“This isn’t only about contraception — this is about managing periods and other symptoms that can come with hormonal changes,” Dr. Jacqueline Gougeon said at a news conference Thursday with Health Minister Uzoma Asagwara, Families Minister Nahanni Fontaine, most of the women in the NDP caucus and health-care professionals.

To read the full story, please visit Winnipeg Free Press. 

A researcher might say it’s a combination of academic training and empirical study.

On the other hand, a patient might say you can’t truly understand what it means to live with an illness unless you’ve actually had it.  

Screenshot of Bryn Robinson, co-host of “As PER Usual”

For podcast co-hosts Dr. Anna Chudyk and Bryn Robinson, the answer is actually somewhere in the middle. Their new podcast, “As PER Usual: A podcast for practical patient engagement,” is encouraging researchers to include patients and caregivers as a key part of their research teams to get the fullest picture possible.

The podcast is intended as a place where academics and members of the research community come together with patients and caregivers with experience helping conduct research (patient partners).  Together, they discuss how those with first-hand experience can bring their unique perspective to a field that was traditionally the purview of scientists alone.

“That’s where patient engagement is pushing the envelope,” said Chudyk, assistant professor of  family medicine, Max Rady College of Medicine. “It’s acknowledging that lived expertise is very much a form of expertise, just like scientific knowledge.”

Offered bi-weekly in both audio and video formats, the podcast engages academic researchers and patient partners in conversations about the work they are doing to progress patient engagement in research.

“The patient’s traditional role in research has been as a research subject,” said Chudyk. “Patient engagement is trying to turn that concept on its head and instead have patients as active partners in the research process. We want to think about not only what the science says, but also what patients and caregivers say are the actual research questions and the outcomes we should be looking at.”

The podcast began as the knowledge translation piece of a research study on patient engagement in research co-led by  College of Nursing professor Dr. Annette Schultz and patient partner Roger Stoddard. “We wanted to get our findings out beyond just the typical academic mediums,” said Chudyk.

“I hope that we can reach folks that maybe want to learn more but haven’t yet had the opportunity,” said Robinson, co-host and research engagement manager with Horizon Health. “I’m especially thinking of younger/newer researchers who need the support to do this work, especially grad students and new patient partners who may not be familiar with engagement and aren’t sure about navigating existing institutions that pose barriers.”

For both Chudyk and Robinson, podcasting is a new approach to sharing their work. Despite the learning curve of working in a new medium, they’re excited about reaching out to both patients and academics. “We’re trying to have as broad an audience as possible,” said Chudyk. “We hope to not only spread awareness about our findings, but also be a medium that people can turn to if perhaps they’re curious about patient engagement in research or they’re actively involved in it as well,” said Chudyk.

“I want more people to feel empowered to do this work, to know that there are others who are doing it who can help can guide you,” added Robinson. “I want to see it become the standard – you know, as PER usual.”

For many patients struggling to get an appointment with their primary care provider, the answer is better access.

The University of Manitoba department of family medicine, in partnership with Shared Health, is working to reduce wait times and improve patient access through an innovative new program featuring eight workshops and modules along with a mentored project.

The Access Improvement Model (AIM) program is helping primary care clinics put their own practices under the microscope to find out what’s working – and what isn’t.

“We’ve brought everyone together on this,” said Teri Greenwood, primary care manager for ACCESS Fort Garry, one of two pilot sites engaged in the new program since January. “It’s not just about the doctor and the patient,” said Greenwood. “It’s about everything in between.”

From the front-desk staff and physician assistants to nurse practitioners and the clinic’s physicians, ACCESS Fort Garry has been working with the AIM team to think through how they deliver care, right from when a patient makes an appointment to when they arrive in the examination room.

“It’s really helped us to assess what we’re doing and why we’re doing things,” said Greenwood.

Apple Qin, an improvement specialist with the Max Rady College of Medicine department of family medicine and one of AIM’s facilitators, said clinics often want to jump straight to solutions. “When there are too many people calling the clinic phone, the clinic might just think of adding more people at reception or increasing the number of hotlines,’” said Qin. “But sometimes that’s not the answer.”

