prevention and screening when it comes to cervical cancer, as well as why certain populations are disproportionately impacted by this condition. Tune in to learn more about this unique disease, the actionable barriers standing in the way of its eradication, and exciting new screening programs being implemented in Canada.
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
9. MAiD for Mental Health Series Part 2 - Exploring the Positive Outcomes
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
7. Reproductive Health Part 1 - Access to Contraceptives with Dr. Yuyang Wang
We're back again! As the first episode of a multi-part series on women's health, this month's episode addresses Access to Contraceptives in Canada.
Listen in as expert guest speaker Dr. Yuyang Wang brings his enthusiasm, expertise and knowledge to the table. We've got a jam-packed episode ready for you, as we dive into topics including cost barriers, rural-specific factors, the importance of education, and other special considerations that can impact the accessibility of contraceptives.
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
"Sex & U" - Resource for sexual and reproductive health (by the Society of Obstetricians and Gynaecologists of Canada):
Global Contraception Policy Atlas (2023 version):
https://www.srhrpolicyhub.org/region/?region=can
8. MAiD for Mental Health Series Part 1 - Exploring Equity Considerations
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
6. Taking a Good Substance Use History with Dr. Elise Jackson
We're back with another episode and this month we're focusing on one of the most important skills we learn in medicine, history taking! Specifically in this episode we focus on taking a good substance use history while remaining sensitive and providing patient-centred care. Please see below for the terms we discussed in episodes. Enjoy!
Terminology (Terms can change over time and they are usually regionally specific, so this list is most specific to the West Coast)
Substance names
- Up = Stimulants (Usually cocaine, in powder or crack form)
- Down = Opioids (Not specific to a single opioid, but usually in BC refers to fentanyl)
- Side = crystal methamphetamine (or crystal)
- Combinations:
- Speedball = cocaine and opioids
- Goofball = Crystal meth and opioids
Quantity of substance
- A Point = 0.1 gram
- 8 ball/a ball = 1/8 of an ounce = 3.5 g
Route of Injection
- Smashing = inject in any form (IV, IM, SC)
- Muscling = intramuscular injections
- Skin popping = subcutaneous injections
- Jugging = injection directly into the jugular vein
5. Reframing Encounters and Partnering with Patients - Trauma Informed Care
4. Gender Affirming Care Series Part 2 - What does "transitioning" mean?
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.
Resources and References:
Trans Care BC Primary Care Toolkit (Updated March 2023): www.phsa.ca/transcarebc/Documents/HealthProf/Primary-Care-Toolkit.pdf
Trans Care BC Testosterone Consent: www.phsa.ca/transcarebc/Documents/HealthProf/pctoolkit-testosterone-consent.pdf
Trans Care BC Estrogen/Testosterone Blocker Consent: www.phsa.ca/transcarebc/Documents/HealthProf/pctoolkit-estrogen-testosterone-blocker-consent.pdf
3. Gender Affirming Care Series Part 1 - Healthcare experiences of trans and gender diverse people
In the first episode of this special multi-part series on Gender Affirming Care, I chatted with 3 special guests who are advocates for inclusive trans care. Rae, Lucas, and Dr. Thompson all bring their own experiences and perspectives in how medical trainees can engender (pun intended) change in medical education with respective to gender affirming care.
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.
Resources and References:
- Trans activist leaving Canada https://www.cbc.ca/news/canada/london/sorrenti-trans-activist-leaving-canada-1.6559289
- WHO definition of Gender Affirming Care https://www.who.int/standards/classifications/frequently-asked-questions/gender-incongruence-and-transgender-health-in-the-icd
- Trevor Project Youth Mental Health Survey https://www.thetrevorproject.org/survey-2020/?section=Introduction
- Mental Health Disparities Among Canadian transgender youth https://pubmed.ncbi.nlm.nih.gov/28007056/
- Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436369/
- Dr. Thompson’s article in Perspectives on Medical Education about teaching a Gender Affirming Care Framework https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600495/
- Broken Arm Syndrome https://pubmed.ncbi.nlm.nih.gov/36736052/
- Injustice at Every Turn: A Report of the National Transgender Discrimination Survey https://transequality.org/sites/default/files/docs/resources/NTDS_Report.pdf
- Trans-misogyny https://www.juliaserano.com/av/TransmisogynyPrimer-Serano.pdf
- Racialized Equity Labor: https://academic.oup.com/socpro/article-abstract/67/2/286/5488730?redirectedFrom=fulltext
Bonus: The power of words in Gender Affirming Care
Enjoy this bonus episode discussing some introductory terms and concepts to be familiar with as we kick off the Gender Affirming Care series! In the next few months, we will be exploring different facets of gender inclusive care with a variety guests from different backgrounds and lived experiences.
