Web 2.0 THE WAVE

Transcription

Web 2.0 THE WAVE

LE
SPÉCIALISTE
Le magazine de la Fédération des médecins spécialistes du Québec
Vol. 13 no. 4 | December 2011
Web 2.0
THE WAVE
TWIN
CERTAINTIES... p. 40
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comptes collaborent avec des partenaires
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1
Les Services bancaires mobiles RBC sont offerts par la Banque Royale du Canada. VPS66393
(11/2011)
PUBLIREPORTAGE
Summary
LE SPÉCIALISTE IS PUBLISHED 4 TIMES PER YEAR BY
THE FÉDÉRATION DES MÉDECINS SPÉCIALISTES DU QUÉBEC
EDITORIAL Committee
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7
WORD FROM THE PRESIDENT
Ends, Our Predictions For 2012...
2011
8
IN THE NEWS
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WEB 2.0
THE WAVE
LE
SPÉCIALISTE
Le magazine de La Fédération des médecins spéciaListes du Québec
Vol. 13 no4 | Décembre 2011
Fédération des médecins
spécialistes du Québec
2, Complexe Desjardins, porte 3000
C.P. 216, succ. Desjardins,
Montréal QC H5B 1G8
Telephone: 514-350-5000
• Web 2.0 and Healthcare
• Medical Specialists are
Surfing… So is the FMSQ
PUBLICATIONS MAIL
Mailing Indicia 40063082
• Have You Met
@DrBarretteFMSQ?24
LEGAL DEPOSIT
4th quarter 2011
Bibliothèque nationale du Québec
ISSN 1206-2081
• The Physician and
Social Networks
• Integrating Social Media
into Your Medical Practice
All pharmaceutical product advertisement’s have been approved by the
Pharmaceutical Advertising Advisory Board (PAAB).
CCAB audits the medical specialists and residents database
(11,115 copies audited for June 2011) The FMSQ also
distributes around 1,000 copies to Researchers and
Professors of the 4 Medical Faculties in Quebec, as well as managers and leaders
of the Québec healthcare system.
The authors of signed articles are sole responsible for the opinions expressed
therein. No reproduction without previous authorization from the publisher.
The mission of the Fédération des médecins spécialistes du Québec is to defend
and promote the economic, professional, scientific and social interests of the
medical specialists who are members of its affiliated associations.
THIS EDITION’S ADVERTISERS:
• Desjardins
• Telus mobilité
• RBC Banque Royale
• Financière des professionnels
• Sogemec Assurances
• ASSS du Bas-Saint-Laurent
• Club Voyages Berri
• IMS Brogan
• La Personnelle
• Services aux médecins MD
• Groupe Conseil Multi-D
• Discovering Mobile
Medical Applications
35 22
Web 2.0
LA VAGUE
DEUX
CERTITUDES...
Voir texte p. 40
27
30
32
REAT NAMES IN QUEBEC MEDICINE
G
r. François A. Auger, Microbiologist and Infectious
D
Disease Specialist
36 CONTINUING PROFESSIONAL
EDUCATION
38 SERVICES AUX MEMBRES
A vantages commerciaux
2
3
4
6
8
12
13
14
34
43
44
16
39 FINANCIÈRE DES
PROFESSIONNELS
40 SOGEMEC ASSURANCES
42 LE MOT DU PRÉSIDENT
Réalisations et prédictions...
LE SPÉCIALISTE | VOL. 13 No. 4 | DECEMBER 2011 | 5
Tournée
de conférences
En tant qu’investisseur, il semble de plus en
plus difficile de conserver vos repères dans la
turbulence actuelle des marchés financiers. Pour
assurer l’atteinte de vos objectifs futurs, vous devez
d’abord savoir où vous vous situez maintenant!
Le temps d’une conférence, nous vous proposons
de partager notre réflexion sur les événements les
plus porteurs de 2011, les voies qui s’ouvrent à vous
en 2012 ainsi que les éléments qui s’annoncent
déterminants pour l’avenir de vos placements.
Venez planifier votre itinéraire financier avec les
experts de la Financière des professionnels!
.
Accueil : 18 h - Conférence : 18 h 30 Un repas sera servi.
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ou téléphonez-nous aux numéros suivants :
Vous êtes ici
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Montréal (ACDQ dentistes)
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Claire Morin
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514 350-5050 ou 1 888 377-7337
514 282-1425 ou 1 800 361-3794
418 658-4244 ou 1 800 720-4244
819 564-0909 ou 1 866 564-0909
Actionnaire de la Financière des professionnels depuis 1978
WORD FROM THE PRESIDENT
Dr. Gaétan Barrette
2011 Ends,
Our Predictions For 2012...
The year 2011 has been a very hectic one, and everybody at the Federation has put their
shoulder, in fact both their shoulders to the wheel! At this point in the year, we normally
say it is ending. The operative word here is “normally”, because things are a bit different
at the FMSQ. After months of negotiations with the government, we managed to reach
a satisfactory new Agreement, without conflict on either side. Since then, we have been
concentrating on the future allocation of the gains we have made. We have therefore started
out on a round of visits to the medical associations and, during the remaining few weeks of
2011, we will be maintaining the rhythm in order to finalize our meetings and move forward
with work on the allocation planned for 2012.
O
ther issues have been brought to a satisfactory conclusion
in 2011, not only with regard to the Federation and its
members but also for patients in Quebec. One particular
example is the agreement reached with the MSSS on the treatment
costs imposed on patients with macular degeneration. We had
to present the Minister of Health with a 48-hour ultimatum to pay
these costs, but the effort was well worth the while.
We also saw the launching of the construction of the future
CHUM. Even though the FMSQ was forgotten as far as an
invitation to attend the official event was concerned, with all the
bigwigs present, we are well aware that the project now finally
under way would never have been on this scale if it had not been
for the FMSQ’s intervention during the summer and fall of 2008.
I would also remind you that, during the round of negotiations
conducted by the government with its employees, the Federation
was the first medical group to support the claims made by the
Fédération interprofessionnelle de la santé du Québec (FIQ).
The same comment applies to Crown prosecutors and Quebec
lawyers. The FMSQ emphasized the essential role played by
these groups in the public health and judicial systems and the
importance of negotiating an agreement that respected their
professional contribution. There was good reason for our campaign
“Expertise has a price”!
Finally, our Federation supported adding new professional activities
to those reserved to Quebec pharmacists. To keep up with the
Web 2.0 site introduced in this issue, our support was on Twitter
(see page 24).
And, to close the year, I am particularly glad about the
realization of an undertaking that has taken a certain time – or
some would say “has certainly taken time” – to achieve. But
time arranges all things, we are told. We have managed to
reach agreement on implementing a parental leave program,
as you will have read in the recent INFOnégo newsletter.
I believe that this accomplishment should be underlined twice,
rather than just once. The Federation had already reduced
membership fees for new parents, and this program will be
further improved to take other parental situations into account.
I want to underline the determination of Dr. Josée Parent who,
as Vice President of the Federation (2009-2011), took up
the challenge and kept a close watch on it at all times. I am
sure that medical specialists who are parents are thanking
Dr. Parent (how fitting!) for making this promise come true!
The coming year is sure to bring its quota of health issues,
because there is a great deal to be done to enable our public
system to function better. We already know what will not happen
in 2012: electronic patient records will not see the light of day,
nurse‑practitioners will still be left aside, intermediate resources
will be insufficient to free up beds, operating room productivity
will not be able to be increased, macular degeneration treatments
and in vitro fertilization will not be available in all establishments,
etc. I am not going to go any further. This list could be used as
a basis for decision-makers’ resolutions but, as we all know,
resolutions are made to be broken.
This year, the coming holidays will be particularly well-deserved
at the Federation! I hope that you, too, will be able to enjoy the
festive season with your family and friends. On behalf of all my
team, I wish you Season’s Greetings!
Yours in solidarity!
S
L
IN THE NEWS
New Collaboration
While both were working at the Hôtel-Dieu de Lévis hospital,
Dr. François Paquet, an emergency medicine specialist, and Yves
Lessard, a nurse, had the bright idea of combining their talents
to create an original project: a cartoon strip on the subject of the
healthcare system in Quebec.
As each of them admits to more than 20 years experience in the
healthcare network, they have accumulated many anecdotes
from which they freely draw their inspiration. They also collect
suggestions from their peers (should you be interested).
POUR TOUS VOS
BESOINS D’ASSURANCES
STAT’s first volume was published earlier this
year by Éditions Moelle Graphique (www.
moellegraphique.com) and the authors are
actively preparing the second volume. In
addition, the authors regularly post a new
strip on their web site (www.statcomics.com).
From now on, Le Spécialiste will be including a strip from this series
in each issue of the magazine.
Grâce au
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[email protected] / www.sogemec.qc.ca
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filiale de la
8 | LE SPÉCIALISTE | VOL. 13 No. 4 | DECEMBER 2011
IN THE NEWS (SUITE)
The 2011 Education Day - A Great Success!
The 4th Interdisciplinary Education Day organized by
the Fédération des médecins spécialistes du Québec’s
Professional Development Office was a great success.
From 240 participants at the first Education Day in
2008, attendance at the 24 sessions presented during
the day reached near to 650 persons.
Speakers, moderators and panellists addressed participants on
subjects as varied as fibromyalgia, a critical reading of randomized
studies, planning for retirement and how surgery and radiology
complement one another in the case management of common
surgical pathologies.
The objective of Interdisciplinary Education Days is to bring
physicians of various specialties to speak with one another in order
to improve patient case management. Presentation subjects are
mainly proposed by medical associations and scientific committees
while the final program is put together by a planning committee.
During lunch, the Quebec Council on Physicians’
Continuing Professional Development awarded
a Special Mention in the framework of the Prix
de l’innovation pédagogique en développement
professionnel continu (DPC) 2011 to Doctors
Renée-Claude Duval, Simon Pierre Proulx, Line
Archambault, Richard Goulet, Leila Ben Amor
and Annick Vincent. The title of their project was Trousse d’outils
d’évaluation TDAH enfants-adolescents (Evaluation Toolkit for
Childhood and Adolescent ADHD).
The President’s Cocktail marked the end of the day’s activities
and provided physicians the opportunity to network. Earlier,
the Federation’s President, Dr. Gaétan Barrette, had issued
an important message on the role of physicians in the case
management of patients and in healthcare services as a whole.
RESERVE THE DATE
OF NOVEMBER 9,
2012 RIGHT NOW
FOR THE 5TH
EDITION OF THE
INTERDISCIPLINARY
EDUCATION DAY.
From left to right: Madame Céline Monette, from the CQDPCM,
Dr. Renée-Claude Duval, pediatrician, Dr. Simon-Pierre Proulx, general
practitioner, Dr. Line Archambault, psychiatrist and Dr. Richard Goulet,
pediatrician. Missing from the picture: Dr. Leila Ben Amor and Dr. Annick
Vincent, both psychiatrists.
S
L
IN THE NEWS
Building the new UHCs of Montreal
Since September 2010, we have been reporting photographically on how construction work is
advancing on the new university hospital centres being built in Quebec. As a picture is worth a
thousand words, what better way to keep track of these projects!
The new McGill University Health Centre will open its doors in the fall of 2014, while the CHUM is
expected to open in 2018.
CHUM
Picture taken on November 11, 2011
Research Center Construction Work
MUHC
Picture taken on November 11, 2011
S
L
DID YOU KNOW...
Prizes and Awards
Armand Frappier Prize 2011
Dr. Jean-Claude Tardif, a cardiologist
and Director of the Montreal Heart Institute
Research Centre, received the ArmandFrappier Prize for 2011 when the Prix du
Québec recipients were announced. This
prize is the highest distinction awarded by
the Quebec government to a scientist who
has contributed to the development of a
research institute.
Canadian Paediatric Chairs Award
Dr. Robert Thivierge has received the
2011 Pediatric Academic Leadership
Prize awarded by the Paediatrics Chairs of
Canada. This marks Dr. Thivierge’s more
than 30 years’ support of medical education
in pediatric emergencies.
Women’s Y Foundation Community Service Award
Dre. Joanne Liu, a pediatrician at Sainte
Justine University Hospital Centre has been
honoured for her community service with
Doctors Without Borders (Médecins sans
frontières). Over the last 15 years, she has
taken part in more than 20 humanitarian
missions to disaster zones.
Médecins francophones du Canada Annual Prizes
Médecins francophones du Canada handed
the Award of Merit to Dr. Martin Juneau, a
cardiologist at Montreal Heart Institute. The
award honours a physician’s community
commitment and involvement. La Presse
newspaper also named him Personality of
the Week on October 31.
Michel-Sarrazin Prize
he Club de recherches cliniques du Québec
T
bestowed the Michel-Sarrazin Prize for 2011
on Dr. Stanley Nattel, a clinical cardiologist
and director of the Electrophysiology
Research Program at the Montreal Heart
Institute. This prize is awarded each year to
a seasoned Quebec scientists whose energy
and productivity have made an important
contribution to the advancement of
biomedical research.
Prix d’excellence – Centre hospitalier universitaire
de Sherbrooke
The CHUS Board of Directors gave out its
prizes for excellence during its 11th Gala.
They underline the commitment, leadership
and professionalism of people in the field.
The Grand Prix d’excellence was awarded to
Dr. Gaétan Langlois, an orthopedist, Chief
of Surgery and Medical Head of the Patient
Surgical Care Program.
Dr. Muriel Mury, a psy
chiatrist and professor at
Sherbrooke University,
together with Dr. Patrice
Perron, an endocrinologist,
Chief of Medicine and Head
of the Patient Special
ized Care Program, both
received Personality
Prizes in recognition of their investment in teaching and their
outstanding personalities.
Dr. Éric Turcotte, a nuclear scientist and
Clinical Director of the Molecular Imaging
Centre in Sherbrooke, received a Recognition
Award underlining his input during the medical
isotopes crisis where he played a major role
in developing alternative tracers, such as
sodium fluoride.
Prix Léo-Pariseau
The Association francophone pour le savoir
(ACFAS) has awarded the prestigious Prix
Léo-Pariseau to Dr. Claude Perreault, a
hematologist at Hôpital MaisonneuveRosemont and Head of Research at the
Université de Montréal Immunology and
Cancerology Research Institute. This prize
honours the work of a person working in the
field of biological or health sciences.
Dr. Perreault is the first Quebec medical specialist to have
successfully carried out a bone marrow graft.
Grand Prix de Québec-Transplant
Dr. Denis Marleau, a gastroenterologist and
founder of the liver transplant program of
CHUM-Hôpital Saint-Luc, has been awarded
the Grand Prix of Québec-Transplant in
recognition of leadership shown by a
professional in the advancement of organ
donations in Quebec.