A thorough evaluation of the clinic itself can go a long way, she said. Where needed, additional training is included for all staff members. “We teach them about different technologies, process improvement, skill sets, tools and methodologies,” said Qin.

At Access Ft. Garry, they’ve already made changes like adding information screens to the clinic and ensuring all team members have access to updates and clinic news.

They’re currently engaged in a longer-term project to identify what barriers patients might be facing when they book an appointment but don’t come in.

So far, Greenwood says the hardest part of the process is the time commitment.

“There’s a lot of demand for health care and our focus is providing care to patients,” she said. “But this process has made us take the time to stop and assess. It’s really been worth it.”

Ultimately, Qin would like to see a culture of continuous improvement in clinics across the province, supported by the AIM program. “We want to bring as many new clinics on board as possible,” she said. “We’re here to facilitate and help them along the way.”

For more information, contact aim@umanitoba.ca or visit the program’s website.

Café Scientifique brings experts together with non-researchers for a discussion about the questions their work has raised for a non-research audience. Café is sponsored by the office of the vice-president (research and international) VPRIO and is a part of the Learning for Life Network.

“Our Café presentations this year were an engaging and insightful look into some of the extraordinary research breakthroughs that take place every day at UM,” says Annemieke Farenhorst, associate vice-president (research). “Researchers are working to improve the lives of people in our communities, and Café is a wonderful opportunity to share this progress with the public. I want to extend my gratitude to the researchers and content experts who presented this year, as well as everyone who joined us and asked questions in-person and online.”

All Café Scientifique presentations are permanently featured on the University of Manitoba Youtube channel:

Technology for Healthcare Service and Public Input, Feb.22, 2023 – Understanding patient experiences, perspectives, and outcomes is critical to improving healthcare services and how it is delivered. Today, input from patients informs new developments in technology that provide a more person-centered and accessible healthcare experience for all.

Featuring UM researchers: Alanna Baldwin, Gayle Halas, Jennifer Henzel, and special guest Sarah Kirby from the George & Fay Yee Centre for Healthcare Innovation.

Time is Brain: Preventing, Treating, and Recovering from Stroke, March 15, 2023 – As part of International Brain Awareness Week and in conjunction with the Manitoba Neuroscience Network, UM researchers highlighted new methods to identify those at highest risk, and innovative rehabilitation techniques to help patients recover from stroke, third leading cause of death in Canada.

Featuring UM researchers: Jillian Stobart, Jai Shankar, Amir Ravandi, & Ruth Barclay.

Racism and COVID-19: Understanding Racism during the pandemic in Canada, USA and Mexico, March 29, 2023 – During the COVID-19 pandemic, an international team of researchers led by experts at the University of Manitoba examined conditions that contributed to a rise of racism across North America.

Featuring UM researchers: Lori Wilkinson, Jeremy Patzer & Kiera Ladner.

Wellbeing in Youth: Supporting Teens with Higher Body Weight, April 26, 2023 – Teens with higher body weights face a significant risk of mental health difficulties, due to the complex intersections of weight-related stigma and other related adversities.

Featuring UM researchers: Leslie Roos, Jon McGavock, Emily Cameron, and special guest Mae Santos, Registered Dietitian.

Windows on the Universe, May 10, 2023 – We have entered a new era where astrophysicists and nuclear physicists can work in concert to piece together the puzzles that astrophysical observations present. Physicists and astronomers are exploring new frontiers in understanding the ultra-small and mega-large in this next era of precision astrophysics.

Featuring UM researchers: Kyle Shiells, Juliette Mammei, Samar Safi-Harb, and special guest Jorge Piekarewicz from Florida State University.

On a Shaky Podium, May 24, 2023 – To address recent allegations of abuse in sporting organizations in Canada, organizations receiving funding from Sport Canada must provide Safe Sport Training to help prevent maltreatment in sport. This extensive toxicity led Canada’s federal Minister of Sport to declare that we are experiencing a safe sport crisis. UM experts are working from legal, pedagogical, psychological, and sociological perspectives to make sport safe(r) for all Canadians.

