Happy Wednesday! Postcall here, ready to sparkle up your morning like laser lights on a disco ball.

Here’s a fun fact: Did you know October comes from the Latin octo because it once was the 8th month of the year? The original Roman calendar only had 10 months, leaving out the 61 days that are now Jan. and Feb. Seems like the Romans wanted to deny the dregs of winter just as much as we do 🤷🏼‍♀️

Now time for some headlines!

• Get Your 💩 Together

  ^{A new, high-tech test in the wake of contaminated meatloaf.}

• What patients might say this week 🙊 

  ^{“I’ve been hearing about this new drug, the Siberian Tiger?”}

• The Batman to my Superman, the PA to my Doctor 🦸‍♀️🦹‍♀️

  ^{Will BC finally let PAs into the ER?}

• Play: Postcall med-themed crossword puzzle vol. 2! ⛳️

  ^{We’ve done it again.}

Driving these numbers: A last-minute deal over the weekend kept the US government open but couldn’t stop stocks from trending downward. But at least inflation looks less menacing - Paul Beaudry, former deputy governor of the Bank of Canada, says we have “a 70% chance of a soft landing.”

Get Your 💩 Together

The source of Calgary’s shiga toxin-producing E. coli (STEC) outbreak has been identified, as BC introduces a new, single-specimen stool test.

What happened: Alberta's chief medical officer announced that bad lunch meat is responsible for the 351 lab-confirmed cases of STEC in Calgary daycares — specifically, meatloaf and vegan loaf meals served on Aug. 29. The City of Calgary has laid charges against the catering company, Fueling Minds, which faces $120,000 in fines. Six children still remain in hospital due to the outbreak with hemolytic uremic syndrome. Meanwhile, BC has implemented a new, “high tech” stool test that will detect STEC quickly and efficiently.

Why it’s important: Historically, when patients presented with diarrhea, they required multiple stool samples to rule out an infection — namely, the C&S, C. difficile, and O&P. Infections like STEC were not routinely detectable using these tests. A new laboratory test has been introduced in BC called the Infectious Diarrhea Panel (IDP), which combines these tests to literally get your $hit together. The IDP incorporates nucleic-acid amplification, antimicrobial susceptibilities, and detects the 14 most common and relevant pathogens that cause infectious diarrhea (like STEC), which were previously routinely undetectable.

Who should you send immediately for a stool IDP?

• Severely immuno-compromised patients AND new diarrhea

• Patients with mild-moderate diarrhea for > 7 days, not clearly resolving

• Patients with severe diarrhea (regardless of duration), i.e., > 10 stools per 24 hours, bloody stools, fever ≥ 38.5, or abdominal pain.

Postcall’s take: The rapid implementation of COVID-19 testing infrastructure has made it possible to roll out tests such as the IDP. Who knows what else is coming down the diagnostic pipeline? For patients and providers alike, the IDP represents a faster, more precise, and hassle-free test.

To finish, a friendly reminder to avoid “Pop Tartare,” no matter how hungry you are while on-call.

What patients might say this week 🙊 

1. "Can I get a script to the Zoo?"

Patients can now be prescribed a visit to the Toronto Zoo as part of a new initiative to address mental and physical wellness needs.

2. “Should I switch to a NOAC for my afib?”

The Frail AF trial showed that switching from vitamin K antagonist (VKAs) to a non-vitamin K oral anticoagulant (NOAC) in frail older patients with atrial fibrillation was associated with more bleeding complications compared to continuing VKA treatment and no reduction in thromboembolic complications.

3. “Mask up!”

Dr. Bonnie Henry says, “Masks are mandatory in health-care settings.” As of Oct. 3 (yesterday), health-care workers, visitors, and volunteers will be required to mask up in BC. Meanwhile, Ontario and Quebec still leave that decision up to individual hospitals. Other provinces, like Alberta and Saskatchewan, removed their mandates earlier this year.

4. “How do I focus better?”

Adults (in 40s and 50s) are increasingly being diagnosed with ADHD. While treating it with meds can be life changing, it may also cause serious side effects such as psychiatric issues, heart attacks, strokes, appetite loss, or sleep interference.

The Batman to my Superman, the PA to my Doctor 🦸‍♀️🦹‍♀️

Every superhero needs reliable teammates, and physician assistants (PAs) might just be what the doctor ordered.

What happened: Last Wednesday, the College of Physicians and Surgeons of British Columbia (CPSBC) and the Ministry of Health unveiled a proposal that PAs can work with doctors in the ER once they register with the CPSBC.

