Ken Flegel

Binge drinking: all too prevalent and hazardous

Alcohol use is the third greatest contributor to the global burden of disease,[1][1] estimated to cause 3.8% of all deaths. Among people aged 15 to 44 years, alcohol is estimated to result in 4.6% of all disability-adjusted life years lost and a disproportionate number of fatal injuries.[2][2]

Health care workers must protect patients from influenza by taking the annual vaccine

No right-thinking physician would ever knowingly harm a patient or fail to do some essential thing that would result in harm to a patient. This principle of medical practice is enshrined in the Latin dictum primum non nocere (first, do no harm). But when 55%–65% of physicians fail to take the

Protecting against Clostridium difficile illness

Background and epidemiology: A gram-positive, anaerobic bacterium that is common in the environment, Clostridium difficile is transmitted by the fecal– oral route. Its resistant spores are ingested, survive passage through the stomach and ultimately reside in the colon.[1][1] Antimicrobial therapy

Competing interests and undergraduate medical education: time for transparency

In many medical schools in North America and elsewhere, future generations of physicians are taught by some expert faculty who receive funds from the pharmaceutical industry. This situation is unavoidable to some degree, because affiliations between physicians and industry are common. [1][1]

Getting to the electronic medical record

By custom, the medical record has been stored as a paper file in the physicians office. The keeper of the record has been the physician — a banality in which lie 2 deeper concepts: one of ownership and one of access. Lately, it has come to be understood that the physician and the patient own the

Personalized medicine: a windfall for science, but what about patients?

Personalized medicine is holding out the promise of administering medicines specifically tailored to a person’s specific genome or metabolism — drugs that cure without adverse effects.1 No doubt, “stretch goals” and strong convictions help in the long and laborious struggle to unlock the

Better management of chronic pain care for all

Chronic pain is no respecter of age, wealth or status. Ramage-Morin has estimated that 500 000 Canadians aged 12 to 44 years, 38% of seniors in long-term care facilities and 27% of seniors living at home experienced pain on a chronic basis.[1][1],[2][2] Worse still, a review of the European

Choosing when and how to die: Are we ready to perform therapeutic homicide?

The Dying with Dignity commission of the Quebec National Assembly has issued its report after two years of public hearings, consultations with experts and visits to countries where there is now some experience with a range of options on ways of dying.[1][1] The commission and the Charest government

Get excess salt out of our diet

Once a commodity of exchange, salt is now a commodity of disease and death. We underestimate how much excess salt we eat and how much harm it can do. The greatest harm comes from high blood pressure and its consequences. Of the estimated 1 billion people living with hypertension,[1][1] about 30% can

Being smarter with smartphones

Seemingly overnight, smartphones have become the latest must-have, irreplaceable tool in the armamentarium of the contemporary clinician. However, their use is often banned or seriously limited in health care institutions, best depicted by ominous signage from Big Brother — “no cellphones or