Featuring UM researchers: Sarah Teetzel, Martine Dennie, Shannon Moore, Lori Wilkinson & Leisha Strachan.

Join us again for the next Café Scientifique season, planned to begin in November 2023.

“We’re trying to deliver 21st-century care with a 1950s model of health-care delivery and funding,” says André Picard. “We have an Edsel, but we need a Tesla.”

Picard, the award-winning health reporter and columnist for The Globe and Mail who is also a bestselling author in the health field, was the guest speaker at a UM gala on May 26 at the Manitoba Museum.

The celebration was held to mark the 50th anniversary of the 1973 founding of the department of family medicine in what is now the Max Rady College of Medicine.

Picard, whose honours include being named Canada’s first Public Health Hero by the Canadian Public Health Association, addressed more than 340 primary health-care providers, educators and guests at the gathering.

The medical system emphasizes sickness care, not health care, Picard said, and as far back as he can remember, it has lurched from crisis to crisis.

“The pandemic didn’t break the health-care system,” he said. “It was already broken.”

Results from the 2022 OurCare national survey estimate that more than one in five Canadian adults – 6.5 million people – do not have a family physician or nurse practitioner they can see regularly for care. Emergency departments are overflowing or closing, and it can take months or years to see a specialist.

In Picard’s view, hope lies in strengthening the all-important primary level of care. “I believe the future of medicine belongs to family medicine,” he said.

Other speakers at the gala described how UM is working hard to be part of this solution. Family medicine – already one of the largest departments in the Max Rady College of Medicine – recently went the extra mile to create an additional 10 residency spaces.

“We reached out to challenge you to say, ‘Who could you take on? What could you do?’” said Dr. Peter Nickerson, vice-dean (health sciences) and dean of the Rady Faculty of Health Sciences. “You did this in the context of coming out of the pandemic, overwhelmed. And yet you still stood up and said, ‘We’ll take more.’”

Manitoba was one of only two provinces that filled all its family medicine residency seats, including the newly created ones, in 2023. “I applaud the department of family medicine for being an integral partner in helping to ensure Manitoba’s strong health-care workforce,” said Health Minister Audrey Gordon.

Dr. José François, head of the department and provincial specialty lead, family medicine, at Shared Health, told the audience, “I strongly believe our department will play an important role in building – and rebuilding – our workforce.

“Over the past 50 years, we’ve had a great track record of stepping up. We’ve demonstrated our ability to provide continuity of care, to build meaningful relationships with patients and families, and [to make] an impact on the health and well-being of our communities.”

The UM department has been a pioneer in rural education for family doctors, François noted. “We established the Parkland residency program 25 years ago,” he said. “It was the first rural residency in the country.”

While the department is based on UM’s Bannatyne campus, over its 50 years the program has grown to include 13 training sites, serving patients as far north as Churchill and as far south as Morden, with Iqaluit to the east and Hay River, N.W.T. to the west. 

In 2018, Dr. Mandy Buss, a 2011 graduate of family medicine’s northern remote stream, was named the first Indigenous health lead for the department. She is helping to guide the next generation of practitioners to ensure cultural safety for Indigenous patients and to work toward reconciliation.

The department has embraced and advanced team-based care through initiatives such as bringing the master of physician assistant studies (MPAS) program under its umbrella. François described MPAS as Canada’s leading physician assistant program.

Some of the department’s latest advances include new programming in its enhanced skills program, with a focus on addressing the addictions crisis. Two new professorships in research are working toward leading-edge quality improvement for residents. And a newly launched peer-support program is underway to combat physician burnout.

“I want to commend all the UM faculty … who play a pivotal role in providing primary care in their communities while serving as teachers and mentors, educating and training the next generation of family physicians,” said Nickerson.

“Everything we learned during the pandemic – like adaptability and fortitude – as faculty members, clinicians, learners, stayed with us. Indeed, it made us even stronger and more resilient.”

The University of Manitoba Rady Faculty of Health Sciences has educated and trained the majority of practicing family physicians around the province and it is an honour to celebrate the department of family medicine (DFM) on this milestone.