DID YOU KNOW... (SUITE)
Transœsophageal Echocardiography Multimedia
Manual: One of the five best
As part of its Medical Book Awards 2011, the British
Medical Association has praised the second edition of the
Transœsophageal Echocardiography Multimedia Manual,
designating it as one of the best books on cardiology published
in 2010.
This work, coauthored by
Drs. Pierre Couture, André Denault
and Jean-Claude Tardif of the
Montreal Heart Institute (MHI)
among others, covers the new
developments and challenges
awaiting anesthesiologists,
cardiologists, heart surgeons,
intensive care specialists and
others interested in perioperative
transesophageal echocardiography
not only before, during and after
heart surgery, but also for its
applications in hemodynamics,
electrophysiology and major non-cardiac surgery, such as liver
and kidney grafts. The Manual also deals with the treatment of
critical patients by intensive care medical specialists.
Are you working with trans patients?
Action Santé Travesti(e)s et Transsexuel(le)s du Québec (ASTT(e)Q
(Quebec Action for the Health of Transvestites and Trans-sexuals)
has just launched Je m’engage, a guide intended for Quebec
health care and social service providers working with this clientele.
Around 60 pages long, the guide deals with hormone replacement
therapy, the defence of transgender patients/clients, and much
more. Health-related circumstances and issues experienced
by trans people are not generally taught in a classroom. Most
professionals acquire their expertise through experience, and this
guide has been devised to promote the development of services
appropriate to this atypical population. To order a copy of the
guide, please send an email to [email protected].
The Holidays are here
After a year filled and enriched with positive
developments, the Fédération des médecins
spécialistes du Québec wishes you a wonderful
Holiday period and an excellent year in 2012.
On this same occasion, the Federation invites you
to be generous towards the disadvantaged in our society. In
Quebec, one person in eight lives in poverty. Please support
the efforts which have been undertaken since 1939 by the
organizations that are now grouped under the Centraide banner
(www.givetocentraide.ca). In Quebec, there are 18 Centraides
that support more than 1,700 community organizations
throughout the regions and, together, they come to the aid of
1,300,000 disadvantaged individuals.
Je décide où je pratique
Au Bas Saint-Laurent
Je prends soin
des autres, de mes proches, de moi...
Choisissez une qualité de vie exceptionnelle
Majoration de la rémunération de 25 à 30 %
Kamouraska | Témiscouata | Rivière-du-Loup | Les Basques
Rimouski - Neigette | La Mitis | La Matapédia | Matane
www.agencesssbsl.gouv.qc.ca
[email protected]
DID YOU KNOW... (SUITE)
New Publications
CE QUE LE
S I DA
A CHANGÉ
« Depuis maintenant presque trente ans, je participe
aux soins des personnes atteintes par le VIH-sida.
J’ai vécu la sombre époque où ce mal d’origine inconnue n’avait même pas de nom, j’ai vu des patients
aussi jeunes que je l’étais mourir dans des conditions
terribles et le plus souvent rejetés par leur famille.
J’ai aussi été le témoin de moments extraordinaires
d’entraide et de solidarité.
Dr. Arthur Amyot, a gerontopsychiatrist at
Hôpital du Sacré-Coeur de Montréal, in
collaboration with René Des Groseillers, a
psychologist, has published “Vivre avec un
proche qui vieillit” (Living with an aging family
member) with Éditions Bayard. This book
gives a general outline of this stage in life
when both the body and mind are subject
to multiple changes. It includes motricity,
cognitive problems, autonomy, dependence
and institutionalization. Dr. Amyot believes that coping with
aging is greatly facilitated by the support of someone close to
the person. This role, however, has limitations which must be
learnt and accepted.
CE QUE LE SIDA A CHANGÉ
In the collection Vivre avec…
Ce que le sida a changé
S I DA
J E A N - P I E R R E R O U T Y est médecin dans le
Service d’hématologie et d’immunodéficience de
l’Hôpital Royal Victoria de Montréal.
ISBN 978-2-923511-34-4
9 782923 511344
In the same collection, Dr. Nagy Charles
Bedwani, a children’s psychiatrist at Hôpital du
Sacré-Coeur de Montréal, has published “Vivre
avec un adolescent mentalement souffrant”
(Living with an adolescent who has mental
problems). This book answers the questions
of people who are living or supporting
adolescents with psychiatric problems. It will
help parents and educators understand the
nuances and fine points of these disorders, as
well as their impact on the lives of the young people afflicted.
JEAN-PIERRE ROUTY
Avoir croisé le chemin de personnes souffrant du sida
m’a profondément marqué. Les leçons qu’elles m’ont
données et la confiance qu’elles m’ont accordée
pendant ces trente années m’ont permis de tenir le cap.
Ce livre en forme d’abécédaire est né du point
d’équilibre entre la période sombre du début de
l’épidémie et ce printemps de l’espérance, où un
premier patient a pu être officiellement déclaré guéri
du sida grâce à une greffe de cellules souches. Nous
vivons un moment unique : le plateau de la balance
semble désormais pouvoir pencher du côté de la vie. »
On the 30th anniversary of the discovery of
AIDS, Dr. Jean-Pierre Routy, a hematologist at
McGill’s Royal Victoria Hospital has published
CE QUE LE
Ce que le sida a changé, a book that gives the
broad outline and small details of the history
A CHANGÉ
of this unique disease. The author, who has
decided to devote his life to AIDS, relates three
decades that have radically changed sexual and
interpersonal relations. Dr. Routy paints a vibrant picture of the
beginnings of this epidemic and the parade of deaths, while
still maintaining his faith in the future at a time when advances
in medicine help him keep his patients alive.
J E A N - P I E R R E
R O U T Y
Le pouvoir anticancer des émotions
Dr. Christian Boukaram, a radio-oncologist
at Hôpital Maisonneuve-Rosemont, has
published Le pouvoir anticancer des émotions
(the anticancer power of emotions). The book
takes a new look both at this disease and the
world that surrounds us. The author emphasizes
the importance of an emotional balance in our
hectic lives.
S
L
Abrégé d’anesthésie et de réanimation
ublished by Presses de l’Université de Montréal,
P
this digest repeats several chapters of the
4th edition of the Précis d’anesthésie et de
réanimation, which sets out the fundamental
principles of anesthesiology and, in particular,
allogeneic blood products and blood-sparing
techniques, preoperative evaluation and
preparation, airway control, treatment of acute
pain, local anesthetic and curarizing agents, etc.
Alzheimer’s disease
Dr. Serge Gauthier, a neurologist and Director
of the Alzheimer Research Unit at the McGill
Centre for Studies in Aging, has published with
Judes Poirier, Ph.D., Director of the Molecular
Neurobiology Unit, Douglas Mental Health
University Institute, a complete guide to help
people who know or live with an affected
person to better understand this illness. The
authors clarify the various stages and give details of recent
research, new approved therapies, as well as clinical trials and
new prevention strategies.
Les Secrets du Pérou
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Départs garantis du 20 mai au 2 juin et
du 6 au 19 juillet - Max 30 pers.
14 jours / 12 nuits / 34 repas - À partir de 4660$*
Autres destinations et autres dates de départs disponibles,
Consultez
les spécialistes
en voyages de votre agence partenaire.
informez-vous
!
Contactez-nous pour tous les détails !
BERRI-UQAM
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*Prix par personne, en occupation double, incluant toutes les taxes et réductions selon les conditions des brochures Horizons lointains et Préliminaire
Europe et Méditerranée 2012. Les prix de cette publicité peuvent être modifiés advenant une augmentation de nos coûts. Voir à ce sujet les conditions
générales des brochures Horizons lointains et Préliminaire Europe et Méditerranée 2012, rubrique « Prix et garantie de prix ». La TPS et la TVQ sont
incluses lorsqu’applicables. Titulaire du permis du Québec.. Club Voyages est une division de Transat Distribution Canada Inc. Permis No 753141 au Québec.
Prix excluant le 3,50$/1000$ de services touristiques achetés qui représente la contribution des clients au Fonds d’indemnisation des clients des agents de voyages.
Concours Prix IMS Brogan 13e édition
Deux bourses
de 3 000 $ à gagner
DESCRIPTION DU CONCOURS
RÈGLEMENTS
Le Conseil consultatif d’information sur la santé d’IMS
Brogan a créé les Prix IMS Brogan pour souligner les travaux
de médecins et pharmaciens concernant l’utilisation clinique
efficiente des médicaments. Ces prix représentent une valeur
totale de 30 000 $ qui est répartie de la façon suivante :
L’auteur principal (premier auteur) de l’article doit être un
médecin spécialiste membre d’une association affiliée à la
Fédération des médecins spécialistes du Québec. Tout article
original paru dans une revue pharmaceutique ou médicale
spécialisée (excluant les entrevues et articles de journaux)
au cours de l’année civile (de janvier à décembre 2011)
peut être soumis à condition qu’il appartienne à l’une des
catégories précisées ci-dessus. De plus,
▪ à la Fédération des médecins omnipraticiens du Québec
(FMOQ) et à la Fédération des médecins spécialistes
du Québec (FMSQ) deux prix de 3 000 $ à chaque
fédération pour un article sur l’utilisation appropriée
des médicaments;
▪ aux pharmaciens, par l’entremise de l’Association
québécoise des pharmaciens propriétaires (AQPP), deux
prix de 3 000 $ chacun pour un article sur l’utilisation
appropriée des médicaments;
▪ à chacune des quatre facultés de médecine, un prix
de 2 000 $ à un étudiant pour la meilleure note en
pharmacologie;
▪ aux facultés de pharmacie (Université de Montréal et
Université Laval), deux prix de 2 000 $ aux étudiants
méritants pour un stage à l’extérieur.
DESCRIPTION DES PRIX DÉCERNÉS
Deux bourses de 3 000 $ seront décernées à deux médecins
spécialistes (ou deux groupes de médecins) s’étant distingués
par l’excellence de leur article sur l’utilisation efficiente de
médicaments, à titre d’exemple :
▪ importance de l’observance du traitement médicamenteux;
▪ meilleur traitement dans le cas d’une maladie donnée;
▪ revue de l’utilisation de médicaments dans un contexte
clinique;
▪ utilisation efficiente de médicaments les uns par rapport
aux autres dans un contexte clinique.
▪ les traductions, adaptations ou reproductions d’articles
ne sont pas admissibles;
▪ les articles acceptés pour publication mais non encore
publiés ne sont pas admissibles;
▪ les articles en deux parties comptent pour un seul texte;
▪ si un article a été rédigé par plus d’un auteur, le prix
sera remis à l’auteur principal.
SÉLECTION DES ARTICLES
Les articles seront soumis par leurs auteurs qui devront les
faire parvenir, avant le 31 janvier 2012, au directeur de
l’Office de développement professionnel de la Fédération
des médecins spécialistes du Québec, 2 Complexe
Desjardins, porte 3000, Montréal (Québec) H5B 1G8. Ils
seront ensuite évalués par un comité de sélection mis sur
pied par l’Office et composé d’un représentant de chacune
des quatre facultés de médecine du Québec.
Le directeur de l’Office communiquera à IMS Brogan le
nom des auteurs des deux articles retenus comme étant les
meilleurs. IMS Brogan remettra officiellement le prix lors
d’une conférence de presse.
DOSSIER
Web 2.0
THE WAVE
With the arrival of personal computers and the democratization of computer science, the new information and
communication technologies have literally revolutionized how we work... and live.
Today, whether it’s at work, at home or at play, with the help of a single click, a panoply of services or tools
aimed at making life easier is opened to us on devices of all types (telephones, tablet computers, personal
digital assistants, netbooks, personal computers, etc.). Telephones have become smartphones. With the help of
various applications, we have access to a multitude of tools (restaurant guides, calculator, GPS, Facebook page,
dictionaries, encyclopedias and translation tools, transportation schedules, games and more). Interesting, no?
Yes, but even if people are surfing more and more often, a large number are still afraid to get their feet wet.
In this dossier, Le Spécialiste has looked over the technologies and tools that can be useful to medical specialists
in their professional practice as well as in their personal lives. Insofar as Web 2.0 is concerned, the Federation
is not being left behind. In addition to being present on social networks, the FMSQ will shortly be inaugurating
its new portal.
Rather than being totally swept up by the wave, this dossier will help you keep your head out of the water.
Keep this issue at hand in your technological first-aid kit.
We like receiving your comments. Please don’t hesitate to swamp us with e-mails: [email protected].
Enjoy the reading and the surfing!
LE SPÉCIALISTE | VOL. 13 No. 4 | DECEMBER
4 | DECEMBER 2011 2011 | 15
| 15
By Véronique Clément
INTERACTIVE MEDIAS, FMSQ
Web 2.0 and Healthcare
Since its inception, the Internet had already revolutionized how we access information. The arrival
of the ‘social’ Internet and Web 2.0 have also permanently changed our attitude with regards
to information. With the multiplication of collaboration platforms and intelligent mobile devices,
people are no longer satisfied with passively receiving information; instead, they ask questions,
provide comments, and create their own information.
The popularity of Web 2.0 is constantly increasing, within all
age groups and in all areas, including that of medicine. While
physicians take part in communities of practice, communicate
their knowledge or learn about advances in the world of medicine,
patients search the Web, have conversations, ask questions
within discussion groups. Web 2.0 has definitely modified how
we work and play. It also carries its load of changes to be faced
by physicians and their patients.
A Portrait of Web 2.0
Web 2.0 started up in 1995, but really took off in the middle of
the last decade with the arrival of major players like MySpace
(2003), Facebook (2004), YouTube (2005) and Twitter (2006).
More recently, smartphones and tablet computers joined the party
and increased the speed at which social networks are emerging.
g One Word or Another, but Which is the Right
One?
Web, Net, Internet: is there a difference between
these terms?
According to the Office québécois de la langue française’s Grand
dictionnaire terminologique (terminological database), the Internet
is a global computer network made up of groups of national,
regional and private networks linked together through the TCP-IP
communications protocol. The Web, for its part, is a system based
on the use of hypertext which permits searching for information
on the Internet, access to this information and its viewing.
Nowadays, these terms all refer to the same concept and are used
as such in this text.
Generation Y individuals (from 18 to 34) are still the most
connected today, but there is a clear majority of people regularly
using social networks. According to the CEFRIO’s survey
NetTend@nces 2011, in Quebec, 73% of Internet users,
representing 59% of adults, are regular users (at least once a
month) of these online media. “Although the level of activity on
social networks goes down with age, it is also true that two
out of three Internet users in Quebec between the ages of 45
and 54 (69%), a bit more than half of those between the ages
of 55 and 64 (55%) and more than a third of those over 65
(39%) do take part in at least one activity on social networks.”
