The Dose21:09I haven’t had my regular checkup since before the pandemic. What should I ask my doctor?
If you haven’t been in to see your family doctor in the last two years, now may be the time to do it. So if I haven’t had my regular checkup since before the pandemic, what should I ask my doctor? We find out from Dr. Peter Lin, a Toronto-based family doctor and a director at the Canadian Heart Research Centre. 21:09
The pandemic interrupted routines for health, work and family – including regular checkups.
So if you haven’t been to see your family doctor since before March 2020, now may be the time.
“There’s a lot of diseases still going on,” Dr. Peter Lin, a Toronto-based family doctor and a director at the Canadian Heart Research Centre, told CBC podcast The Dose.
“If you have diabetes, high blood pressure, all of those things need some fine-tuning.”
Those who have a chronic illness or new pain should see their health-care provider right away, he said.
And if you’re overdue for an age-related cancer screening test, like a Pap smear, colonoscopy or a mammogram, get in touch with your family doctor.
If you’re unsure whether you need a checkup, several physicians told The Dose about what to consider before making an appointment.
Who should book an appointment?
Contrary to its name, an annual checkup isn’t something most people need every year, said Dr. Tara Kiran, a family physician at St. Michael’s Hospital.
“That’s a little bit of a misnomer.”
Instead, most practitioners and their staff look at several factors before seeing someone.
“What we do is really try and target preventive care based on people’s health history and their age, sex and the [medical] history of their family,” said Kiran, who is also the Fidani Chair for improvement and innovation at University of Toronto’s department of family and community medicine.
Dr. Tara Kiran says not everyone needs a yearly physical, especially those who are young, healthy and don’t have physical or mental health concerns. (Ed Middleton/CBC)
Staff also triage patients based on who is closest to the “cliff edge,” Lin said.
“If you have a pain, a lump or anything like that, let’s get those things checked out now. Those are the things that we want to see right away.”
Patients without any complaints can be moved to a lower priority.
Dr. Peter Lin is a family doctor and frequent contributor to CBC. He says that patients should catalogue their symptoms before getting to a checkup. (Samantha Lui/CBC)
If you do have an issue, create a list of symptoms before you get to your doctor’s office, because that can help narrow down areas to test or examine, Lin said.
And if it’s your first visit, he said, it’s useful for patients to write down their family medical history.
Cancer screening
The pandemic also delayed access to cancer screening in many provinces.
Screening stopped in mid-March 2020 across most of the country, with programs restarting at limited capacity a few months later, according to the Canadian Cancer Society.
What that means is that there are a lot of people due – or overdue – for regular screening, a critical tool in catching cancer early.
“We want to capture cancers at a time that they’re small and at a time that we could actually use the word ‘cure,'” said Dr. Iris Gorfinkel, a family doctor, vaccine researcher, and a health contributor with CBC News.
“That’s why screening is so important.”
In Canada, criteria for cancer screening is based on a person’s age, lifestyle and family medical history.
If you think you’re among those past due for routine screening, Gorfinkel, Lin and Kiran suggest calling your primary care provider – many can perform a Pap smear in their office or provide a referral for other tests.
WATCH | How the pandemic delayed routine skin cancer screening:
Concerns about missed skin cancer screening during pandemic
5 months ago
Duration 2:03
Doctors are concerned some Canadians missed opportunities for skin cancer screening during the pandemic because they didn’t make in-person visits to their doctors that could’ve caught illnesses when they are more treatable. 2:03
Women aged 25-50 who are sexually active should get a Pap test at least once every three years, Kiran said, and anyone sexually active should routinely get tested for sexually transmitted infections.
Checking up on mental health
When it comes to mental health, the pandemic’s effects have been wide-ranging and some people may need medical help.
Kiran said warning signs include eating more, a decrease in exercise or an uptick in alcohol or cannabis habits.
“Your family doctor might be able to provide you with tips, some very concrete strategies and maybe even medications to help.”
Another issue family doctors are seeing is long COVID, a condition that typically emerges within three months of having a COVID-19 infection – with symptoms lasting at least two months.
Kiran recommends that people reach out to their physician if they have symptoms of long COVID, which range from shortness of breath, fatigue, chronic pain and cognitive difficulties, more than a month after getting the virus.
Family doctors can also offer help for those whose mental health has worsened during the pandemic. (David Donnelly/Radio-Canada)
Routine vaccinations
The pandemic also saw many doctor appointments get cancelled for children – and some may be behind on routine vaccinations.
“Those are vaccines that are traditionally given in schools, and they were actually paused during the pandemic,” Kiran said. “Now we’re trying to play catch-up.”
As the health-care system navigates the ongoing pandemic, and the delays created by it, not every Canadian will get an immediate appointment with their family doctor.
“We are trying to do the best job we can in terms of triaging in terms of who it is that we really need to see and see more urgently,” Kiran said, adding that younger, healthier people may have to wait.
Lin and Kiran said there are some tools people can use while they wait for an appointment.
For mental health concerns, Kiran refers patients to Wellness Together Canada’s website or Anxiety Canada’s online resources.
For people with hypertension, Lin said blood pressure monitors are accessible again so people can monitor themselves and look for any trends to flag to their doctor.
And for teens behind on routine vaccines, immunization clinics for adolescents are happening at some public health units across the country.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