On May 26, 2023, the Department of Family Medicine’s 50^th anniversary gala will take place at the Manitoba Museum celebrating DFM’s leadership and acknowledging partners and communities who have contributed to its success.

The evening will start at 5:30 p.m. with a reception/exploration of the Manitoba Museum galleries, including the Nonsuch Gallery. The gala dinner begins at 7:00 p.m. and will feature a keynote address by André Picard, an award-winning health journalist and columnist at The Globe & Mail who will share his valuable insights on public health issues in Canada.

Ron Paley’s Big Band will provide lively music for the evening. It promises to be an evening of fun, entertainment and inspiration.

Be part of celebrating DFM’s leadership in delivering health-care services across Manitoba for five decades, and look forward to a future with an increased number of primary care physicians meeting the health-care needs of all Manitobans.

With over 300 tickets sold, this is your last chance to purchase individual tickets for the gala – ticket sales close on May 10. Don’t miss out on the opportunity to celebrate the department of family medicine! Get your tickets today through Family Med 50^th anniversary gala  Eventbrite page.

If you can’t make the gala but would still like to support  and celebrate the work of the department of family medicine, the DFM Future 50 Fund  has been established to help address the doctor shortage by recruiting and retaining family physicians and physician assistants, promoting interdisciplinary primary care, and increasing research and innovation to shape the future health system including in areas such as assistive technology and quality improvement.

Gifts to the Department of Family Medicine’s Future 50 Fund will directly impact areas of research and innovation, scholarship, and building leadership capacity within family medicine and across the province.

In addition to her role as mother of three, Anderson is a physician and a clinical teacher with the department of family medicine, Max Rady College of Medicine  at the Rady Faculty of Health Sciences. For her, there were just too many unanswered questions and so little support from the medical community.

But life for her son, Nicholas, meant living with both cerebral palsy and a severe form of epilepsy that caused three to four seizures an hour and medications that left him in a near catatonic state.

“Raising a child who is medically fragile is scary,” said Anderson. Nighttime was the worst since a vomiting seizure could mean choking to death. Getting a full night’s sleep was a thing of the past.

After exhausting all other options, Anderson decided it was finally time to try cannabidiol (CBD), a non-psychoactive compound found in cannabis plants. “I gave him just one drop,” she remembers. “He slept through the whole night.”

She continued the treatment and within a week, she started to notice subtle changes. But the best part was the spark coming back into his eyes. “He’d basically been a zombie.”

Nicholas enjoying a snowy day, skiing with his family.

CBD has been a godsend for Anderson and her family, but she cautions that it’s no silver bullet. “He has good days, and he has bad days.” But instead of spending his time between home and the hospital, Nicholas can now go to school. He’s even gone skiing with his family. 

CBD oil has gained public attention for its potential therapeutic benefits, but in terms of actual research, it’s early days. In Canada, CBD is legal and regulated under the Cannabis Act, which was passed in 2018. Anderson says it’s still not well understood by primary health care providers and it’s not sold in pharmacies, where a patient could receive support and information about potential drug interactions from a pharmacist.

“Having success with something so controversial, and then having nobody that will help you with it, just questions the ethics of what we do,” said Anderson.

She began educating herself, with support from researchers in Montreal and Israel as well as contact with growers willing to share their knowledge. She began slowly incorporating the use of cannabis into her own practice for patients who had not received relief from any other treatment, but soon realized she wanted to get more involved with research.

One of the local researchers she connected with is Dr. Lauren Kelly, associate professor of pharmacology and therapeutics, Max Rady College of Medicine, and the clinical trials director at the Children’s Hospital Research Institute of Manitoba (CHRIM).

“Even before legalization, there were lots of kids receiving palliative care using cannabinoids,” said Kelly, who sat on the Health Canada Scientific Advisory Board for health products containing cannabis. “But no one was studying it. No one was advising them on what products to choose or how much to use.”

To date, Kelly has been awarded more than $2 million to do research on medical cannabis and has three clinical trials with children planned and underway. “Our research program, C4T, has grown so quickly because the interest has way outpaced where we are with the science,” she said. “It’s fueled by passion from parents.”

