Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada
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Case Reports
Patient advocacy by rural emergency physicians after major service cuts: the case of Nelson, BC.
Efforts at cost containment through regionalization have led to reduced services in several rural emergency departments (EDs) in Canada. As a result, questions have been raised about patient safety and equitable access to care, compelling physicians to advocate for their patients. ⋯ We describe our experience of patient advocacy after major service cuts at Kootenay Lake Hospital in Nelson, BC. Despite mixed results, we suggest increased physician involvement in patient advocacy.
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Aboriginal people are substantially more likely to be injured or die in motor vehicle crashes (MVCs) than the general population. However, research examining MVCs among Canadian Aboriginal populations is limited. We examine trends and gaps in the Canadian literature and suggest priorities for future research. ⋯ This review indicates that rates of death, hospital admission and injury related to MVCs are twice as high among Aboriginal populations than the general Canadian population, which highlights a major public health concern. Priorities for future research should include examination of the social environment, more rigorous methods and collaborative research in partnership with Aboriginal communities.
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Several agents can be administered during procedural sedation and analgesia (PSA) in the emergency department (ED). The purpose of this study was to determine the PSA agents commonly used by physicians working in nontertiary EDs, and to assess the physicians' comfort level administering the agents as well as their knowledge of adverse effects of the agents. ⋯ Physicians practising in nontertiary EDs used more often, remained more comfortable with and were more familiar with older sedation agents than newer agents.
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This paper quantifies the proportion of family physicians in rural practice and, in particular, initial rural practice. It examines differences between graduates of Canadian and international medical schools. ⋯ The results of this study suggest that graduates of international and Canadian medical schools treat rural practice differently. International graduates may decide on a rural location as a means to set up practice in Canada or fulfill a return-of-service obligation, whereas graduates of Canadian medical schools may make a conscious choice to practise in rural locations. Decreasing proportions of international medical graduates in rural practice may be a result of increased opportunities for Canadian postgraduate training and full licensure.