Changements de pratique en médecine de famille : conséquences de la féminisation et des différences générationnelles

RésuméÀ partir de 48 entrevues menées auprès de médecins de famille du Nouveau-Brunswick, cet article expose le triple phénomène qui frappe cette profession : la féminisation de la médecine, le désir des jeunes médecins de famille d’avoir un équilibre entre leurs vies professionnelle et personnelle ainsi que la réduction des heures de travail des médecins plus âgés. Ces trois phénomènes entrainent des changements de pratique à considérer pour évaluer les besoins futurs des effectifs médicaux.AbstractBased on 48 interviews with family doctors in New Brunswick, this article exposes the three phenomena that affect this profession: the feminisation of medicine, the desire of young family doctors to find a balance between their professional and personal lives, and the reduction of work hours for older doctors. These three factors bring changes in practice that must be considered in the assessment of future needs in medical staff

Virtual follow-up care among breast and prostate cancer patients during and beyond the COVID-19 pandemic: association with distress

Background: The purpose of this study was to investigate associations between self-reported distress (anxiety/depression) and satisfaction with and desire for virtual follow-up (VFU) care among cancer patients during and beyond the COVID-19 pandemic. Methods: Breast and prostate cancer patients receiving VFU at an urban cancer centre in Toronto, Canada completed an online survey on their sociodemographic, clinical, and technology, characteristics and experience with and views on VFU. EQ5D-5 L was used to assess distress. Statistical models adjusted for age, gender, education, income and Internet confidence. Results: Of 352 participants, average age was 65 years, 48% were women,79% were within 5 years of treatment completion, 84% had college/university education and 74% were confident Internet users. Nearly, all (98%) had a virtual visit via phone and 22% had a virtual visit via video. The majority of patients (86%) were satisfied with VFU and 70% agreed that they would like VFU options after the COVID-19 pandemic. Participants who reported distress and who were not confident using the Internet for health purposes were significantly less likely to be satisfied with VFU (OR = 0.4; 95% CI: 0.2–0.8 and OR = 0.19; 95% CI: 0.09–0.38, respectively) and were less likely to desire VFU option after the COVID-19 pandemic (OR = 0.49; 95% CI: 0.30–0.82 and OR = 0.41; 95% CI: 0.23–0.70, respectively). Conclusions: The majority of respondents were satisfied with VFU and would like VFU options after the COVID-19 pandemic. Future research should determine how to optimize VFU options for cancer patients who are distressed and who are less confident using virtual care technology

Factors Influencing Family Medicine Resident Retention and Newly Graduated Physicians’ First Practice Location

The New Brunswick Medical Society states that New Brunswick has a shortage of physicians. This study examines retention of newly graduated family physicians from the Dalhousie University family medicine residency sites in New Brunswick from 2005– 2014, and factors influencing physicians’ choices of first practice locations. Approximately half of respondents remained in New Brunswick to establish their first practice. The majority who left New Brunswick to establish their first practice have not returned, whereas most who remained still practice in New Brunswick. Choice of first practice location was influenced by a combination of personal and professional factors. Reasons for leaving New Brunswick were predominantly personal.La Société médicale du Nouveau-Brunswick affirme qu’il y a une pénurie de médecins. La présente étude porte sur la rétention des médecins de famille nouvellement diplômés du Département de médecine familiale de l’Université Dalhousie qui ont choisi de faire leur résidence au Nouveau-Brunswick de 2005 à 2014 et sur les facteurs qui ont influencé les choix des médecins quant à l’emplacement de leur premier cabinet. Environ la moitié des répondants sont restés au Nouveau-Brunswick pour ouvrir leur premier cabinet. La plupart de ceux qui ont quitté le Nouveau-Brunswick pour ouvrir leur premier cabinet n’y sont pas revenus, alors que la plupart de ceux qui y sont restés exercent toujours leur profession au Nouveau-Brunswick. Le choix de l’emplacement du premier cabinet a été influencé par un ensemble de facteurs personnels et professionnels. Les raisons pour lesquelles les nouveaux médecins quittaient le Nouveau-Brunswick étaient surtout de nature personnelle

Risk Stratification and Cancer Follow-Up: Towards More Personalized Post-Treatment Care in Canada

After treatment, cancer survivors require ongoing, comprehensive care to improve quality of life, reduce disability, limit complications, and restore function. In Canada and internationally, follow-up care continues to be delivered most often by oncologists in institution-based settings. There is extensive evidence to demonstrate that this model of care does not work well for many survivors or our cancer systems. Randomized controlled trials have clearly demonstrated that alternate approaches to follow-up care are equivalent to oncologist-led follow-up in terms of patient outcomes, such as recurrence, survival, and quality of life in a number of common cancers. In this paper, we discuss the state of follow-up care for survivors of prevalent cancers and the need for more personalized models of follow-up. Indeed, there is no one-size-fits-all solution to post-treatment follow-up care, and more personalized approaches to follow-up that are based on individual risks and needs after cancer treatment are warranted. Canada lags behind when it comes to personalizing follow-up care for cancer survivors. There are many reasons for this, including difficulty in determining who is best served by different follow-up pathways, a paucity of evidence-informed self-management education and supports for most survivors, poorly developed IT solutions and systems, and uneven coordination of care. Using implementation science theories, approaches, and methods may help in addressing these challenges and delineating what might work best in particular settings and circumstances

Virtual follow‐up care among breast and prostate cancer patients during and beyond the COVID‐19 pandemic: Association with distress

Abstract Background The purpose of this study was to investigate associations between self‐reported distress (anxiety/depression) and satisfaction with and desire for virtual follow‐up (VFU) care among cancer patients during and beyond the COVID‐19 pandemic. Methods Breast and prostate cancer patients receiving VFU at an urban cancer centre in Toronto, Canada completed an online survey on their sociodemographic, clinical, and technology, characteristics and experience with and views on VFU. EQ5D‐5 L was used to assess distress. Statistical models adjusted for age, gender, education, income and Internet confidence. Results Of 352 participants, average age was 65 years, 48% were women,79% were within 5 years of treatment completion, 84% had college/university education and 74% were confident Internet users. Nearly, all (98%) had a virtual visit via phone and 22% had a virtual visit via video. The majority of patients (86%) were satisfied with VFU and 70% agreed that they would like VFU options after the COVID‐19 pandemic. Participants who reported distress and who were not confident using the Internet for health purposes were significantly less likely to be satisfied with VFU (OR = 0.4; 95% CI: 0.2–0.8 and OR = 0.19; 95% CI: 0.09–0.38, respectively) and were less likely to desire VFU option after the COVID‐19 pandemic (OR = 0.49; 95% CI: 0.30–0.82 and OR = 0.41; 95% CI: 0.23–0.70, respectively). Conclusions The majority of respondents were satisfied with VFU and would like VFU options after the COVID‐19 pandemic. Future research should determine how to optimize VFU options for cancer patients who are distressed and who are less confident using virtual care technology