Quebec adults who use social networks
at least once per month according to age
92%
86%
69%
59%
63%
40%
17%
Quebec adults
as a whole
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 and over
Base: Quebec adults (n = 1006)
Source: NetTend@nces 2011 • CEFRIO (Centre to promote research and
innovation in organizations)
The field of healthcare does not escape this phenomenon and
the number of physicians connected to the Web is constantly
on the rise. The most popular social networks meet the needs
of physicians’ general interests in great part, but there are sites
specifically created for physicians and their patients. Each social
medium was developed more or less in response to its target
public and aimed to satisfy its various needs: social contacts,
developing professional networks, partnerships, etc.
Even if most people do not start off by analyzing how they are
going to use social networks, for physicians such a reflection
before the fact can make a real difference. What do you need?
Do you want to be connected on a personal or a professional
level, or both? Who would you want to talk with or, to the
contrary, is there anyone you don’t want to meet online? How
much free time do you have each day or week to devote to
it and what device will you use to connect to your accounts?
Some sites require a more regular presence or more sophisticated
equipment. A good understanding of one’s needs and of existing
online sites will avoid a lot of problems!
This article aims at providing an overview of Web 2.0 and its possibilities. If
converting to 2.0 interests you, you can get a professional to guide you, a
person who has extensive knowledge of social networks and their uses and
who also understands the reality of being a physician as well as the stakes
involved for your practice. These people are often known as interactive media
specialists or social media and Web 2.0 strategists.
Web 2.0
LA VAGUE
To Be or Not to Be…
Average number of hours per week
spent on social networks
8.6
Quebec adults
as a whole
0.6
0.6
0.5
0.2
0.5
0.6
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 and over
Base: Internet users in Quebec who have participated at least once on social
networks (n = 591)
Source: NetTend@ances 2011 • CEFRIO
Twitter? 140 Characters and 2 Codes to
Start with…
Although Twitter is not easy to use for the neophyte, it does
open the door to a significant number of discoveries and makes
it possible to talk with people in the field of healthcare wherever
they are in the world. Twitter has two main symbols that allow
one to navigate through its continuous flow of information: the
@ sign (identifying the person to whom the message is
addressed) and the # symbol (hashtag) that identifies the
subject of a conversation and thus allows one to follow a
thread in particular.
Gathering around Hashtags
Several communities, sharing an interest in common, set up
weekly virtual meetings with the help of hashtags. This is the
case with #HCSMCA (Health Care Social Media Canada) where
various people with an interest for social networks in healthcare
(physicians, patients, IT consultants, communications specialists,
healthcare administrators, nurses, etc.) share their thoughts on
the subjects suggested by members of the community. The
province of Quebec has a very visible presence there! These
meetings allow sharing knowledge, exploring new avenues, and
discussing stakes, always in a spirit of collaboration. Transcripts
of conversations and more information on the #HCSMCA
community are available online: http://bit.ly/o4Knxb.
It can also happen that hashtags are created on the spot to
follow developments in relation to a specific event. For example,
you can look up #JASP2011 for the 2011 Annual Public Health
Days which took place at the end of November; or #RSNA2011
for the Radiology Society of North America Scientific Meeting
and Annual Assembly (from November 27 to December 2, 2011).
Social networks do not interest everyone, but whether you
know it or not, you may already be on them. These media
accept input 24 hours per day, 7 days per week. You have
friends, family, colleagues and, in the area of healthcare, patients
who use them, not always cautiously, alas! Physicians should
test this assertion by googling their own names. If they aren’t
already in circulation, we’d be very surprised. Patients discuss
their physicians, evaluate them, formulate complaints as well
as congratulations. The essence of an online presence is that,
if you are not there, you cannot take part in the conversation
going on about you.
Even if identity theft is not all that current on social networks, it
can happen. Whether you intend to make regular use of these
sites or not, it is strongly recommended that you “reserve”
your name on them (i.e. Facebook, Twitter, LinkedIn) in
order to avoid having someone else usurp your identity. As
a physician, you can check doctor evaluation sites like www.
rateyourdoctor.com and www.rateMds.com to see if someone
has in fact used your name. If such is the case, you must make
sure you ask for your profile (generally by sending your request
to the site’s webmaster) and, at the very least, add a short
biography of yourself as well as accurate contact information!
:-(
Warning!
When you launch a search for your name on the Web, you can
be surprised by what is being said about you. Your first reaction
is often to want to delete any and all public comments.
To start with, you have to realize it is difficult to completely
delete information circulating on the Internet. Even if it is erased
from one site, it may already have propagated itself over the
Web and there’s no way of knowing it. You have to take into
account that once published online, information is both public
and permanent. A strong reaction to comments can sometimes
shine the spotlight on them whereas ignoring them can make
them pass unnoticed.
:-)
Tip!
Whether you are active or not on social networks, it is always
interesting to know what is being said about you and to maintain
a minimum of control on such information. A useful tip is to take
advantage of Google’s alerts (http://www.google.com/alerts)
to keep up to date. You should set up separate alerts to make
sure you cover all possible forms of your identity, for example
Dr. Samuel Gariépy, Dr. Gariépy, Samuel Gariépy, Samuel
Gariépy M.D.
Most Popular
Name and Description
Facebook is a social networking site between groups
of Internet “friends” who can use it to provide personal
information (age, marital status, profession, etc.); publish
information on each individual profile’s “wall”; share
photographs, videos and hyperlinks; take part in public
discussion groups; organize events; create pages that increase public
awareness of specific organizations, etc.
Facebook allows its users to interact by publishing comments or even
making their preferences known by using the “Like” button. Several
other functionalities exist on Facebook that can be added to pages via
various external applications, with a resulting increase in the possibility
of interaction between users.
Twitter is a social networking and microbblogging
service that enables users to send out, at no charge,
text-based posts (tweets) to a list of subscribers
(followers) via a personal information thread. It also allows
users to subscribe to other persons or organizations and
follow what they publish, react to it and repost it through the RT
function (retweet).
The short messages (maximum of 140 characters) gave rise to
a shorthand unique to Twitter that can sometimes be difficult to
understand for a new user.
Used principally like a newswire, Twitter also allows publishing links, in
particular to photos and videos.
LinkedIn is a business-related social networking service
that can be used for everything related to one’s
professional life: to find or offer a job, to obtain
recommendations, for market development, etc. In
particular, it allows one to build a professional
community: to discuss, ask questions or answer those from other
people by taking part in groups, publish information on one’s
professional experience, studies, interests, etc.
Google+ is Google’s social networking site. It is a hybrid
site with some of the functionalities found on Facebook,
Twitter and LinkedIn. It allows users to publish personal
or professional information to various groups of contacts
(circles), to share photos, videos and links, to follow their
interactions by subscribing to their profiles, etc. It is also possible to
comment on what is published and to make one’s preferences known
by using the “+1” button.
Like Facebook, Google+ offers a lot of functionalities that can be
added to a page through the use of applications and that allow one to
interact in various ways with other users. The advantage of Google+,
when compared to other social networks, is that managing groups with
whom one shares information is relatively simpler and its conditions of
use, for the moment, are more transparent.
Examples of Use for a Physician
• Read and share information considered
pertinent by the user;
• Set up exchanges with students within a private
discussion group;
• Subscribe to pages belonging to organizations
that interest us in order to be kept abreast of the
latest news (for example, the FMSQ has its page
on Facebook on which it posts its latest news:
https://www.facebook.com/laFMSQ).
*W
arning: Content published on a Facebook page may
seem private, but, in the vast majority of cases, they
are public. When you write on this site, it is like writing
for a newspaper. Make sure your comments have been
validated before putting them online.
• Take part in group chats (TweetChat)
(e.g. #HCSMCA) with other people on subjects
of interest;
• Follow discussion threads of influential people
or organizations in one’s field in order to keep
up to date on the latest news
(e.g. @DrBarretteFMSQ, @FMSQ, etc.);
• Publish important information on one’s own blog
in order to circulate it on the Web.
• Take part in multidisciplinary discussions;
• Publicize one’s professional achievements.
Google+ provides social networking very similar
to Facebook’s offering. Its advantage resides in
simpler management when it comes to publishing
content, through circles of friends, thus allowing
a physician to avoid communicating personal
information to a patient or to colleagues who have
signed up to follow him or her.
It is still, however, a young network (launched in
June 2011) and less used than Facebook. It is still
difficult to forecast its future.
Web 2.0
THE WAVE
Most Popular (suite)
Name and Description
WordPress is a content management system (CMS)
developed and contributed to by a community of
programmers (Open Source), who provide continuous
improvements. Its functions include the simple, intuitive
and cost-free (or reduced cost, depending on
requirements) creation of a blog and even, with some additional
knowledge, of a web site. WordPress provides for the publication of
entries and for sorting them (by date or by category, for example), for
the creation of web pages, for managing external and backtrack links,
for sharing published content and for receiving comments.
A blog is a type of simplified web site that publishes items (entries) used
mainly for more informal, responsive and interactive communications.
SlideShare is a Web 2.0-based slide hosting and
sharing service for multimedia presentations. Users can
upload presentations in PowerPoint, PDF, Keynote or
OpenOffice, as well as webinars, to a personal account
and publish them online, either publicly or privately, and
obtain an evaluation or comments.
Diigo is a kind of online reminder system generally
used for office work. It is a social bookmarking
website that allows users to file their favourite
web-pages and to find them easily with the help of keywords, to
highlight passages and attach notes, as would be done for a printed
article, the only difference being that it is done online. It also allows
users to make lists of any useful information found on the Web and to
save it by subject in their own personal space on the Diigo “cloud”
(Diigo server available on line). It is then possible to access this space
from any computer, smartphone or tablet computer at any time. It
allows user to share their discoveries with acquaintances and to
search the discoveries of other people who share similar interests.
YouTube is a video-hosting and sharing website.
It allows users to create personal accounts and to send,
view, evaluate, comment and share video sequences
with the Internet as a whole or with a specific group.
Videos are classified by category and can be found
through keywords.
According to Wikipedia, “A wiki is a website that allows the creation
and editing of any number of interlinked web pages via a web
browser... (wikis) are often used collaboratively by multiple users.”
A wiki is developed with a simple-to-use software tool and generally
results in a knowledge library enriched by its community. Wikipedia,
the free encyclopedia is the best-known example. Public or private, a
wiki allows you to track modifications so as to be able to return to a
previous version or view the history of the site’s pages.
Examples of Use for a Physician
• Create a personal blog to communicate with a
community of Internet users on one or several
subjects in the field of healthcare;
• Develop a web site to present one’s
association, clinic or product (e.g. a book being
published, etc.);
• React to certain entries published by
other members of the medical community
via comments.
• Archive and make available multimedia
presentations from one’s conferences;
• Consult presentations by other individuals on
subjects of interest or for educational purposes
(e-learning, for example).
• Archive, highlight and annotate texts on the
Web and access them from any computer or
mobile device;
• Share web-pages and online articles within
work groups;
• Sort bookmarks along certain themes to share
them with colleagues or patients.
• Share educational videos aimed at patients or
students (e-learning);
• View video sequences on specific themes
(e.g. khanacademy, type2diabetes, etc.).
• Share knowledge on a given subject within a
practice or multidisciplinary group;
• Collaborate on developing an idea or a project,
like writing a brief for example;
• Centralize information or create a knowledge
library in a department (a collective memory).
Healthcare 2.0
The 2.0 Patient
Social networks and mobility are now inserting themselves into
medical practices, such as investigation, case management, and
patient monitoring; in addition, they impose their own rhythm. The
field of healthcare, still uncomfortable faced with these changes,
feels jostled : whether it’s a frustrated patient’s comments
making the rounds on the Web and undermining a physician’s
or an establishment’s reputation; or confidential information
unknowingly leaked on an employee’s Facebook page, infringing
the profession’s code of ethic; or even, the announcement of
a revolutionary new treatment on social networks that spreads
at the speed of light and generates emotional reactions, like
the Zamboni treatment of multiple sclerosis. Each day, such
examples continually pile up all around the planet.
As was previously mentioned, increasing numbers of patients
want to take control of their health and do so with Web 2.0
applications, in particular. These patients, networking together, are
collectively building a new system of parallel knowledge, which
is not scientific, but which collates personal experiences. With
the help of social networks, patients joined self-help groups by
establishing virtual links between one another. Social networks
in the area of healthcare are often used to express emotions,
especially anxiety or fear, but also provide mutual aid, empathy
and acceptance. They are also used as meeting places for
organizing pressure groups (lobbies).
In principle, nothing has changed. There have always been
unsatisfied patients or rumours of miracle cures. What has
changed is the speed at which information is propagated,
whether true or false, its impact zone and the traces it leaves
behind. It is therefore not surprising to see physicians and other
healthcare professionals apprehensive about social networks.
For the medical community, among the main stakes are the
protection of personal data, the professional code of ethics,
productivity, the loss of control over information and the
redefinition of social exchanges to name only a few. The Web
2.0 is taking over at enormous speed even if no “best practice”
has been defined and the benefits of using it have not yet been
clearly demonstrated for physicians and their patients.
Health on the Net Foundation
(HON): a Guarantee of Quality for
Medical Information...
Since the Internet contains all kinds of
information, how can we differentiate the good
from the bad, the truth from the rumour or
popular beliefs?
In the field of health, there’s an organization
whose mission is to guide users to reliable
Internet sites, sites that contain truthful,
trustworthy and accurate information. The HON foundation,
a non-governmental entity, was founded in 1995 and has its
headquarters in Geneva. HON delivers certificates to businesses
and organizations that publish Internet sites dealing with health
or providing medical information. The organization seeks to make
sure that the latter is exact, reliable and objective. To obtain one
of the certificates delivered by HON, you must start by proving
that the information contained on the site is in line with the HON
code of ethics. The site’s entire contents are evaluated before any
certificate is issued (and unfortunately, delays are often long!).
(www.hon.ch)
People also use Web 2.0 to locate a panoply of information that
complete, confirm, infirm and question the physician’s diagnosis.
On the Web, complex medical terms become accessible and
popular with the masses. The CEFRIO’s NetTend@nces 2010
survey ranks the category “health and medicine” in 7th place
among the information most searched for on the Internet with
48% of Internet users who indicate a regular interest (at least
once a month). In generation A (55 and over), health is in
1st place with 63% of people indicating an interest.
Most people who search the Internet regarding health issues
trust the information they find and many let themselves be
influenced by it. Web 2.0 is a large contributor to the development
of hypochondria which, because of the virtual nature of the
information received, is often rechristened cyberchondria.
ON NOVEMBER 22, 2011, THE GOOGLE
SEARCH ENGINE LISTED 8,460,000 RESULTS
FOR THE TERM “COMMON COLD” AND
756,000,000 FOR THE WORD “CANCER”.
IT IS NOT LOGICAL TO THINK THAT ALL
THE PROPOSED RESULTS EMANATE FROM
RELIABLE SOURCES OFFERING SOUND ADVICE.
The quality of online information is extremely variable and can
even be dangerous. A patient can self-diagnose and order
medication online without ever having entered a physician’s office!