Producer's note: the accompanying episode will be released on Thursday, Mar 9.
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.
2. BMI is not what you think it is: Health At Every Size
Producer’s note: The audio for this episode is a bit unstable at times, so apologies for that in advance.
In this episode, I chatted with Dr. Katarina Wind, a recent Family Medicine graduate and a weight-inclusive practitioner about weight and fatphobia in healthcare. We talked about the history and application of BMI to medicine, her personal journey with weight perception, and how to approach discussions around weight with patients. The sources from the introduction are included below.
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
SourcesReferences
- Rathbone, JA, Cruwys, T, Jetten, J, Barlow, FK. When stigma is the norm: How weight and social norms influence the healthcare we receive. J Appl Soc Psychol. 2020; 00: 1– 17. https://doi.org/10.1111/jasp.12689
- Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33. doi: 10.1037/0003-066X.62.3.220. PMID: 17469900.
- Loveman E, Frampton GK, Shepherd J, Picot J, Cooper K, Bryant J, Welch K, Clegg A. The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health Technol Assess. 2011 Jan;15(2):1-182. doi: 10.3310/hta15020. PMID: 21247515; PMCID: PMC4781196.
- Lee JA, Pausé CJ. Stigma in Practice: Barriers to Health for Fat Women. Front Psychol. 2016 Dec 30;7:2063. doi: 10.3389/fpsyg.2016.02063. PMID: 28090202; PMCID: PMC5201160.
- McPhail D, Orsini M. Fat acceptance as social justice. CMAJ. 2021 Sep 7;193(35):E1398-E1399. doi: 10.1503/cmaj.210772. PMID: 34493569; PMCID: PMC8443289.
- https://www.brown.edu/news/2016-12-12/famine
- https://www.huffingtonpost.co.uk/entry/south-asian-health-colonial-history_uk_620e74fee4b055057aac0e9f
- https://obesitycanada.ca/guidelines/weightbias/
- https://thischangedmypractice.com/why-i-no-longer-prescribe-weight-loss/
- https://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.html
1. The Art of Medicine in Mental Health and Substance Use
In this episode, I chatted with Dr. Marcus Greatheart, a family physician and social worker, who works with a large population of patients with mental health and substance use issues. We talk about the importance of recognizing our privilege and how we can walk alongside our patients.
If you have any questions or want us to cover a specific topic, email us at justmedicinepod@gmail.com.
Dr. Greatheart’s resources
- Trans Pulse Study: https://www.cmajopen.ca/content/9/4/E1213.short
- Serious Illness Conversation Guide (Ariadne Lab): http://www.bccancer.bc.ca/new-patients-site/Documents/SeriousIllnessConversationGuideCard.pdf
- Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference by Stephen Trzeciak and Anthony Mazzarelli
- Cleveland Clinic R.E.D.E to Communicate model of communication in Healthcarre: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513605/
Introduction References
Podcast Trailer: Welcome to Just Medicine
Welcome to Just Medicine! Here, we mean “just” in the fairness capacity and not in the “only” sense. In fact, this podcast is not “just” about medicine but how medicine is applied and adapted to the real-world conditions of our patients. This is a student-led podcast created by medical students for medical trainees. We will be bringing episodes to you monthly, where we sit down and chat with a guest about a social justice topic that they are passionate about.
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