Both Anderson and Kelly say it’s now time for doctors to catch up – and quickly. “Physicians can’t just say they don’t want to talk about it,” said Kelly. “That’s just pushing frustrated parents to the recreational and legacy market, with uncontrolled products and without oversight. So, by refusing to have an honest and informed discussion with the family in front of you, what you’re saying is that you don’t really care about the safety of their child.”

For more information on Jennifer Anderson’s medical journey with cannabis, visit www.anythingcanhappendoc.com to learn about her documentary “Anything can happen: a look at cannabis in paediatric medicine,” which follows her story as a physician with her son and three of her patients.

According to the Canadian Medical Association’s 2021 National Physician Health Survey (released August 24, 2022), there’s been a sharp increase in the reporting of burnout and even suicidal ideation in the past 12 months (1.7 and 1.5 times higher, respectively) compared with in 2017.

“There is more demand than there are physicians,” said Dr. Jacqueline Gougeon. “There’s that constant pressure to take on more and more, especially since the pandemic.”

Gougeon, a lecturer with the department of family medicine, took on the role of peer support team physician coordinator a year ago. With support from the Well Doc Canada program and Doctors Manitoba, she’s working on a peer support program that will teach physicians how to respond when their colleagues reach out for help using techniques like empathetic listening. “I think it’s really important to move away from treating burnout and managing it to asking how do we prevent it?” said Gougeon.

She knows all too well the toll burnout can take. As a family physician, Gougeon provides low-risk obstetrical and newborn care along with a full family medicine practice. She’s also involved in clinical teaching and is the education director of the bilingual family medicine residency program at the University of Manitoba. In addition, she has her own family, with three young children.

Gougeon remembers being home one evening after a full day when she was called to the hospital. She expected a short delivery for the patient – already a mother of eight – but at 3 a.m. with no end in sight all she could think about was her own exhaustion, both physically and mentally. “I honestly considered quitting obstetrics, thinking this is just not working for me,” said Gougeon. “I can’t do this on top of everything else.”

But when the baby was born and she learned the grateful parents had named their new child after her, the dark cloud started to lift. “Professional fulfillment doesn’t have to come in the form of someone naming a baby after you,” said Gougeon. “But workplace satisfaction is still an important piece of the puzzle.” Research shows that losing that feeling of achievement, of making a difference, is one of the key factors leading to burnout. But she wants to make it clear that this is more than just a personal issue or a lack of resilience in doctors themselves, it’s the result of systemic problems within the medical profession itself. “Making real change is going to take organizational approach and a culture shift.”

Gougeon says leadership’s support for the new peer support program is one step in the right direction. She also points out that it isn’t meant to replace the resources offered by Doctors Manitoba like Physicians at Risk or MDCare. “Reaching out to those services might be a big step for somebody, whereas peer support can be sort of an informal touch base and then figure out together what might be the next steps.”

Gougeon is hopeful the program will offer physicians one more tool in their resilience toolkit and help keep them not just surviving in their roles, but thriving.  The new program is expected to launch in June 2023.

For more information or to learn more about ways to get involved, contact Dr. Jacqueline Gougeon at jacqueline.gougeon@umanitoba.ca.

FOR THE LOVE OF TECHNOLOGY! SEX ROBOTS AND VIRTUAL REALITY
Can human sexual partners be replaced by robots or virtual reality? Just like everything else, sex as we know it is changing with the advancement of technology. Read more.

MICROPLASTICS MAY AFFECT HOW ARCTIC SEA ICE FORMS AND MELTS
We thought we were being sustainable, repurposing plastics into clothing. After making their way north through ocean currents, microplastics may be affecting the Artic food web. Read more.

MEASLES OUTBREAK: WHY ARE ANTI-VAXXERS RISKING A PUBLIC HEALTH CRISIS?
Parents have unlimited access to health information, but it might be providing them with “myth-information.” Read more.

HOW TO THINK YOURSELF INTO A FIT PERSON
Just in time for your New Year’s resolution. Studies show that by adopting an exercise identity, it can become the driver you need to change your lifestyle. Read more.

