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The External Parts of the Male Reproductive System

The reproductive system of both males and females are specialized in function and that they only work with the specific gender they are given to.  While the female reproductive system is more complex as it houses the environment a fertilized egg will grow into, the male reproductive system is in no way a simple one as well.  Perhaps, the most visible difference of the male reproductive system to that of the females is that the male have an external protruding structure.  This external structure is situated outside of the body and consists of the penis, the testicles, and the scrotum. Read more…

What's in the news: Apr. 1 -- Journal stirs up Gaza-Israel trouble

BREAKING NEWS: All 10 provincial and three territorial governments announced that, in light of a comprehensive "common sense" review, they will enact the following reforms immediately:

  • jointly funded pensions will be made available for private-practice physicians;
  • billing codes will be created to pay doctors fairly for remote consultations by telephone, email or video uplink;
  • reasonably significant portions of health budgets will be dedicated to disease prevention, health promotion, and chronic disease management;
  • efficient methods of evaluating foreign-trained doctors will be put in place;
  • and compensation will be provided to developing countries whose doctors they recruit to come to Canada.
In other news, federal aviation regulators said pigs will be granted commercial airline pilot licences. Happy April Fools' Day. (And sorry for getting your hopes up.)

And now for the real news...

CMAJ under fire for Gaza articles
Canadian Medical Association Journal editor Dr Paul Hébert implicitly admitted that his journal may not have covered both sides of the story in its two-article coverage last month of the health impact on Palestinians of the recent war in Gaza. [CMAJ editor's note]

After the two articles -- Christopher Mason's "Gaza's health care system crippled before — and after," which described the devastation wrought by Israel's 18-month-long blockade; and "On the ground in the Gaza strip," by Francois Dumont, about a Palestinian doctor and a Palestininan nurse (pictured right) who treated patients in Gaza City throughout the war -- were published in the March 17 issue, 240 letters poured in over just a few days, many expressing outrage that the journal had seemed to focus on the deaths and injuries to Palestinians in Gaza without contextualizing the matter by also describing the deaths and injuries to southern Israelis caused by rockets fired from Gaza.

The balance of the letters, many of which were written by physicians, scolded the journal for publishing what one person called "Palestinian propaganda" and what others saw as a willful ignorance of Hamas's role in creating the dangerous medical conditions in Gaza. Some letter writers, albeit fewer in number, commended the CMAJ editors for publishing the "ghastly truth." (You can read all the letters here and here.)

Alberta health reforms struggling
New data showed that wait times have lengthened over the past year in Calgary for emergency care, surgeries and longterm care placements. [Calgary Herald]

"Things have deteriorated substantially in recent months," said Dr Tom Noseworthy, a wait times expert from the University of Calgary. "It's at an all-time low for me. I've never seen it like this."

The problems' growth complicates claims the provincial government made last year when it unveiled sweeping reforms to the province's health governance structures, particularly its decision to abandon regionalized administration in favour of a single centralized decision-making body based in Edmonton. "There needs to be a massive and quick infusion of new people into the healthcare workforce in the province of Alberta," then Alberta Liberal health critic Dave Taylor told me at the time. "Just rearranging the board governance system doesn't address that — it's like rearranging the deck chairs on the Titanic, when in fact somebody should be grabbing the wheel and changing course." [National Review of Medicine]

Ken Hughes, the chair of the new "superboard," said to the Calgary Herald of the new statistics, "Some measures... in health care were at least as good as they were a year ago... There are some that are not as good. We're not happy about that."

The Calgary Herald's editorial board rebuked Mr Hughes's optimism that things would soon improve in Calgary. "A risky operation gone wrong" was the description the editorial board applied to the "deregionalization" plan. "Why has the province gone down this road, reversing a system that was working? The Alberta model was a success, it's been copied by other provinces and has received international recognition. [...]

"Health Minister Ron Liepert said: 'I never anticipated in the first year or even the first couple of years that we would actually see improvements on the front line.'

"There is a vast difference between seeing no improvements and having health-care outcomes plummet. For those Albertans unlucky enough to need a system they have paid into their whole lives at this time of transition, Liepert's comments must be sickening." [Calgary Herald editorial]

Kelowna cancer test controversy
A controversy has exploded in BC about what some claim are over one year's worth of potentially botched breast cancer pathology tests in Kelowna. [AM 1150] Dr Kirk Ready, who was lab chief at the Interior Health Authority until he resigned last year, wrote a letter last month in which he described conditions at the lab as "filthy" and some of the practices employed by the lab as "jaw-dropping."

"In the worst episode that I became aware of, 19 bodies were being stored in the [Kelowna General Hospital] morgue," he wrote in his letter. "The cooler only held 12 bodies, required that staff rotate the bodies in and out of the cooler to slow decomposition."