Why this is interesting: With Canada’s healthcare system facing its own crisis, provinces are gearing up for solutions.

• According to the CAPA, PAs in primary care settings can be used for 75% of all visits without physician-level care referral, reduce wait times by 1.9x and “left without been seen rates” by half.

• BC has been called “the last of the holdouts”, as over 1,000 certified PAs across Canada are already employed in ERs.

Yes, but… There is still lots to iron out, including the scope of practice. Unlike physicians, PAs complete a 2-year post-bachelor curriculum, but don’t complete a residency, and lack regulatory status.

Bottom line: BC’s move to welcome PAs into the ER aligns with BC’s Health Human Resources Strategy in order to improve healthcare access and avoid physician burnout. Postcall even covered one of their initiatives last week, featuring SFU’s new medical school. Maybe Grandpa isn’t too set in his ways!

Does your clinic or hospital employ PAs? Share your experience! Or if you’re in BC, do you support or oppose this? Let us know at [email protected].

🍔 Quick Bites

1: 🧪 Scientists Katalin Kariko and Drew Weissman won the 2023 Nobel Prize in Physiology or Medicine after discovering that mRNA can be manipulated and injected into the body to activate an immune response. This was the research that enabled the development of effective vaccines against COVID-19. When they made the breakthrough in 2005, though, the major academic journals Science and Nature rejected their paper. So don’t worry if your paper is still “under review” — it happens to everyone. 🤷‍♀️

2: 🎃 Get spooky while also getting business-savvy: Read the tale of how Spirit Halloween makes its eye-popping $650M in only 2 months of the year.

3: 🚗 Drive a Hyundai or Kia? They’ve issued a recall for over 600K vehicles due to a potential brake fluid leak in the Anti-Lock Brake System (ABS), which could lead to an electrical short and fire while parked or driving. Fortunately, no injuries or fatalities related to this issue have been reported. Search for your VIN here.

4: 🦦 Want to see more pics like those cute otters above? You’re in luck — Canadian Geographic just announced the winners of the 2023 Wildlife Photography of the Year competition. Pictured: “A raft of curious sea otters checks out a group of sea kayakers, including the photographer, near Spring Island off the western coast of Vancouver Island, BC. Nearly wiped out in the 19th century by fur traders, sea otter populations in BC have rebounded as a result of a reintroduction program.”

Postcall Picks ✅ 

💳️ Buy:  👟 The Adizero Adios Pro Evo 1s, priced at $500, are Adidas's latest running shoes, used by Tigist Assefa to break the women's marathon record. 🏃‍♀️ These shoes weigh 138 grams and are designed for just one marathon plus warmup, costing about $19 per mile.

👀 Watch:

That’s some insane magic from ChatGPT. We’re still holding out for AI vision methods of understanding billing codes though.

🛫 Travel tip: Jetting off to warm destinations is fun and all, but don’t miss out on exciting fall activities close to home!

1. 🌽 Corn Mazes:

   • Chilliwack Corn Maze, British Columbia

   • Fortune Bridge Farms & Toby’s Farm Market, Prince Edward Island

2. 🍂 Hikes through the colours:

   • Alberta Mountain forests, Alberta

   • Elk Glen, Manitoba

   • Valley Forest, Ontario

3. 🐦 Bird Watching:

   • Fundy National Park, New Brunswick

   • Forillon National Park, Quebec

4. 🎃 Pumpkin Picking:

   • Strom’s Farm & Bakery, Ontario

   • Verger Labonte, Quebec

🕹️ Game ⛳️

The response was so overwhelming last week, we had no choice...

Presenting the second instalment of Postcall’s med-themed crossword puzzle!

Just like last time, we recommend forwarding this and your completion time to a friend. A little competition adds that extra oomph. 🤗

Job Opportunities 💼 

Role: Anesthesiologist

• Location: Personnel Management Consultants (Barrie, ON)

• Compensation: $400,000 to $600,000

• Learn more

Role: Neonatal House Medical Officer

• Location: Health Sciences Centre (Primary) and St. Boniface Winnipeg (Winnipeg, MB)

• Compensation: $304,547

• Learn more

Role: Hospitalist

• Location: Aberdeen Hospital (New Glasgow, NS)

• Compensation: $250,000 to 300,000

• Learn more

Role: Pediatric Hemtalogist/Oncologist

• Location: The Hospital for Sick Children (Toronto, ON)

• Compensation: $230,000 to $280,000

• Learn more

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