The danger is that the patient, as opposed to the physician, does
not always have the required discriminating mind to sort through
the large quantity of information received on the fly and has few
ways of knowing if the site he is consulting is from a reliable
source, except through the HON certification (see box at left).
Web 2.0
THE WAVE
Hierarchy of activities on social networks
(at least once per month)
RSS… for a Panoramic View!
All the news at a glance, that is what RSS has to offer.
To
create
content
36.40%
To relay information
40.60%
To maintain a profile
RSS (dubbed Really Simple Syndication) is a
“family of web feed formats” used to publish the
contents of an Internet site without page make-up
or formatting. On subscribing to it (at no charge), it
allows one to read the major headlines of selected
sites without having to visit them individually. The Internet user
can choose how the RSS feed will be received: by e-mail, on a
browser (Internet Explorer, Firefox, etc.), on a smartphone (RSS
app), on a dashboard (NetVibes, GoogleReader, etc.), on a
personalized portal (Yahoo, iGoogle, etc.), to name but a few.
52.20%
To interact with others
55.70%
To consult content
69.90%
Base: Quebec Internet users (n = 806)
Source: NetTend@nces 2011 • CEFRIO
As a physician, even though you can’t prevent patients from
obtaining information on the Internet, you can at least guide and
advise them. There are reliable Web sites and you can print a
list of them to give to patients to direct them towards accurate
information. As well, some discussion forums are better than
others and a visit to them is needed to identify those with good
information and a solid community before recommending them
to patients. A site recommended by a physician will be more
highly trusted and result in a lower tendency to launch searches
throughout the entire Web. By becoming your patients’ ally, the
trust that binds them to you will simply become stronger. And
for those of you already familiar with 2.0, it is always possible
to set off the inaccurate information found on social networks
without feeling obligated to take part in discussions. An honest
discussion of Web 2.0 with your patients will result in making
them aware of their need to take control of their health and
become your partners in your professional relationship.
Web 2.0 and mobility are taking us into the future as much in
our personal as in our professional lives. They are still quite a
challenge, however. Naturally, this paradigm shift is disturbing and
even scary. Neither science nor medical expertise, however, are
at stake. It is only by learning to act in the same arena as patients
that physicians can benefit from 2.0 in their professional practice.
“Meetups” – Not Virtual
Social networks allow people who share the same passions
or ideas to exchange views on a given subject. Unfortunately,
cyberspace is not a physical meeting place. Virtual exchanges
can however sometimes lead to interesting personal meetings...
(Careful! This has nothing to do with personal dating networks!).
One formula is gaining in popularity: “meetups”, informal meetings
of Twitter fans on a given subject. The first meetup of Montreal’s
health and social services collaborators (#HCSMCA) took place
on November 3rd, and brought together some thirty individuals
to talk about their passion and to discuss upcoming stakes in
the area of health and social networks.
And “Tweetups”…
Like meetups, tweetups are discussions between fans, virtual
ones. A date, time of meeting and hashtag are given and
exchanges take place in the twittersphere. A nice way of meeting
stakeholders from around the world.
WEB 2.0 AND MOBILITY ARE
TAKING US INTO THE FUTURE AS
MUCH IN OUR PERSONAL AS IN OUR
PROFESSIONAL LIVES.
S
L
By Véronique Clément, Interactive Medias
and Nicole Pelletier, APR, Director
Public Affairs and Communications, FMSQ
It’s Confirmed…
Medical Specialists are Surfing…
So is the FMSQ
On June 15, 2011, we sent out an e-mail to all members of the FMSQ, francophones as well as
anglophones, inviting them to complete an online survey. One reminder and a few weeks later, 1341
medical specialists had responded (1210 in French and 131 in English). Without any claim to being
a scientific exercise, the goal of this survey was to help us finalize the contents of the Federation’s
new portal.
Since medical specialists are among the publics targeted by the
portal, it made sense for us to seek to understand their interest
for Web 2.0; by the way, 73% of respondents confirmed they
had already visited the FMSQ’s website.
We note that 85% of respondents overall surf the Web at least
once a day and that 88% of them read their e-mails from one
to several times a day. While surfing the Web, certain subjects,
among those proposed, are of special interest, i.e. general news
(76%) and scientific information (73.6%). Also of interest are
medical news in Quebec (34.4%), international medical news
(29.5%) and social networks (18.5%). Other areas of interest
mentioned include technological development and technology in
general, medical education, online training (e-learning), business
and economic news. To the question requesting they identify their
favourite websites, no less than 770 suggestions were provided
by respondents.
Physicians have definitely adopted both computer and mobile
technology, which is why over the next year, among respondents,
63% will have a smartphone, 32% a tablet computer and 86%
a personal computer.
Where to find the FMSQ in cyberspace
The FMSQ is not somewhere out on the fringes of the (new)
environment resulting from the development of the Internet. It has,
in fact, been making a place for itself for some time and hasn’t
hesitated to critique its own presence, limited though it may be,
in the virtual dimension. Our conclusion is that if the Federation
wants to set out on the path of social media and social networks,
it has to make an effort to respect the rules in order to reach its
communication objectives.
Site or Portal?
All of the brain-storming concerning a not only increased but also
effective presence on the Web and on social networks, started
DÉCOUVREZ
COMMENT
out with an evaluation
of the FMSQ’s website,
a site that has
unfortunately been left
on itsASSURANCES
own for too long.
VOS
ÉVOLUER
If being present on POURRAIENT
the web for an organization
like ours is
essential, even required,
“beast” itself
has to be fed. We thus
AUtheMÊME
RYTHME
made a firm resolution to set up a permanent home there and to
QUE VOTRE STYLE DE VIE
make ourselves comfortable... All joking aside, the Federation’s
BESOINS.
website originally setET
up VOS
in the 1990’s
and revamped in 2007
will have a completely new look for the new year. From being
essentially informative, the fmsq.org (or www.fmsq.org) address
will become as of January 2012, a modern easy-to-use and
diversified integrated portal.
To get there, we chose
POUR
a totally new platform
for EN SAVOIR PLUS :
content management (Liferay)
1 800 361-5303
IMPORTANT
that will allow us to514
make
350-5070 / 418 990-3946
You will receive soon
changes easily and as often
as necessary. The strong
an email giving you your
Par will
courriel ou Internet :
point of the new portal
username and password
[email protected]
be the section reserved
for
to enter the member
medical specialists.www.sogemec.qc.ca
Each
only section of our
member in good standing
new portal.
will be able to register and
access a personal profile.
From this interface, the
physician will have access to content that is reserved exclusively
for FMSQ members (messages, labour news, etc.) and receive
personalized information according to specialty, gender and, at
times, language of correspondence.
SOGEMEC ASSURANCES
filiale de la
POUR TOUS VOS
BESOINS D’ASSURANCES
In addition, each physician will be able to modify contact details
Grâce au
directly from a profile, see videos destined exclusively for members,
attend online conferences and more. In short, the section “For
Physicians” on the new portal has been rethought to satisfy
our current and future needs to exchange information and
communicate between the FMSQ and its members. We naturally
intend to develop this new medium even further.
SERVICE PRÉFÉRENCE
SOGEMEC ASSURANCES
ÉVOLUE AVEC VOUS
Work on this impressive “job site” (nothing to do with the saga
in the construction industry) started in September and will be
finished by the end of the year.
Qu’il s’agisse d’assurance professionnelle
ou personnelle (vie, invalidité, auto, habitation),
le service Préférence de Sogemec Assurances
THE sait
FMSQ
ALSO TOOK
TO REFLECT ON ITS
répondre
à toutesTIME
vos attentes.
PRESENCE AND USE OF THESE NEW MEDIA. WE
IDENTIFIED TWO MAIN AXES FOR OURSELVES
IN 2.0: FIRST, BUILD SOLID COMMUNITIES
INTERESTED IN SPECIALIZED MEDICINE ON
EACH OF THE PLATFORMS USED BY THE FMSQ
(TWITTER, FACEBOOK AND YOUTUBE) AND
ENGAGE A CONVERSATION WITH OUR
2.0 COMMUNITIES, MADE UP OF INDIVIDUALS
WITH VERY DIVERSE BACKGROUNDS.
As for the @FMSQ account, it deals with specialized medicine
and is used to interest a wider community. The FMSQ created
its own hashtags in order to obtain maximum visibility and allow
followers to connect with their main interests:
daily press clippings on the subject of
health and healthcare;
#Vigie_Sante:
communicate statistics, numbers that
illustrate the situation in the healthcare network;
#Maths_Sante:
distribute and promote articles
that have appeared in the magazine Le Spécialiste;
#LeSpecialisteFMSQ:
content directly related to specialized
medicine (major issues, prizes and awards given to
members, suggested reading material, etc.).
#MedSpecialisee:
When we publish information on the FMSQ’s website that could
be of interest to our communities (press releases, for example),
we systematically send out a message on Twitter. We tweet
interviews with Dr. Barrette on television and radio: beforehand,
to announce them and, afterwards, to highlight key messages in
interview extracts and provide URLs where the interviews can be
seen or heard. We also retweet articles written by reporters to
whom Dr. Barrette granted interviews and take part in discussions
launched by people we follow on Twitter.
Face to Facebook…
Building 2.0 Communities
As social networks have become unavoidable, the FMSQ also
took time to reflect on its presence and use of these new media.
We identified two main axes for ourselves in 2.0: first, build solid
communities interested in specialized medicine on each of the
platforms used by the FMSQ (Twitter, Facebook and YouTube)
and engage a conversation with our 2.0 communities, made up
of individuals with very diverse backgrounds. How? By regularly
supplying them with value-added content that is directly related to
our federation interests, an opening that is still very little exploited
in the French-language 2.0.
“Tweeting” Specialized Medicine
We have decided to split our interventions on Twitter
into two entities: the @DrBarretteFMSQ account and
the @FMSQ account.
The President’s account is used to provide commentary on
news items, issue opinions and take part in hashtag sessions
(for example, #clubexrdi). The content remains mainly political
and labour-related and uses hashtags that are most common
in these areas, i.e. #assnat (the National Assembly) and #polQc
(Politics in Quebec). The #SantéQc (Health in Quebec) hashtag was
developed by the FMSQ and is starting to appear in contributions
from other members of the TwitterSphere. It identifies a content
that is directly linked to a political or labour aspect of healthcare.
SOGEMEC ASSURANCES
filiale de la
The FMSQ’s Facebook page has been up for several
months already and continues to receive regular feeds.
It publishes information similar to what appears on Twitter,
but in a longer format since the maximum message length is no
longer of concern (announcing interviews with Dr. Barrette,
providing newspaper articles regarding the FMSQ or specialized
medicine, etc.). However, for the moment, the FMSQ has decided
not to make of Facebook its primary channel. This platform will
be developed in a second phase, once the web portal and the
Twitter accounts have hit their stride.
For You on YouTube
he FMSQ has a YouTube channel where it makes its
T
video productions available: mon histoire santé,
passionnés pour la vie, etc.
As you can see, the FMSQ is now in 2.0 mode. By using the full
range of Internet possibilities, we maximize our chances of attaining
our Federation’s communication goals. As opposed to the field
of healthcare, in this world, viral is a good thing!
If you are also part of this universe, we invite you to get in touch
with us and to share the information published by the FMSQ with
your own communities!
S
L
Have You Met @DrBarretteFMSQ?
Here are a few of the exchanges that have appeared on the FMSQ President’s Twitter account.
The Twitter thread allows us to interact with people,
whether they’re from the healthcare field or not, as well as
reporters, politicians, etc. It’s always interesting to read
what they have to say...
dominiquehardy dominiquehardy (journaliste)
Le @DrBarretteFMSQ est maintenant sur
twitter. Va-t-on avoir assez de 140 caractères
pour parler des enjeux de la médecine au Qc ?
À suivre.
24 fév
rBarretteFMSQ Dr Gaétan Barrette
D
@dominiquehardy On ne peut pas tout régler en
140 caractères, mais on peut certainement discuter
et c’est ce que je compte faire !
On November 18, 2011
Dr. Barrette was up to
and had
119 tweets
1591 followers.
It’s always a good idea to set the limits of our presence on
Twitter to avoid misunderstandings or disappointments…
DrBarretteFMSQ Dr Gaétan Barrette
@
Pour tout savoir sur “ le pourquoi du comment ” de
ma présence sur Twitter, lisez ma charte d’utilisation
http://bit.ly/eKAuYS
15 mar
Claude Claude Villeneuve V
@DrBarretteFMSQ Une excellente idée que
d’expliquer les principes de sa présence sur
Twitter !
15 mar
Seb_Fassier Sebastien Fassier Au moins c’est clair ! RT @DrBarretteFMSQ:
Pour tout savoir sur “ le pourquoi du
comment ” de ma présence sur Twitter
http://bit.ly/eKAuYS
15 mar
Lyne_Robichaud Lyne_Robichaud @DrBarretteFMSQ Merci de me suivre.
Super, votre charte d’utilisation de Twitter !
Je la signale en exemple au gouv Qc
http://bit.ly/mhrov9 4 jul
We sometimes use hashtags (# + keyword) to tweet
directly during public affairs broadcasts…
simondurivage Simon Durivage La Q. #clubexrdi : Les pharmaciens veulent jouer
un rôle accru en santé, les médecins hésitent à le
leur confier. Vous, êtes-vous d’accord ?
lizafrulla Liza Frulla @simondurivage Les médecins ont la
réputation de protéger leur territoire.
Soyons plus ouvert pour être plus efficace #clubexrdi
15 mar
DrBarretteFMSQ Dr Gaétan Barrette La proposition des pharmaciens améliorerait
immédiatement les services aux patients et
augmenterait l’efficacité du système #clubexrdi
15 mar
MatLeVeteran Mathieu Tremblay @DrBarretteFMSQ Bravo pour votre
honnêteté intellectuelle Dr Barrette. Je suis
un pharmacien tanné de courir après les MD #clubexrdi
15 mar
magregoire Marie Grégoire Le ministre Bolduc doit agir. Les
pharmaciens font une proposition
raisonnable qui est dans l’ordre des choses. #clubexrdi
15 mar
This exchange of views inspired the host of the show to ask
for a telephone interview directly with Dr. Barrette. And the
exchange was carried on for a few more days on Twitter.
docseggi Gilles Tousignant
@DrBarretteFMSQ les pharmaciens ne sont ils pas
a risque de conflit d’intérêt ?
23 mar
DrBarretteFMSQ Dr Gaétan Barrette
@docseggi Comme il a été dit, les pharm. et
les médecins devront s’entendre en vertu de
leur code de déonto, mais ca vaut la peine d’essayer.
23 mar
Web 2.0
THE WAVE
Twitter complements our presence in traditional media...