Interior Health officials are now reviewing cases from that time period and will issue a full report soon. Pressed for a full investigation, Health Minister George Abbott demurred, maintaining that "No inaccuracies have been found." [Globe and Mail] [Vancouver Province] Dr Ready has refused to back down from his claims despite Mr Abbott's comments. [Vancouver Sun]

Dr Ready guessed that there could be as many as 109 patients affected by problems at the Kelowna laboratory, and also claimed he had been told to keep quiet about problems there during the current election campaign. [Kelowna Daily Courier]

If there are indeed systemic problems in Kelowna, this would become the fifth major incident over the last several years in which Canadian pathologists or laboratories have been faulted for committing multiple errors. Recent incidents have arisen in Newfoundland and Labrador, New Brunswick, Ontario and Manitoba. [National Review of Medicine]

BC docs reach accord with government
92% of BC physicians who voted approved the new two-year agreement with the provincial government. "I thank the BC Medical Association for focusing their efforts on targeted health system improvements that will continue to make British Columbia’s world-class health system even better," said Health Minister George Abbott. [Government of BC news release]

The agreement will add $180 million in new funding for physicians over the next two years, though only a small portion will go towards doctors' fee increases. In each of the next two years the agreement will give BC physicians just 0.5% fee increases, intended to offset rising overhead costs. (As a point of comparison, consider that the Canadian dollar's inflation rate is currently 1.4%.) The remainder of the money will be distributed to doctors depending on their age, their practice's location (rural or not), and their specialty, in an effort to increase recruitment and improve retention.

"In these tough economic times, we’re pleased that the emphasis on physician recruitment and retention in B.C. remains a high priority for government," Dr. Bill Mackie, the president of the BC Medical Association, said in the government's press release. "This is a good agreement that will help fill the void in many areas of the province that lack GPs and specialists."

Green and unclean
Quebec Ministry of Health officials warned that some of the environmentally safe disinfectant products used by 70% of Quebec healthcare facilities are not sufficiently powerful to protect patients and practitioners. Some experts have blamed the problem on a lack of regulation of manufacturers of disinfectants. [National Post]

Is Chaoulli a straw man?
The Supreme Court of Canada's 2005 Chaoulli decision, which overturned Quebec's ban on private insurance for certain surgeries when long wait times exist, was described across the country as a major blow to restrictions on private health insurance. But in the intervening years, no insurance companies have sold any such surgical policies in Quebec. Health Minister Dr Yves Bolduc attributed that to the government's success at reducing wait times. "We have such a good access to the surgeries in Quebec, that the industry knows they won't be able to sell any insurance to anybody," he told CBC News. [CBC News]

Teen psych care at issue in NS
Nova Scotia's Progressive Conservative Health Minister Karen Casey sparred with NDP health critic Dave Wilson last week over Mr Wilson's accusation that excessively long wait times for adolescent mental health services are the fault of the government's poor planning. [CBC News]

Agent Orange pay protest
Widows of military veterans from CFB Gagetown, in New Brunswick, protested the federal government's compensation package for victims of Agent Orange exposure. The widows cannot receive compensation for their husbands' exposure because their husbands died before the date established by the government as an eligibility cutoff. [CBC News]

College was right in cosmetic surgeon case, review finds
Ontario's Health Professions Appeal and Review Board declined to find fault with the decision by the College of Physicians and Surgeons of Ontario's complaints committee last year that the general practitioner Behnaz Yazdanfar had not violated any of the college's policies by performing cosmetic surgeries. The review was requested by Dr Terry Polevoy, of Waterloo, who initially complained to the CPSO about Dr Yazdanfar marketing herself as a cosmetic surgeon in 2006. "I am deeply disturbed by their ruling," said Dr Polevoy in an email to reporters. "Is their [sic] nobody at any level who will take responsibility for what happened. There are no appeals to be made above HPARB. This is unforgivable."

In 2007, one of Dr Yazdanfar's patients died after a liposuction procedure [National Review of Medicine], which provided the impetus for changes in the way the CPSO regulates GPs who perform cosmetic surgeries. [Canadian Medicine]

Miracle drug or mediocre shrug?
A five-in-one cardiovascular drug made in India called Polycap, about which a study led by McMaster University researchers was published in The Lancet on Monday, has got reporters around the world worked up into a tizzy of excitement.

The 12-week study, conducted on 2,053 people in India, showed that low-dose Polycap -- a once-daily pill containing 12.5mg thiazide, 50mg atenolol, 5mg ramipril, 20mg simvastatin and 100mg aspirin -- reduced blood pressure, LDL cholesterol levels and heart rate, and the researchers theorized that the drug could be used to prevent cardiovascular problems. [The Lancet abstract]

Among the researchers' claims was that the polypill could potentially decreased the risk of suffering heart disease by 62% and of having a stroke by 48. [McMaster Daily News] Because the trial was just 12 weeks long, however, those numbers are extrapolations based on the short-term findings.