WHY PARENTS SHOULD NEVER SPANK CHILDREN
What used to be a common form of discipline is now linked to poor outcomes such as mental and physical health problems. Read more.

How do I get my research published, you ask? Faculty, graduate students and postdoctoral fellows can learn more and signup to write an article about their research here.

Conversation Canada is an independent source of news and views, from the academic and research community in Canada, delivered direct to the public. UM is a founding member. A team of professional editors work with experts to unlock their knowledge for use by the wider public.

Dr. Charles Penner, associate dean, Brandon satellite program, Max Rady College of Medicine, said that residents are incorporated into the health-care community and the larger community in a more intensive way than in a larger city.

“Brandon is unique in that almost all of the training in the family medicine program is done in Brandon. Brandon is slightly larger and a little bit more isolated in terms of distance from Winnipeg than some of the other rural teaching centres,” he said. “The learning experience is thus a little broader allowing residents to explore some areas of medicine they may not be able to in the other rural centres; but at the same time, it’s a setting in which the resident is completely embedded in the local health-care community and known by all.”

Two of the graduates talked to us about what drew them to rural family medicine, some of the benefits of training in a rural environment and the best part about their experiences in Brandon:

Youcef Soufi [MD/17] – Currently doing temporary locums across various rural practice sites in Manitoba

Where did you grow up? Winnipeg.

Why did you decide to pursue a family medicine residency in a rural environment? A couple reasons went into my decision. One was that the scope of practice in family medicine in rural settings is much broader than in urban settings including providing acute care. Another was the work environment – you get to know your colleagues, nursing staff and specialists in other departments beyond professional interactions. 

Can you describe some of the benefits of the rural residency experience? In Brandon, you get the best of both worlds. It’s considered rural but has all of the benefits of large urban centers. Medical residents in Brandon have unique opportunities in that we receive one-on-one training and mentorship from highly esteemed physicians from a broad range of specialties. Working alongside surgeons, various internal medicine specialists (cardiology, neurology, nephrology and more), pediatricians and OBGYN specialists provided me the opportunity to develop a broad range of procedural skills and medical expertise.      

What was it like lifestyle-wise? It was very enjoyable with plenty of opportunities to be involved in the community. I am a lifelong practitioner of freestyle wrestling as well as Brazilian jujitsu. I began coaching at the local mixed martial arts club and it provided a great avenue for me to establish lifelong friendships outside of work.   

What was the best part? The opportunity to tailor your medical training to your own needs. Our program makes every effort to provide individualized training to each resident based upon their respective medical interests.

What is the next step in your career? I will be doing temporary locums across various rural practice sites across Manitoba. I will definitely stay in rural medicine – I like the broad scope of practice, the collegiality, and the sense of community.

Colleen Pitzel [MD/17] – Currently practicing at the Western Medical Clinic in Brandon

Where did you grow up? Headingley.

Why did you decide to pursue a family medicine residency in a rural environment? I knew I wanted to practice in a smaller centre and I wanted my training to reflect what my practice would look like.

Can you describe some of the benefits of the rural residency experience/lifestyle? In Brandon and southwestern Manitoba, the medical community is small, and you get to know each other better than you would in a bigger centre. I got to personally know, work and train with most of the specialists. Also, there is less competition with other residents for training opportunities in a smaller centre. There are many opportunities for one-on-one learning and I got the chance to do a variety of procedures while on rotations.

What is it like lifestyle-wise? Brandon is a small city and everything is a 10 minute drive away. You’re not spending 20-30 minutes or longer in traffic like in Winnipeg.

What was the best part? The best part was the training. I ended up getting to do a lot of procedures and I didn’t have to compete for learning opportunities. I also really enjoyed the collegiality between family doctors and specialists.

What is the next step in your career? I’m excited to start my practice at the Western Medical Clinic in Brandon. I look forward to seeing where my career takes me. I like that in Brandon you can practice small town family medicine but you have a lot of support. Also, I want to do obstetrics, which limits where you can practice. I initially thought I wanted to be in a smaller city but now it (Brandon) feels like the right size.