DrBarretteFMSQ Dr Gaétan Barrette Je serai à l’émission de @Dutrizac l’après-midi, au
98,5 fm à 13h30 pour commenter le Dossier santé
Québec (DSQ) #assnat #polQc. 26 sep
rBarretteFMSQ Dr Gaétan Barrette D
Sur le plan de la gestion, le #DSQ c’est un
échec depuis le début #assnat #polQc
We also use Twitter to communicate directly to politicians,
just like during the last elections... even if many of them
were often flagrantly absent.
DrBarretteFMSQ Dr Gaétan Barrette @premierministre @GillesDuceppe @Ignatieff_M @jacklayton_npdQuel parti politique féd. s’engage à
reconduire en 2014 l’Accord sur la Santé ? 1/2
4 avr
rBarretteFMSQ Dr Gaétan Barrette D
@premierministre @GillesDuceppe @Ignatieff_M @jacklayton_npd Et quel parti s’engage à majorer
l’env. de 41 milliards $ pour 10 ans (2024) ? 2/2
26 sep
rgiraldeau Renaud Giraldeau @ Gros contrat = gros graissage de
patte RT @DrBarretteFMSQ Sur le plan
de la gestion, le #DSQ c’est un échec depuis le
début #assnat #polQc
4 avr
illesDuceppe Gilles Duceppe G
@DrBarretteFMSQ Le Bloc travaillera afin
qu’Ottawa paie sa juste part dans la
prochaine entente sur la santé... 1/2
26 sep
DrBarretteFMSQ Dr Gaétan Barrette Dans le dossier du #DSQ, on n’a jamais eu
de plan clair et les délais n’ont jamais été
respectés. #assnat #polQc
4 avr
GillesDuceppe Gilles Duceppe @DrBarretteFMSQ et que la “clause
Québec” soit conservée. 2/2
26 sep
christian_leduc Christian Leduc @DrBarretteFMSQ Vous ne sentez pas
une amélioration depuis la refonte de la
gouvernance du printemps dernier ? #DSQ
27 sep
DrBarretteFMSQ Dr Gaétan Barrette @christian_leduc Êtes-vous sérieux ?
26 sep
christian_leduc Christian Leduc @DrBarretteFMSQ Non, pas vraiment ! :) Les
com. sont d’ailleurs archi mauvaises: RAMQ,
MSSS et agences régionales se renvoient la balle.
4 avr
This message was taken up (retweeted) by several
persons, including @HGagneTVA (reporter) and
@DanBigras (a well-known personality). It generated more
than 20,000 comments in less than 20 minutes!
DrBarretteFMSQ Dr Gaétan Barrette On coupe 300M$ en santé et ça ne paraîtra pas ?
2 options: on gaspille ou on nous ment. Est-ce ça
la fameuse méthode Toyota ? #assnat #polQc
20 sep
27 sep
PolitiqueMM Michel Martin @DrBarretteFMSQ Est-ce ça la fameuse
méthode Toyota ? En effet, des freins qui ne
fonctionnent pas et un accélérateur qui reste collé :-))
DrBarretteFMSQ Dr Gaétan Barrette Voici un lien vers l’entrevue que j’ai accordée
hier à @Dutrizac au sujet du #DSQ: 985fm.
ca/audioplayer.ph… #polQc #assnat
20 sep
27 sep
This exchange allowed a reporter from Le Devoir to
learn of the interview granted by Dr. Barrette on 98.5 FM
and to select an extract that was quoted in her article:
L’informatisation du réseau de santé s’échelonnera
jusqu’en 2021. It was like hitting two birds with one stone!
And sometimes the message is one of solidarity and
encouragement, on one side or the other...
DrBarretteFMSQ Dr Gaétan Barrette Bravo aux bénévoles qui prêteront main forte à
la grande corvée. Protégez-vous du soleil et des
moustiques et soyez prudents !
10 juin
S
L
Useful links for
your address book
Keep up with the FMSQ
fmsq.org
Twitter
YouTube
@DrBarretteFMSQ
@FMSQ
youtube.com/
LaFMSQ
Facebook
facebook.com/
laFMSQ
By Me Laurence LeGuillou, Solicitor
and Me Sylvain Bellavance, Director
Legal Affairs, FMSQ
Web 2.0
THE WAVE
The Physician and
Social Networks
Social networks, like Facebook, Twitter, LinkedIn and others represent some of the most
important communication tools available today and all of them touch us in different ways.
They offer us a world of possibilities that will only continue to grow over the coming years.
The arrival of social networks, however, has caused a number of us to ask ourselves
questions on what impact they will have, both in our personal and professional lives.
The physician cannot escape this reality. Since social networks
provide for very large scope publications and that it’s impossible
to control these once the content is out on the net, the physician
must use vigilance when using them. We thus wish to examine
the impact of social networks from the point of view of an
active medical practice. To start with, it has to be mentioned
that using social networks does not fall under a specific and
new legal framework, but rather that the physician’s rights and
obligations in this respect must be examined in light of existing
legal frameworks. We will therefore deal with this subject under
four aspects: the physician’s private life, his or her ethical
obligations, the general rules of civil law and exercising
hospital privileges.
1) S
ocial Networks and the Physician’s
Private Life Traditionally, several persons have invoked the fundamental
right to privacy when others have wanted to look closely at their
actions. Certain employees thus contested their employers’ too
inquisitive eye and beneficiaries objected to insurers looking into
their personal activities.
When it comes to using social networks, the limit between
aspects of private and public life has become fuzzy. Social
networks offer the possibility of networking with numerous
Internet users and of communicating with an enlarged circle of
“friends.” In this context, the majority of current jurisprudence
indicates that a person cannot reasonably have an expectation
of privacy on social networks.1
It is important for the physician to realize that it may prove very
difficult to claim that the activities he or she is involved in on
a social network belong to one’s private life even if they are
personal activities. Caution is needed and it must be understood
that any statements made while using social networks could
be subject to criticism, whether they are work-related or not.
A social network’s publications could also be admissible as
proof in court.
For example, a tribunal allowed an employer to produce
photographs originating from an employee’s Facebook page,
where she could be seen on vacation in the Dominican Republic
assuming positions that were incompatible with the lower back
pain she complained of to her physicians.2 In another case, a
worker claiming she had been subjected to harassment at work
produced her colleagues’ statements as published on Facebook
in order to support her claim to the CSST.3
2) S
ocial Networks and the Physician’s
Ethical Obligations
The physician’s ethical obligations are numerous and we cannot
study them extensively here. We do wish, however, to mention
some of them as they are pertinent, in our opinion, to the use
of social networks.
Personal Information and Confidentiality on Social
Networks
In an article published by the Canadian Medical Protective
Association (CPMA), it was stated that while “...physicians
are aware that disclosing patient information in public
spaces such as hallways and elevators may breach their
duty to protect patient confidentiality and privacy, they
may not realize similar discussions on social networking
or professional websites can also constitute a breach.”4
Whether it concerns communicating about a patient’s specific
condition or publishing a comment on Facebook on how the
day played out, a physician must be careful with the information
he or she publishes. According to the Collège des médecins du
Québec, “the physician must be careful when he provides
advice on healthcare through the use of information
technologies. He or she must be conscious that there is an
obligation to respect rules inherent to the confidentiality of
the information he or she has obtained and that professional
secrecy must be maintained”5 (translated from the French).
THE CODE OF
ETHICS REQUIRES
PHYSICIANS TO
AVOID TAKING
PART IN INDISCREET
CONVERSATIONS
CONCERNING A
PATIENT OR TO
REVEAL THAT
A PERSON HAS
CALLED UPON THEIR
SERVICES..
The Code of Ethics requires physicians
to avoid taking part in indiscreet
conversations concerning a patient
or to reveal that a person has called
upon their services.6 This should be the
case on a social network. Publishing
photos or videos taken by a physician
in the workplace could also imperil
the professional secrecy he or she is
expected to maintain. As indicated by
the CPMA, the danger does not originate
only from publishing nominative data.
Certain rare clinical problems or the
specific situation of a patient could result
in patients recognizing themselves or
being recognized by others. The physician
should therefore avoid publishing
information that would permit this identification.7
“Friends” on Social Networks
Professional Relationships and Social Networks
As we have seen, various ethical obligations dictate that
physicians must be cautious regarding their publications on
social networks. However, the fact that personal information
was divulged, that a colleague’s reputation was attacked or that
another person’s image was discredited on a social network
also opens the door to the possibility for the physician of being
held responsible for these acts. At this point, general provisions
regarding civil responsibility apply.
According to the Code of Ethics, physicians must not denigrate,
breach the trust, use disloyal methods or intimidate anyone who
is in a relationship with them in the exercise of their profession,
like a colleague or a member of another professional body.8
Because social networks imply a nearly limitless distribution of
their publications, this general principle becomes all the more
important when it concerns both the physician’s writings and
any images or videos that could be published.
Publishing Medical Opinions on Social Networks
The Internet provides many sites promoting exchanges. Whether
the physician gives medical advice in his or her office or on a
social network, the principle is the same: his or her professional
medical responsibility could be implicated. As required by the
Code of Ethics, a “physician, expressing medical opinions
through any public information medium, must express
opinions in keeping with current information in medical
science on the subject and indicate the caution with respect
to a new diagnostic, investigative or treatment procedure
which has not been sufficiently tested.”9
The Collège des médecins du Québec also reminds us that “if
the physician disseminates information on health, he or she
should mention that such information is general in nature
and is not linked to the state of health of a specific patient
and that it does not replace the examination required for
each case.” In addition, the Collège recommends that physicians
include a statement in their e-mail messages, as well as on
the web sites they use, explaining that the patient-physician
relationship does not exist before the physician has accepted
the mandate. This is to avoid having persons send confidential
information before the mandate is accepted.10
We can be justified in asking whether it is appropriate or not for
physicians to become “friends” with their patients on Facebook
or another social network. It seems to us that, generally, various
ethical obligations make this “friendship” incompatible. It should
be noted, in particular, that the physician must at all times maintain
his or her professional independence11 and must abstain from
intervening in his or her patient’s personal affairs.12
Advertising and Social Networks
Social networks are an effective way of advertising. In this
regard, the Collège des médecins du Québec reminds us that
“information that cannot appear in a printed advertisement
can no more appear in a virtual communication.”13
3) Social Networks and Professional
Liability
Reciprocally, the physician is also entitled to respect for his or her
fundamental rights. Certain sites give patients the possibility of
rating their physicians and publishing comments regarding them.
It is important to remain vigilant regarding the misunderstandings
that can occur. A physician’s reputation is one of the most
precious assets in the medical profession since the patientphysician relationship is based primarily on trust. If a physician’s
reputation is attacked on a social network, not only would the
latter be justified in requiring the persons responsible to retract or
delete the litigious content, but he could also ask for reparation
of damages caused by this attack, in particular to “compensate
for the humiliation, scorn, hatred or ridicule”14 (translated
from the French) he has been subjected to.
It might be difficult to track and identify the author of an
anonymous comment. In such a case, or in the case of insolvency,
it might be better to evaluate the responsibility of the site’s
hosting service which published the comments. The legal
framework does not generally provide for hosting services to
be held responsible for activities taking place on a site nor to
monitor the information that is published there. Nonetheless,
the hosting service can be held responsible if it can be proven
that the service knew that these publications were used for
illicit purposes or that it was aware of circumstances making
this apparent and that it did not act promptly to make access
to the documents impossible.15
Web 2.0
THE WAVE
4) Social Media and Hospital Practice
The Latest News…
The increasing emergence of numerous social network results
in more and more employers adopting policies to guide their
employees in the use they make of social networks. Although
several activities on social networks are undertaken in the
framework of a person’s personal life, certain employers have
nonetheless had to intervene when these personal activities
were prejudicial to the interests of the company. As a result,
some employees were fired after having used social networks
to publish various derogatory comments concerning their
employer or its clients.16
The Federation discussed all of these aspects with representatives
of the AQESSS and those other organizations representing
physicians and dentists. After these discussions, the AQESSS
agreed to revise its model policy in order to withdraw any
reference to physicians and
dentists it might contain and
IMPORTANT
to so inform all hospital
If your hospital centre
establishments. If your
hospital centre has adopted
has adopted a policy
a policy on social networks
on social networks that
that includes physicians,
includes physicians,
please let us know.
please let us know.
Recently, the Association québécoise d’établissements de santé
et de services sociaux (AQESSS) proposed to limit the personal
and professional use of social networks, inside and outside
the hospital. However, the policy proposed by the AQESSS
is aimed not only at members of the hospital staff, but also at
physicians. The FMSQ intervened to denounce the inclusion
of physicians in this policy, which constitutes a breach of their
professional status.
We must insist on the fact that a physician is an independent
professional and that his or her relationship with the hospital
centre is different from that of an employee. Moreover, a physician
has various professional and ethical obligations which may prove
incompatible with the rules proposed by the AQESSS. The
physician is, before all, at the service of his or her patients and
of the population and it is possible that, in these circumstances,
he might have to denounce a prejudicial situation.
Thus, the physician’s “paramount duty is to protect and promote
the health and well-being of the persons he attends to, both
individually and collectively.”17 He must “avoid any situation in
which he would be in conflict of interest, in particular when
the interests in question are such that he might tend to favour
certain of them over those of his patient or where his integrity
and loyalty toward the latter might be affected.”18 In addition,
the physician must advise public health authorities when he
“has reason to believe that the health of the population or of a
group of individuals is threatened.”19
The Federation has under
taken to increase awareness among physicians concerning
the use social networks, which is what we hope we have
accomplished with this article. For any other questions, please
do not hesitate to get in touch with us.
References:
1For example, see: Lougheed Imports Ltd. (West Coast Mazda) v. United
Food and Commercial Workers International Union, Local 1518, 2010
CanLII 62482 (BC L.R.B.).
2
Garderie Les “ Chat ” ouilleux inc. c. Marchese, C.L.P. 340513-71-0802,
26 octobre 2009.
3
Landry c. Provigo Québec inc. (Maxi & Cie), 2011 QCCLP 1802.
4Canadian Medical Protective Association. Using social or professional
networking websites can breach confidentiality. Ottawa: CMPA, June
2010. http://www.cmpa-acpm.ca/cmpapd04/docs/resource_files/
perspective/2010/02/pdf/com_p1002_7-e.pdf.
5Collège des médecins du Québec. Le médecin, la publicité et les
déclarations publiques : guide d’exercice (in French only). Montréal :
CMQ, août 2010, p. 12. http://www.cmq.org/fr/Public/Profil/Commun/
AProposOrdre/Publications/~/media/Files/Guides/Guide%20
publicite%20declarations%202010.ashx?111128
6
Code of ethics of physicians, RRQ, c M-9, r 17, s. 20.
7
Supra note 4.
8
Supra note 6, ss. 110 and 111.
9
Supra note 6, s. 89.