McMaster's Dr Salim Yusuf, the principal investigator of the study, presented the results at the American College of Cardiology's annual meeting in Orlando on Monday. The drug, he said, would "certainly revolutionize heart disease prevention as we know it." [Hamilton Spectator]

University of Minnesota health journalism professor Gary Schwitzer, though, called much of the lay media's enthusiasm "hyperbole" and "very premature." [Schwitzer health news blog] He pointed to the Associated Press's more balanced coverage, which warned of dosing problems, as well as the notion that we should treat people for heart disease before they show any signs of needing treatment for it. [Associated Press]

Evidence-based researcher wins award
Receiving a Gairdner Wightman award on Tuesday for his leadership in Canadian medicine, McMaster epidemiology professor Dr David Sackett dedicated the award to "to every patient who has ever been put at a disadvantage because of medical ignorance and arrogance." [Toronto Star]

Charity appeal from Canadian medical aid group
The "Donate a Day for Africa" campaign asks physicians to donate their income for April 7 to support Canadian Physicians for Aid & Relief's work in rural Africa. Last year 110 health professionals donated more than $70,000. This year CPAR's goal is to get more than 200 health professionals to contribute $140,00. Early donations have already come in from 118 people, for a total of $52,572. [Donate A Day For Africa]

"In these challenging times..."
The recession has presented a tough advertising challenge for Montreal plastic surgeon Arie Benchetrit. On April 7, he'll be discussing "how to maintain a youthful appearance at a relatively low cost in these challenging times." (Relatively being the operative word, of course.) There's no need to worry about the "imagined" cost, he suggests: Botox goes for under $400 and microdermabrasion for the low, low price of $150! "Looking good," crowed his Cosmedica clinic's press release, "doesn't have to be expensive!" [Cosmedica news release]

Every last one?
The US Preventive Services Task Force recommended screening all teenagers -- with or without symptoms -- for depression. [Associated Press]

Pharmaceutical firepower
Merck allegedly sought to discredit physicians who questioned the safety of its since-withdrawn painkiller Vioxx. "We may need to seek them out and destroy them where they live," wrote one Merck employee in an email exposed in an Australian court. [The Australian]

Medical mistakes in Boston
A special issue of Grand Rounds all about medical errors is online at Running a Hospital, the blog of Paul Levy, the president/CEO of the giant Beth Israel Deaconess hospital in Boston. [Running a Hospital]

Coincidentally (I think), Boston surgeon Loren J Borud received the dishonour of being named the Poster Child of Medical Malpractice 2009 by the Thai website YOxyz, to commemorate his achievement of falling asleep while performing surgery at Beth Israel Deaconess Medical Center, leaving his patient with a number of complications. [YOxyz] [Boston Globe]

Constant aaaarghs
The formula for calculating a general practitioner's anguish:
"A=P(LxVx1,000/T)+F+M+H, where A is anguish in Aaaarghs!, P is the number of annoying things the patient says (while I’m here, I don’t know where to start, there’s just one more thing, and so on), L is how late you’re running, V is the number of visits allocated to you that day, T is the previously calculated time available per item, F and M are constants of 100 Aaaarghs! each, added if it’s Monday morning or Friday evening, and H is the number of days since your last holiday."
That's from the hilarious and uproarious British doctor-blogger who goes by the pseudonym Copperfield. [Pulse]

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9 comments:

  1. sharon2 April, 2009 10:35 AM

    RE: Aaargh!

    In BEDMAS we know you "take care of what's in the brackets FIRST" :)

    Delete
  2. sharon2 April, 2009 10:37 AM

    RE:
    Careful comments made about Israeli/anything conflicts

    "Pray for the peace of Jerusalem ...as an act of obedience"

    Nothing careful about that comment, folks!

    Delete
  3. Sam Solomon2 April, 2009 10:51 AM

    Sharon,

    RE: Aaaargh formula

    Good point.

    But as a fairly regular reader of Doc Copperfield I can tell you that patient advocates should just thank heavens he didn't make the variable P (annoying things the patient says) a geometric multiplier rather than a linear one. He exercised quite a lot of restraint in drafting his formula.

    Delete
  4. sharon2 April, 2009 12:30 PM

    hahahaha, Sam....

    just remember the exponents ( geometric multipliers) are the "second" step....... :)

    Delete
  5. Sam Solomon2 April, 2009 12:37 PM

    I admit my algebra is more than a little rusty. I do, however, recall something about apologizing on behalf of my dear aunt Sally. PEMDAS.

    Delete
  6. sharon2 April, 2009 12:58 PM

    Sam... are you an American? We Canucks don't use PEMDAS

    Delete
  7. Sam Solomon2 April, 2009 1:24 PM

    I'm Canadian but I was educated in the U.S. through high school, where we were apparently taught bastardized versions of mnemonics for the order of operations. Please Excuse My Derivative American Schooling.

    Delete
  8. sharon2 April, 2009 3:39 PM

    forgiven.....

    speaking of mnemonics ...and cryptic writing styles :) ... can't believe no one picked up on the OOOTTAFAGVAH re-interpretation in the neurology post

    :( ... one can only hope

    Delete
  9. Anonymous23 August, 2009 9:43 AM

    Why publish information concerning the antics of Terry Polevoy?

    Polevoy's pathology includes making false and vexatious complaints to regulators. Findings are always in favour of the defendant...

    Perhaps the real story is Polevoy's chronically disgraceful and unprofessional behavior.

    Delete

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