10 Supra note 5.
11 Supra note 6, s. 63.
Although the Federation is of the opinion that physicians must not
be included in this type of policy, this does not mean that they can
make inappropriate use of social networks without consequences.
In fact, physicians practicing in hospital settings are subject to
various obligations and some breaches could, depending on
circumstances, result in the imposition of disciplinary measures
or the non renewal of hospital privileges. This is why it is still
important to remain vigilant.
13 Supra note 5.
14Baudoin JL et Deslauriers P, La responsabilité civile. 7e éd. Cowansville,
Yvon Blais, 2007, p. 553.
15
An Act to establish a Legal framework for information technology,
RSQ, c C-1.1, ss. 22 and 27.
16In particular, see Alberta Union of Provincial Employees v. Alberta
(R. Grievance), 174 L.A.C. (4th) 371 (Ponak, Bartee et Workman),
2009 ABQB 208, Chatham-Kent (Municipality) v. National Automobile,
Aerospace, Transportation and General Workers Union of Canada
(CAW-Canada), Local 127 (Clarke Grievance), [2007] O.L.A.A. No. 135
et Wasaya Airways LP v. Air Line Pilots Assn., International (Wyndels
Grievance), 195 L.A.C. (4th) 1.
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Interviews and Text by Patricia Kéroack
Integrating Social Media
into Your Medical Practice
Dr. Christian Boukaram is a radio-oncologist
at Hôpital Maisonneuve-Rosemont. His book
Le pouvoir anticancer des émotions (The AntiCancer Power of Emotions) has just been
published. In the press release announcing this
new volume, there is a comment that says: “Get
in touch with Dr. Boukaram on social networks.”
Le Spécialiste wanted to know more...
Dr. Boukaram, you opened a Facebook page and a
Twitter account for your book’s launch. What was
your goal?
My publisher suggested this approach because it’s the new way
of promoting books. I took advantage of my spouse’s knowledge
and talents because she’s a marketing specialist and guided my
first steps.
Social networks have become inescapable and are an excellent
way of initiating a dialog with people who share our opinions or with
whom we can discuss matters. As my book deals with a complex
subject, social media allow me to popularize certain aspects and to
get closer to people. I answer their questions in simple language.
Answering everyone takes a lot of time... Are you the one
who answers?
I work with a person who keeps watch and takes on the role of
community agent. She’s the one who weaves the links around my
network and who “posts” links of interest in my various pages.
I’m still not completely at ease with all the functionalities, but I do
plan on developing the required skills rapidly. I supervise what is
done, what is said and I provide answers and decide where to
place them. As soon as my promotion tour is finished, I plan on
spending more time on social networks and personally responding
to the questions I am asked.
Let’s talk about your Twitter account to start with. The
first thing we see is your book.
It really is a promotional page, I admit. Twitter is a tool with a lot of
potential and I haven’t explored all its possibilities yet. I love this
media and every day I discover new facets to it.
Do you use Twitter in the framework of your
clinical practice?
Not really, or rather I haven’t yet found how it could be integrated
into my practice. I think that Twitter will allow me to enter into
relationships with other individuals and to discover an interesting
way of exchanging ideas. To be continued.
Will you go as far as taking part in “meetups”, those non
virtual meeting places where people who tweet on a given
subject can get together informally to talk?
Why not? I think that’s a marvellous idea. It’s unbelievable what these
social networks uncover for us... You’ll invite me to the next one?
Have you thought of adding a personal charter?
That’s an excellent suggestion and, if I want to protect my identity,
it’s essential, especially since I’m working on building a web site and
blog. I intend to include more information on myself on the site as
well as on my background and my book.
What about the Facebook community? How many “friends”
do you have or want to have and do these include patients
of yours?
Up to now, my Facebook page has been visited mainly by
acquaintances of mine. I don’t have any patients on this page at
the moment, but should it happen, I wouldn’t refuse.
If one of your patients asked you a medical question on
this page, how would you react?
Facebook is certainly not an appropriate medium for questions
dealing with medical matters. You have to meet the person, perform
a physical exam, administer a questionnaire, and these are things
that the Internet does not provide. I answer questions of a general
nature, I popularize and clarify information regarding the book and
I stop there.
How far will you go using social networks?
Above all, I want people to know me in order to organize activities
later on to collect funds to provide psychosocial and emotional
support. In Quebec, we have to develop a way for all patients who
go to the hospital for cancer treatments to meet a psychologist or
a social worker. Such resources are still very limited today.
I work full time and social networks could take an ever-increasing
part of my life. Above all, I need to draw the limits and establish in
advance where I want to go and how much of myself I want to invest.
Web 2.0
THE WAVE
r. David Lussier is a geriatrician at the Institut
D
universitaire de gériatrie de Montréal (IUGM). He
has become a truly passionate “tweep.” In his
view, social networks have become indispensable
whether for personal or professional reasons.
Which social networks do you use?
I use Twitter and Facebook, but each in a different way. I use
Facebook only occasionally and for personal reasons. I post a few
comments and photos of family activities or travel. My “friends”
are members of my family or close friends. The entire contents
are protected and accessible only to my “friends.” It’s my way of
keeping in touch with the persons within my circle that I don’t
see very often. I use Twitter more frequently. The comments I
post there are accessible to everyone and there is no personal
or private information.
How did you learn about Twitter?
Last March, a reporter wrote an article following a meeting we
had had. I wanted to see people’s comments on the article and
thus signed up for Twitter. In addition to reading those comments,
I discovered the social network.
Do you use Twitter mainly for personal or
professional reasons?
It’s a combination of both. I see this social network as a way of
sharing my ideas and my values. Sometimes I comment on news
stories or social debates, especially when I feel they concern me.
However, I try to make Twitter an information vehicle for the public
about the fields of medicine that interest me, in particular ageing and
chronic pain. Twitter is an excellent way of sharing this information
in order to debunk myths that persist in the population. It is very
important for me to improve the image of ageing in the population,
to educate people on the role of the geriatrician and the IUGM. The
patient’s empowerment is crucial and he or she has to become
an active partner in the handling of his or her health problems. I
believe that the media, especially the Web and social networks,
are a good way to meet these objectives of informing the general
public and patients. On the other hand, I also exchange comments
with a few people on subjects that interest me personally, like
running and bicycling, but this is becoming less and less frequent.
Do you also use Twitter to get information?
Yes. By subscribing to institutions, media, reporters or physicians
working in areas that interest me, I am kept informed on what
is happening there. This information, however, has more social
interest than a scientific one. There is very little scientific information
of interest on Twitter, even emanating from scientific institutions
or organisations, because the information we find there is mainly
destined for the general public. On the other hand, it’s a good way
of gathering information that could be pertinent for my patients.
Do people ask you questions or try to get virtual
medical opinions?
Sometimes, but it’s rare. When it does happen, I provide answers
if they prove to be of general interest. For example, I may be asked
if one should get the flu vaccine. If it’s a very specific question that
could be considered a consultation, I answer very clearly that I
cannot respond and suggest that the person consult a physician.
For a while, I had removed the fact that I’m a physician from my
profile in order to avoid such questions. Since I now want to use
Twitter, among other media, to communicate medical information,
I have reinstated my profession on my profile. Nonetheless, it is in
third rank in the descriptors I use concerning myself, the others
portray me as a person (father, cyclist, etc.).
Do you believe that using social networks can be harmful
to the public, in general, and to physicians, in particular?
Of course. As physicians, just like everyone else, you have to know
how to control your use of social networks in order to avoid it
taking over all your time and harming your professional productivity.
Addiction to social media is now a well-known phenomenon,
and physicians are certainly not immune to it. I even realized, at
one point, that I had crossed the line. It’s from that moment that I
modified my own use to make it almost exclusively professional.
From a guilty pleasure, it has become an idea-promoting tool.
The specific risk, for physicians who have identified themselves as
such, is to be solicited for medical opinions, which is something
that must always be avoided at all costs.
You also have to be aware of the weight that our tweets seem to
have. For example, several reporters, some of whom cover the field
of health, have signed up to follow my Twitter thread. As a result, I
will never criticize my institution, a colleague or the healthcare system
in general because I am conscious of the fact these comments
could be circulated much more widely. Occasionally, I have posted
some comments after having met a patient but, obviously, without
any denigrating or identifying elements. The objective was to share
the emotions I felt due to a specific experience.
Are you in touch with some of your patients on Twitter?
No. In fact, I’ve been in touch with very few of the people I deal
with in my “real” life. Since I am a geriatrician, it is improbable that
my patients will become followers of my Twitter thread. On the
other hand, it is very possible that their family members could do
so. I am very careful with the information I share and I make sure
I don’t divulge any information that I wouldn’t share with a patient
within the framework of my clinical practice. I must, nevertheless,
admit that I really don’t want to do so, because I believe that the
medical relationship should take place in the doctor’s office and
shouldn’t be influenced by exterior elements like social media.
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Text by Patricia Kéroack
Discovering Mobile Medical
Applications
On the model of tourism, restaurant and discovery guides, the FMSQ
has compiled its own guidebook, without ranking or comments, to
serve as a directory of sites and applications for medical specialists.
Mobile applications for medical purposes?
Undoubtedly. In the past, the physician would research a case
(occasionally, requiring a lot of time) in various encyclopedias and
other reference tools to find the best treatment, the new molecule or
the ideal prescription for a patient. Today, these same searches can
be done in a flash thanks to the various mobile applications (apps)
available on the market. The physician can now easily consult these
various sources of information while he or she is in clinic or even at
the patient’s bedside.
Every day, hundreds of mobile applications are added to the ones we
already have but are not limited to those who swear by Apple or to
technologically-savvy users who have downloaded tools for general
use, like GPS locators, restaurant rankings, etc. Some applications
have become unavoidable within the medical practice of specialists,
researchers and residents. How to find them? How to identify the
best? Here are a few ideas from Le Spécialiste.
Major pharmaceutical companies, scientific or major medical
association publications or newspapers, research laboratories and
others have developed applications in the areas of:
Diagnostics:
decision algorithms, symptoms, reading
and interpreting results, lists or definitions of pathologies,
medical imagery;
Treatment:
protocols, molecules, medication, contraindications, toxicity, side effects, etc.;
Research:
fundamental research projects underway or
completed, researchers, articles and reports on research,
abstracts, etc.;
Medical
administration: note taking, billing, transcribing
dictated notes, schedules, etc.;
Education:
CHE-CPD learning, monitoring students and
residents, translation and interpretation, etc.
Most applications are available for Android, Apple (iPad and iPhone),
Windows and BlackBerry devices.
There are thousands of mobile applications for physicians,
some extremely specialized. Choosing one can be difficult for a
technological neophyte, but here are a few suggestions to start
your research into the subject.
Some
applications were developed for a specific medical
specialty, others are for all physicians.
Some
applications were developed specifically for students
and residents.
Use
your platform as the first criterion since all applications
are not available for all platforms (Apple, Android, BlackBerry,
Palm and Windows).
Some
applications are free of charge, others must be
purchased and prices can go from $0.99 to several
hundreds of dollars.
According to a study by Bulletin Healthcare among its subscribers,
the use of mobile applications has gone up by 45% between
June 1, 2010 and February 28, 2011. Even though the tendency
up to recently has been for Apple products to dominate the market,
way ahead of the Android, BlackBerry and even Palm platforms,
Some sites to help you find the best apps
As there are hundreds, if not thousands of mobile application
developers, new apps are continuously appearing. It’s a good idea
to regularly visit purchasing and downloading sites or sites publishing
evaluations by colleagues. In addition, some organizations dedicated
to continuing professional development publish reviews of mobile
apps, their content and their perceived value. When it comes to
purchasing and downloading, make sure you use dependable sites to
avoid viruses and other types of malicious attacks. English-language
sites of interest to start your research into mobile applications:
www.imedicalapps.com
This independent Web site was created by physicians and medical
students. To evaluate applications, the authors do not hesitate to base
themselves on their clinical experience. The site is regularly updated.
Applications are listed by type of platform and medical specialty.
www.epocrates.com
ePocrates is another private company specialized in the development
of tools, applications and continuing professional development
services for physicians. The company offers a variety of products
adapted to medical specialties and major fields of practice.
Web 2.0
THE WAVE
the trend seems to be reversing itself rapidly. In fact, according to
the ABI Research, during the second quarter of 2011, there were
more downloads of applications for smartphones under the Android
platform when compared to applications for iOS (Apple’s mobile
operating system).
According to the firm’s report, Android’s free-of-charge strategy is
the reason for this trend. Another interpretation of this data is that
it is more difficult and, as a result, takes more time, to develop an
application for iOS. The main obstacle for developers today would
seem to be the multiple levels of approval and validation required.
For users of Apple products
The essential source to buy and download Apple products is iTune.
Apple is the major supplier of mobile applications. True and false! True
because, today, there are more than 3,500 mobile applications for
physicians, residents and medical students, which does make it the
most important source of applications. False due to the trend mentioned
earlier. The section for medical applications (http://itunes.apple.com/
us/genre/ios-medical/id6020?mt=8) is divided into two: applications
sorted by order of popularity and applications in alphabetical order.
For the Android platform
Mobile applications for Android are going through a development
boom. At the time of writing this article, the medical section of the
Android Market site (https://market.android.com/apps/MEDICAL) had
approximately 500 applications, close to 75% of which were free.
www.ama-assn.org/
The American Medical News site. It contains a few articles on
medical applications, one of which even explains how to create
mobile applications.
www.mobihealthnews.com
MobileHealthNews is an information site that tracks, compiles
and offers the latest developments for the medical field. The site
is an interesting information portal. You can even subscribe to
an electronic newsletter.
For Windows products
If one platform is to go begging, we would have to say it is the
one for Windows applications, although this trend could reverse.
Most applications available for pocket PCs under Windows
(http://medical.windowsmobilesoftware.us/) are calculation wizards
for complex medical formulas; some like them while others claim
they are superficial or incomplete. However, some application
developers like Unbound Medicine (www.unboundmedicine.com)
work together with major organizations like Elsevier, the BMJ Group,
Johns Hopkins Medicine, the American Academy of Pediatrics and
others on various development projects. The future will tell. The
day is barely dawning for applications under the Windows Mobile
platforms and others. The market is constantly in effervescence and
many new developments are expected over the next few months.
Applications from Quebec?
Absolutely! Quebec is not excluded from the mobile apps market.
Dr. Luc Lanthier, an internist at the Centre hospitalier universitaire de
Sherbrooke, has created an application based on his book, Guide
pratique de la médecine interne, the first edition of which came out
in 1999 in book form and was updated in 2010. His application,
on the iPad and iPhone platform, provides for rapid searches
which would have otherwise taken substantial time and effort.
http://itunes.apple.com/fr/app/lanthier-guide-pratique-medecine/
id442932968 ?mt=8
ZoomMed, a company on the south shore of Montreal, specializes
in the development of medical interfaces and computer
solutions and has created applications to quickly generate drug
prescriptions. These applications can be combined with various
other installed applications providing for electronic health records.
http://www.zoommed.com/zmd/clients_fr.aspx
In addition, a company in Rimouski, EXOPC, has taken on the tablet
computer market with its own version under the name of EXOPC
Slate. Mobile applications are installed on the tablet and, once all
data is entered, it is synchronized with a desktop computer, thereby
reducing to zero the risk of possible interference from wireless
networks. http://solutions.exopc.com/
www.pepid.com
From the Bellboy to the Smartphone…
PEPID Medical Information Resources is a private company
founded in 1994 by an emergency medicine specialist. The
company develops multiplatform software for clinicians,
hospitals, research centres and others in the field of healthcare.
PEPID has developed several mobile applications for the various
platforms. Their services are available via a paid subscription.
It hasn’t been so long since the best way of reaching a physician in
a hospital, or out of it, was through the use of a beeper. Today, the
use of beepers tends to be rare, as physicians (and some hospital
centres) increasingly prefer to turn to more efficient solutions, like the
smartphone. The use of these electronic tools is virtually exploding.
We can no longer ignore this trend and those responsible for
information technology in hospitals will have to take these tools into
account. Their priority should be to manage security protocols for all
types of telephones and personal digital assistants (PDAs).
www.appadvice.com
This is a site completely dedicated to Apple applications. One
section is for physicians who use the iPad: the most frequently used
applications are listed there (http://appadvice.com/applists/show/
apps-for-doctors-with-ipads).
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GREAT NAMES IN QUEBEC MEDICINE
By Patricia Kéroack
It’s all a matter of culture!
If human beings had the same regeneration capabilities as salamanders, Dr. François A.
Auger would definitely be working on another project, because this issue’s Great Name in
Medicine is fired by extreme challenges and has a thousand projects in mind for the future.
Dr. Auger was born in Quebec City of a French mother and a
Quebec father, who was a cardiovascular surgeon. However,
as a youngster, he knew nothing of his father’s career; at home,
surrounded by his family, his father just did not speak about
it. François loved science and mathematics; at university, he
opted for being an actuary but quickly realized that it didn’t really
interest him. Fate decreed that one day he accompanied his
father to the hospital, a fascinating new world that was totally
unknown to him.
Right away, he took steps to change his area of study and also
took time to review his way of doing things and his priorities.
He wanted to take time to live while, obviously, still maintaining
excellent academic results! He had a passion for culture and
began going to see classic and art films two or three times
a week. When he could not get to the cinema, he ended his
evenings reading a good book. Jokingly, Dr. Auger says that
reading is his one and only drug! His passion for culture will
never fade.
With his degree in his pocket, he had to choose between general
medicine or a specialty. To start with, he pictured himself working
in a remote village looking after the health of others; the person
who must decide to send a patient far away for special care. “A
heavy responsibility”, as he says. On the other hand, he could
move into a medical specialty which would expand the limits
of our knowledge.
Finally, developing specific expertise in a given field drew him more
than anything else. And, during practical training, he discovered
laboratory specialties, particularly microbiology and infectious
diseases. He found it possible to care for patients in a clinical
setting as well as via the thorough analysis of blood tests in a
laboratory, validating the clinical notes or perhaps giving rise to
a completely different approach to treatment.
Dr. Auger became a microbiologist in 1982 (Université de
Montréal), and then did a subspecialty in Maryland where he
stayed for a second year as Guest Scientist for the National
Institute of Allergy and Infectious Diseases. During this year, he
organized what was to become the largest congress on AIDS,
an emerging disease still unknown in Quebec and in which he
developed a great deal of expertise. He showed great interest in
AIDS and published five scientific articles. He was then offered
a position in Baltimore where he could have continued his very
promising career.
Instead, he decided to return to Quebec City, where Hôpital
Saint-Sacrement was waiting to offer him special consideration.
He was granted time for his research activities, once his clinical
duties had been completed, obviously! From 1985 on, he set up
and became director of LOEX, the Laboratoire d’organogénèse
expérimentale (Laboratory of Experimental Organogenesis),
followed by the FRSQ Research Centre at CHA the Centre
hospitalier universitaire affilié (Affiliated University Hospital Centre).
Starting with a team of 15 or so people, today he directs more
than 625 staff at the CHA Research Centre alone. And, when he
speaks about his projects, he gives all the credit to his employees.
But where do the projects he works on come from? Dr. Auger
is a true enthusiast. He admits having pushed his luck … As
soon as someone presents him with something new that might
have an impact on his work or his patient, his interest sparks.
Dr. François A. Auger
Microbiologist and Infectious
Disease Specialist
This was how, one day, at the request of plastic surgeon
colleagues and with the financial support of the Fondation des
pompiers pour les grands brûlés du Québec (Quebec Firemen’s
Foundation for Severe Burn Victims), he became interested in
tissue culture and reconstruction. In the space of a single year’s
research, he successfully achieved the first epidermal culture
and its human transplantation. Cell engineering became the
main focus of his research and, very quickly, his expertise would
gain an international reputation. Since the creation of LOEX, he
has directed work on cell renewal, skin reconstruction, blood
vessels, corneal grafts, to give only a few examples. He only
uses live human sources for his work.
Many challenges and projects lie ahead for Dr. Auger. Research
is, first and foremost, a question of money, which is sometimes
impossible to find and which depends on various factors.
He is passionate about fundamental research, and the vast
knowledge he has acquired over the years proves it. But he
has not forgotten what helps him keep a healthy balance in his
life: culture, books and films.
L
S
CONTINUING PROFESSIONAL EDUCATION
By Gilles Hudon, MD
DIRECTOR OF HEALTH POLICIES AND THE OFFICE OF PROFESSIONAL DEVELOPMENT
The CMQ and RCPSC Agree
CPD is Thriving at the FMSQ
The Royal College of Physicians and Surgeons of Canada (RCPSC) recently advised the
FMSQ that it was recognizing it as an organization providing Continuing Professional
Development (CPD) for a 5-year period (June 2011 to June 2016). This letter resulted from
the latest CPD certification visit.
Why is a certification visit necessary?
Excellent results…
The Collège des médecins du Québec, by virtue of the obligations
and powers conferred on it by law, requests professional
associations to assume the responsibility of providing their
members with activities and educational tools that meet the
recognized criteria. In certifying continuing medical education
programs and CPD, the CMQ’s Medical Studies and Certification
Committee ensures that physicians’ professional associations
have fulfilled their responsibilities in a proper manner. Hence,
the CME/ CPD certification visits every five years.
The results obtained over the last four 5-year certification visits
show a consistent improvement in the CPD activities of the
OPD and the associations affiliated with the FMSQ. In 1995,
certification was on a voluntary basis and 21 associations
participated: 13 received full certification for 5 years and
8 obtained partial certification for 3 years, provided they corrected
“major shortcomings”. In 2000, the CMQ ruled that participation
in the certification visit was mandatory, and 33 associations
appeared: 19 were considered to be in full compliance and
received full certification for 5 years; 14 received certification
for 2 years, conditional upon correcting some shortcomings.
In 2006, following the creation of two new associations,
31 out of 35 received unconditional full certification for 5 years
and only 4 associations had to improve certain aspects to
ensure compliance.
Five-year certification visits
The latest certification visit was held in the offices of the FMSQ
in February 2011, the sixth in 30 years. The FMSQ Office of
Professional Development (OPD), the CPD units from each
of the 34 affiliated associations (CPDU) and the Société des
experts en évaluation médico-légale du Québec each met with
the visiting physicians. Several innovations were made this
year: a principal visitor from outside the Collège was invited
(Dr. Michel Rouleau, respirologist and Director of the Continuing
Professional Development Centre at Université Laval). He was
accompanied by management representatives of the CMQ’s
Medical Studies: Dr. Anne-Marie MacLellan, Director, and
Dr. Ernest Prégent, Deputy Director. For the first time, the RCPSC
was invited by the CMQ to join it in the certification visit, and had
delegated as its representative Dr. Gisèle Bourgeois-Law, an
obstetrician-gynecologist by training and the present Associate
Dean of Continuing Professional Development at the University
of British Columbia. It was also the first time that the certification
visit lasted 4 full days: representatives from 9 associations
(the Association President, members of the CPDU and the
administrative assistant) were allotted 45 to 60 minutes daily.
It was also the first time that the new certification criteria drawn
up by the Continuing Medical Education Certification Committee
were applied. There are 19 of these, divided into 4 sections
in a more logical fashion than the previous criteria: 1) General
objective; 2) Field of activity; 3) Planning and implementation of
CME/CPD activities; 4) Organization and administration.
Lastly, in 2011, 33 out of 35 associations were granted
unconditional 5-year full certification; only 2 received a 2-year
certification conditional upon carrying out minimal corrections.
In addition to the CMQ certification granted to the affiliated
associations, the OPD obtained joint certification by the CMQ
and RCPSC, with a mention of exemplary compliance for 7 of
the 19 evaluation criteria. The FMSQ’s OPD has thus become
the first Canadian organization, other than a university or national
association, to be certified by the RCPSC in recognition of the
Office’s expertise and the high quality of the continuing education
programs developed over the years by the Federation and the
CPDUs of its affiliated associations.
What the certification visit does not mean…
The certification visit to a CPD provider is not an end unto
itself, but rather an exercise to see what has happened over
the previous 5 years and to plan the future. Certification is not
intended to sanction or punish, and the same strict evaluation
criteria apply to all. Instead, the visiting physicians take the
time to understand associations’ specific aspects, and apply
the certification criteria in a more individualized manner taking
into account each association’s size, means and procedures,
highlighting their strengths and homing in on the weaknesses.
CONTINUING PROFESSIONAL EDUCATION (SUITE)
Corrective action is requested and new projects suggested.
Certification is the constant improvement of the quality of CPD,
which does not deal solely with preparing group activities but is
an integral part of any action likely to improve the quality of care.
A look at the achievements of the last
5 years
The activities of the FMSQ’s OPD and the CPD of the affiliated
associations are very closely linked. Improvements and progress
have been made during the last 5 years.
Association CPDUs are also making constant progress. Year
in, year out they collectively organize some 120 activities that
attract 7,000 to 8,000 physicians – an investment of around
$6M. But they do not limit themselves to the organization of
scientific meetings. They also take part in drawing up guidelines,
act as experts to certain government or other organizations,
and set up increasingly sophisticated Internet sites, with a CPD
section reserved for use by all members, as requested by the
College. It is interesting to note that, over the years, a number of
CPD unit presidents have subsequently become the president
of their association.
The Federation’s OPD has taken on new personnel, increased and
Upcoming challenges
upgraded its activities and the tools available to the associations.
Réjean Laprise, Ph.D., was hired in 2005 as a research and
Since the FMSQ Office of Professional Development is now
development consultant for 2 days a week. He now spends
recognized as a certified provider of Continuing Professional
up to 4 days a week in developing new concepts and advising
Development by the RCPSC, it must set up a structure that
associations on the preparation of their activities. The 6-monthly
allows it to receive affiliated associations’ applications for
meetings of the FMSQ’s Professional Development Council have
certification of their group activities, so that compliance with
been held religiously, and have progressed from being information
RCPSC criteria can be verified. This means that participants can
meetings (prior to 2006) to training sessions for facilitators. A
claim Maintenance of Certification section 1 credits. A copyright
subject of interest is presented at each meeting, usually by our
policy (a hot topic these days!) also has to be developed with
CPD consultant assisted by a guest speaker. The meetings were
regard to the media, the artistic world and even education.
previously intended for CPDU presidents only. Now, all CPDU
members, as well as administrative assistants and
Association directors are invited; this has meant
THE CONCEPT OF PROFESSIONAL DEVELOPMENT HAS SEEN
we have had to move outside FMSQ offices since
RAPID
CHANGES OVER THE PAST 10 YEARS. ITS FOCUS USED
none of its rooms can hold 70 people or more.
TO BE THE ACQUISITION OF NEW KNOWLEDGE. NOW, IT IS
A 3-year strategic plan was drawn up in 2009;
STRONGLY ORIENTED TOWARDS THE PERFORMANCE OF
it is scrupulously adhered to and constantly
CAREGIVERS, INCLUDING PERFORMANCE EVALUATION AND
updated. New forms and tools have been created
for the associations, such as contracts governing
THE IMPROVEMENT OF QUALITY HEALTH CARE.
relationships between the associations and event
sponsors. The activity evaluation form has been
revised in order to accommodate the successive changes to the
The concept of professional development has seen rapid changes
2nd and 3rd cycles of the Maintenance of Certification program,
over the past 10 years. Its focus used to be the acquisition
requiring that not only attendance at an activity be recorded but
of new knowledge. Now, it is strongly oriented towards the
also the results. Facilitators’ training workshops F-201 are now
performance of caregivers, including performance evaluation
available to all medical specialists who organize training, either in
and the improvement of quality health care. The 3rd cycle of
their working environment or at their association. These are held
the RCPSC Maintenance of Certification program is evidence of
twice a year, in Montreal in the fall and Quebec City in the spring.
this; certain newly-created organizations also advocate it: NIQIE
The FMSQ Journée de Formation interdisciplinaire (JFI) was
(the National Institute for Quality Improvement in Education) in
created in 2008, so that specialists from various specialties can
the U.S. quite simply recommends that traditional continuing
meet and discuss subjects of common interest. Participation
medical education be abandoned in favour of Performance
has increased each year. Lastly, we should mention that a
Improvement Continuous Medical Education (PI-CME). The
partnership has been set up with Université Laval permitting
proposed model is easier to administer when CPD is actually
access to an electronic platform so that associations can hold
carried out in a hospital environment. In the United States, for
on-line reading clubs when they wish, at minimal cost.
example, the CME departments of the faculties of medicine are
very much involved in the training of all caregiving staff in their
own university hospitals and NIQIE favours merging the continuing
quality improvement and professional development departments
into one. For professional associations not directly involved
with health care, performance evaluation and improvement will
be far more difficult to achieve than the straight acquisition of
knowledge and will represent a substantial challenge for CPD
providers in coming years.
L
S
NOS FILIALES
www.fprofessionnels.com
1 888 377-7337
www.sogemec.qc.ca
1 800 361-5303
NOS PARTENAIRES
AU
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514 288-8688
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732-8688
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Pour tout savoir sur les avantages commerciaux réservés aux
membres de la Fédération des médecins spécialistes du Québec
et pour connaître nos nouveaux partenaires commerciaux, visitez
le site Internet de la FMSQ au www.fmsq.org/services.
www.fmsq.org
Pour information :
[email protected]
ou 514 350-5274
www.telusmobilite.com
1 855 310-3737
Il ne manque
que vous !
FINANCIÈRE DES PROFESSIONNELS
By André Sirard, CFA
PRESIDENT AND CHIEF EXECUTIVE OFFICER
New Service Partnership
Professionals Financial recently signed a service partnership agreement with Groupe conseil
Multi-D and Facturation informatique Diane Legault/FIDL (Multi-D FIDL). Under this agreement,
the Financial will now be able to offer physicians Mutli-D FIDL medical billing services; these also
include strategic planning, accounting management, financial statement preparation, tax filing
and assistance with incorporation.
Multi-D FIDL, a significant addition
Groupe conseil Multi-D is a well-established Quebec company
that has been providing consulting services to Quebec physicians
since 1969. Last July, it concluded a partnership agreement
with Facturation informatique Diane Legault/FIDL, a billing
agency that was established in 1985. The combined strength
of these two companies and their known expertise in providing
essential support services represent a significant addition to the
Professionals Financial program.
A consistent desire for excellence
Setting up service partnerships between Professionals Financial
and other Quebec companies providing the very latest in
services represents a natural step forward in our progression.
Our main objective is to provide a range of services that is even
more diversified, fully suited to the professional and personal
circumstances of our clients, and to meet their specific needs
either via internal expertise or, alternatively, through easily
accessible outside expertise. One example of this is the longstanding collaboration between Professionals Financial and
Sogemec Assurances, which has resulted in many joint activities;
in particular public presentations regarding investment vehicles
and strategies, insurance products and their respective value.
The new service agreement with Multi-D FIDL follows the same
lines and also includes an educational program that will soon
be available to professionals.
Performing in an increasingly complex
environment
Professionals Financial was set up in 1978 by the Fédération
des médecins spécialistes du Québec (the FMSQ) to respond to
the needs of physicians and their families who were not covered
by a retirement plan. It rapidly broadened the range of services
provided. Professional groups which became its shareholders
and partners – including medical specialists, dental surgeons,
notaries, architects, pharmacy owners, medical residents
and members of Médecins francophones du Canada – had
experienced many upheavals with regard to professional practice
and the needs of members for financial services. The range of
services desired continues to expand.
The thirteen mutual funds now offered by Financial were
developed to meet these needs, and Private Management
(a discretionary service) was tailored to clients with assets of
more than $500,000. Private Management’s services are now
developing further with the addition of three new mutual funds
involving Canadian and American stock. An asset-consolidation
service has also been established to facilitate combining clients’
assets under one roof. An increased demand for financial and
estate planning has led to the creation of a multidisciplinary team
of experts. Composed of an actuary, a tax expert, notaries and
financial planners, this team concentrates on financial and legal
aspects, tax matters, insurance, retirement and estate planning,
the preparation of wills and the liquidation of successions
(estates). Lastly, the team dealing solely with young professionals
should be mentioned; its activities for students, interns and
residents also includes a significant educational component.
A stable firm in a changing world
Managing assets of more than $2 billion, Professionals Financial
looks resolutely toward the future. For 33 years, its strength
has lain in sound governance and rigorous ethics from which it
has never swerved. Very strict procedures have been instituted
to ensure compliance with laws and regulations, and high
standards of fairness and ethics are observed. Its board of
directors numbers representatives from each shareholder group,
and these individuals ensure that their members’ interests are
taken into account. This consistently close relationship with its
clients creates a highly dynamic synergy which, in turn, allows
professionals’ expectations and requirements to be targeted
with great precision.
What does the future hold? True to its mission, Professionals
Financial remains focused on the needs of its clients at each
stage in their career, and continues its educational activities.
In a changing world, its expertise, adaptability and faculty for
innovation are powerful assets, on which Quebec medical
specialists can rely, now and in the future!
SOGEMEC ASSURANCES
By Dr. Gilles Robert
PRESIDENT
Drug Insurance
If there’s one subject that is sure to create an argument, it is the
legal obligation to belong to a drug insurance plan.
The FMSQ Plan managed by Sogemec Assurances could quite
simply have offered coverage similar to that available from the
RAMQ, but our role is to provide physicians with the best possible
service, so we have prepared a product that meets this criterion.
Following is a table that shows the features of both plans:
PLAN
RAMQ
FMSQ
OPTION 1
Drug insurance
Coverage
Drug insurance
Deductible
$192 individual
Co-insurance
32%
25%
Drugs covered
RAMQ list
Expanded list (new molecules)
(including travel and trip cancellation
insurance)
$100 individual/single-parent
$200 couple/family
The deductible and co-insurance is the portion assumed by
our Plan members.
There can be no doubt about the fact
that our Plan is far more complete, and
not only with respect to the amount
of the deductible and co-insurance.
The vital importance of a more
comprehensive plan becomes obvious
when a pathology requires treatment
using a new molecule or the drug is not
on the RAMQ List. At least 10.56% of
reimbursements under our Plan fall into
this category.
Also, do not forget that our Plan
automatically includes travel insurance
of $5 million per person covered and trip
cancellation insurance of $10,000 per
insured person every year, regardless
of the number of trips taken.
With Sogemec Assurances, you have the peace of mind that
comes with knowing that, whatever may happen, you are well
covered and in good hands.
By Catherine Felber, B.A., A.V.C., Pl. Fin.
BUSINESS DEVELOPMENT ADVISOR
Twin Certainties...
We all know the old saying that the only certainties in life are death and taxes.
Although death is inevitable, we always hope that we can put it
off and, if possible, escape it altogether. Very wealthy individuals
are turning to cryogenics in the hope that, in the near future, a
cure will be found for whatever caused their death. They have
their bodies frozen, after their death, in the hope that one day
they will be brought back to life!
Likewise, we cannot avoid taxes during our life or at our death.
Good financial planning must always take this fact into account.
How is the amount of tax due at death calculated? What options
do we have? Let us take a closer look at the bill that will be
presented on our death.
The Income Tax Act contains many rules concerning the taxation
of assets at death. The Act allows us to defer the tax bill upon our
death through a tax-free transfer to our spouse (spousal rollover).
However, when the spouse dies, certain assets are passed to
the heirs with tax being levied on 50% of the increase in value
realized (deemed disposition).
SOGEMEC ASSURANCES (SUITE)
Twin Certainties... (suite)
What assets are subject to the deemed disposition rule upon death?
Publicly-traded
Shares
in a small business
Other
Vacant
lots in the inventory
RRSPs
Buildings
Cottage
Boat
shares
company shares
and other registered plans.
The principal residence is usually not taxable.
The death tax is payable even before your heirs receive their
share of the succession (estate). In fact, the succession must
pay these taxes before paying the heirs their share.
Example
Dr. John is age 60; his wife, Joan, is 58.
This immediately creates the money required to pay death taxes.
They are both killed in a car accident.
Now, let us assume that Joan did not die in the car accident:
Let us assume that the investigation shows that John died a few
minutes before Joan.
• First, there is a rollover of assets to the spouse (John to Joan)
• First, the assets are rolled over to the spouse (John to Joan)
• Then, Joan’s estate must pay the taxes.
Now for a closer look at these assets but, above all, what the
tax bill will be.
1. RRSP: $200,000
2. A building that served as John’s clinic was acquired for
$800,000; its current fair market value is $900,000
3. The amortization accumulated on the building over the years
amounts to $500,000 (we have simplified the calculation for
easy reference in this example).
Tax bill calculation
1. RRSP: $200,000 x 48.22 % = $96,440.
2. The increase in the value of the building = capital gain of
$100,000, 50% of which is taxable – i.e., $100,000 x 50%
x 48.22% = $24,110.
3. Tax on recovery of the amortization: $500,000 x 48.22%
= $265,210.
Total tax bill at death: $384,760.
John’s and Joan’s heirs must pay out $384,760 in tax before they
even receive their share of the estate. The Income Tax Act states
that this amount can be paid in yearly installments (maximum:
10). Interest is calculated at the prescribed rate from the day on
which the tax should have been paid. An expensive proposition!
Obviously, if there are other liquid assets in the succession, these
can be used to pay the tax bill.
Alternatively, the principal residence could be put up for sale to
generate cash, providing the housing market is favourable.
The fastest and most economical way to generate cash (liquid
assets) is life insurance.
• W
hen Joan dies in 1, 5, 10 or 20 years, her estate will have
to pay the taxes.
The tax bill will therefore fall due at some unspecified point in the
future – i.e., when Joan dies.
The cost of life insurance
$500,000 death benefit on the life of Dr. John: $11,100 per year.
$500,000 death benefit on the life of his wife, Joan: $7,550
per year.
That’s expensive! However, is it necessary to cover the spouses
individually when the tax bill will only be presented upon the
second death?.
Following is a more economical solution:
$500,000 death benefit on the life of John and Joan, payable
at the second death: $5,000 per year.
You still think this is high?
It would need around 40 years with an annual deposit of $5,000
and a before-tax return of 7% (assuming a marginal tax rate
of 48.22%) to achieve the desired objective – i.e., generate
tax-free liquidities of $500,000.
And if our couple also owned a family cottage?
We mentioned that the principal residence is tax-exempt.
However, the secondary residence is considered an asset
subject to the deemed disposition rule on death. The tax on
the cottage’s increase in value would be added to the tax bill
calculated previously. The heirs may have no alternative but to
sell the family cottage to generate the liquid assets needed.
Fortunately, with a bit of planning, Dr. John and his wife Joan
will be able to realize their dream of passing certain assets on
to their heirs without having to worry about the tax bill.
Do not hesitate to contact a Sogemec Assurances advisor to learn more about
insurance payable at the second death.
LE MOT DU PRÉSIDENT
Dr Gaétan Barrette
Réalisations et prédictions...
L’année 2011 a été très fébrile et tout le monde à la Fédération a mis la main, sinon les deux
mains, à la pâte ! À cette période, on dit normalement que l’année s’achève. J’insiste sur le
normalement, car à la FMSQ c’est un peu différent. En effet, après des mois de négociations
avec le gouvernement, nous sommes parvenus à renouveler notre Entente de façon
satisfaisante, sans heurts ni pour l’une ni pour l’autre des parties. Depuis, nous concentrons
nos énergies à la future répartition des gains obtenus. Ainsi, nous avons amorcé une tournée
des associations médicales et, au cours des quelques semaines qui restent à l’année 2011,
nous maintiendrons le rythme pour finaliser nos rencontres et faire avancer les travaux pour
une distribution prévue en 2012.
L’
année 2011 aura été marquée par d’autres dossiers qui
se sont bien soldés non seulement pour la Fédération et
ses membres, mais aussi pour les patients du Québec.
Pensons notamment à l’entente intervenue avec le MSSS à
propos des frais de traitement imposés aux patients souffrant de
dégénérescence maculaire. Il nous aura fallu lancer un ultimatum
de 48 heures au ministre de la Santé pour qu’il accepte d’en
défrayer les coûts, mais le jeu en valait la chandelle.
Nous avons aussi assisté au coup d’envoi des travaux pour la
construction du futur CHUM. Même si l’on a oublié d’inviter la
FMSQ au lancement officiel parmi tout le gotha, nous savons
bien que le projet, finalement mis en branle, n’aurait jamais eu
cette envergure n’eut été de l’intervention de la FMSQ au cours
de l’été et de l’automne 2008.
Je vous rappelle aussi que, dans la ronde de négociations qu’a
menée le gouvernement avec ses employés, la Fédération
avait été le premier groupe médical à appuyer la Fédération
interprofessionnelle de la santé du Québec (FIQ) dans ses
revendications. Il en a été de même avec les procureurs de la
Couronne et les juristes de l’État. La FMSQ avait alors insisté
sur le rôle incontournable joué par ces groupes dans le système
public de santé et de justice et l’importance d’avoir une entente
négociée et respectueuse de leur contribution professionnelle.
Pas pour rien que nous avions produit une campagne signée :
L’expertise a un prix !
Finalement, notre Fédération a appuyé l’ajout de nouvelles
activités professionnelles à celles réservées jusqu’à maintenant
aux pharmaciens du Québec. Pour être dans le ton du dossier
Web 2.0 qui vous est présenté dans cette édition, cet appui a
été fait sur Twitter (voir p.24).
Et pour clore l’année, je suis particulièrement heureux de la
concrétisation d’un engagement qui aura pris un certain temps,
certains diraient un temps certain, à aboutir. Mais le temps
arrange les choses, dit-on. Nous sommes donc parvenus à
conclure la mise en place d’un programme de congé parental,
comme vous avez pu le lire dans le récent bulletin INFOnégo.
Je pense que cet accomplissement mérite d’être souligné
deux fois plutôt qu’une. La Fédération avait déjà institué un
rabais de cotisation pour les nouveaux parents, programme qui
sera bonifié pour tenir compte d’autres situations parentales.
Je tiens à souligner la détermination de Dre Josée Parent qui, à
titre de vice-présidente de la Fédération (2009-2011), a fait de
ce dossier un enjeu auquel elle a apporté un suivi de tous les
instants. Je suis certain que les parents médecins spécialistes
remercient Dre Parent (nom de circonstance) pour cette promesse
devenue réalité !
La prochaine année ne manquera certainement pas d’apporter son
lot d’enjeux en santé, car il y a beaucoup à faire pour permettre un
meilleur fonctionnement de notre système public. Nous savons déjà
ce que ne nous réserve pas 2012 : le DSQ ne verra pas le jour ; les
infirmières praticiennes ne seront pas encore au rendez‑vous ; les
ressources intermédiaires ne seront pas suffisantes pour libérer les lits,
la productivité dans les blocs opératoires ne pourra être augmentée;
les traitements de dégénérescence maculaire et de fécondation in vitro
ne pourront être offerts dans tous les établissements, etc. J’arrête
ici cette liste qui pourrait servir de résolutions aux décideurs, mais,
nous le savons, les résolutions sont faites pour ne pas être tenues.
Cette année, le congé des fêtes sera particulièrement mérité à
la Fédération ! J’espère que vous aussi pourrez profiter de cette
période pour festoyer avec votre famille et vos amis. Au nom de
toute mon équipe, j’en profite pour vous offrir nos meilleurs vœux !
Syndicalement vôtre !
S
L
Parce que
votre temps est trop
précieux pour le perdre
L’administration de la facturation est souvent complexe, exigeant
beaucoup d’attention et de suivi avec la RAMQ. Pensée par et
pour des médecins, Facturation.net est la seule solution Web sur
le marché à la fois sécurisée, adaptée à votre pratique et simple à
utiliser. Vous entrez vos données en un rien de temps et on s’occupe
de les valider, puis de les traiter pour vous... car vous avez bien
d’autres préoccupations.
Pour des solutions Web allant jusqu’à l’impartition totale de votre
facturation, faites appel à un leader reconnu au Québec. Si vous être
membre de l’AMQ/AMC, un rabais de 10 % vous est accordé.
1 866 332-2638
Pour plus d’information consultez
également le site : Facturation.net
Finances
Pratique
Mieux-être
md.amc.ca

Web 2.0 THE WAVE

Transcription

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