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Dr Alan Ruddiman Doctors of BC President 2016–17

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Dr Alan Ruddiman Doctors of BC President 2016–17 Congenital heart disease: September 2016; 58: 7 • History and evolution of treatment Pages 349–432 • Surgical and interventional management • Special considerations • Successful transition from pediatric to adult care Influenza vaccine in pregnancy Billing tips: Long-term care facility visits Proust: Dr Harvey Thommasen Dr Alan Ruddiman Doctors of BC President 2016–17 bcmj.org September 2016 Volume 58 • Number 7 contents Pages 349–432 A R T I C L E S THEME ISSUE: CONGENITAL HEART DISEASE 366 Guest Editorial: Complexities and considerations Jasmine Grewal, MD, Marla Kiess, MD Established 1959 368 History and evolution of the treatment of adult congenital heart disease Marla Kiess, MD 373 Surgical and interventional management of adult congenital heart disease Andrew Campbell, MD, Ronald G. Carere, MD 381 Special considerations in the management of adult congenital heart disease Jasmine Grewal, MD, Nathan Brunner, MD, Jennifer Ellis, MD, John Swiston, MD, Jonathon Leipsic, MD, Robert Levy, MD, Amanda Barlow, MD, Santabanu Chakrabarti, MD 389 Ensuring a successful transition and ON THE COVER: Dr Alan transfer from pediatric to adult care in Ruddiman at the Spadefoot Toad Vineyard near Oliver, patients with congenital heart disease BC. Read about Dr Ruddi­ Karen LeComte, RN, Brian Sinclair, MD, Sarah Cockell, PhD, Emma Iacoe, RN, man’s family and profes­ Alexia Gillespie, RN, Derek Human, MD sional background, his life experiences, and his ideas for the future of health care O P I N I O N S in BC in the interview be­ ginning on page 410. 352 Editorials Let’s discuss, David R. Richardson, MD (352) The future is not what it used to be, Brian Day, MB (353) 354 Personal View Medical cannabis: Concern with College standard, Donna Dryer, MD, Caroline Ferris, MD, Gwyllyn S. Goddard, MD, Peter A. Gooch, MB, Philippa Hawley, MD, Cecil Hershler, MD, Gill Lauder, MB, Caroline MacCallum, FRCPC, Ian Mitchell, MD, Michael Negraeff, MD, Conrad Oja, MD, Arnold Shoichet, MD, Christine Singh, MD (354); College replies, Gerrard A. Vaughn, MD, Heidi M. Oetter, MD (357); Re: Ah, the good ol’ days, Scott D. Smith, MD (358); The editor replies, David R. Richardson, MD (358); Re: Addressing existential suffering, Stephen D. Anderson, MD (359); Re: Thoughts on professionalism, J.N. Mahy, MD (359); ECO-AUDIT: President replies, Alan Ruddiman, MBBCh (360); Safe prescribing (1), Stephen Environmental benefits of using recycled paper Using recycled paper made with post- M. Shore, MD (360); College replies (1), Gerrard A. Vaughn, MD, Heidi M. Oetter, consumer waste and bleached without the use MD (361); Safe prescribing (2), Owen D. Williamson, MBBC (361); College replies of chlorine or chlorine compounds results in measurable environmental benefits. We are (2), Gerrard A. Vaughn, MD, Heidi M. Oetter, MD (362); Safe prescribing (3), Steve pleased to report the following savings. Wiseman, MD, Carol-Ann Sari, MD (362); Gerrard A. Vaughn, • 1399 pounds of post-consumer waste used College replies (3), instead of virgin fibre saves: MD, Heidi M. Oetter, MD (363); EHRs and burnout (a.k.a. early retirement), Andre • 8 trees C. Piver, MD (363); Joel Fox, MD • 760 pounds of solid waste Re: The impact of excessive endurance exercise, • 837 gallons of water (364); Authors reply, Andrea K.Y. Lee, MD, Andrew D. Krahn, MD (364) • 1091 kilowatt hours of electricity (equivalent: 1.4 months of electric power required by the President’s Comment average home) 355 • 1382 pounds of greenhouse gases (equivalent: How is Doctors of BC doing in meeting your needs? You told us and we are 1119 miles traveled in the average car) Alan Ruddiman, MBBCh, Dip PEMP, FRRMS • 6 pounds of HAPs, VOCs, and AOX combined listening, • 2 cubic yards of landfill space Environmental impact estimates were made 410 Special Feature using the Environmental Paper Network Paper Calculator Version 3.2. For more information visit Q&A with Dr Alan Ruddiman: Doctors of BC President 2016–17 www.papercalculator.org. Joanne Jablkowski 350 BC MEDICAL JOURNAL VOL. 58 NO. 7, SEPTEMBER 2016 bcmj.org #115–1665 West Broadway, Vancouver, BC, Canada V6J 5A4 Tel: 604 638-2815 or 604 638-2858 Fax: 604 638-2917 E-mail: [email protected] Web: www.bcmj.org contents O P I N I O N S ( Continued) 430 Back Page Proust questionnaire: Harvey Thommasen, MD D E P A R T M E N T S EDITOR 396 In Memoriam David R. Richardson, MD Dr James Holmes, Jim Tisdale, MD (396); Dr G. Barrie Purves, Sherrill Purves, MD, EDITORIAL BOARD Brian Hunt, MD (396); Dr John William Ibbott, William Jory, MD (397) Jeevyn Chahal, MD David B. Chapman, MBChB 397 Advertiser Index Anne I. Clarke, MD Brian Day, MB WorkSafeBC Timothy C. Rowe, MB 399 Cynthia Verchere, MD First-time traumatic anterior shoulder dislocations in young patients, Derek Smith, MD Willem R. Vroom, MD MANAGING EDITOR 401 Billing Tips Jay Draper Long-term care facility visits (fee items 00114 and 00115), Keith J. White, MD SENIOR EDITORIAL AND PRODUCTION coordinator 402 Pulsimeter Kashmira Suraliwalla Three BC doctors awarded Order of BC (402); Dr Michael Klein appointed to the associate EDITOR Order of Canada (402); Farewell to Dr Susan Haigh (402); Welcome Dr Jeevyn Joanne Jablkowski Chahal (402); Reminder: Apply for 2016–17 benefits under the Parental Leave COPY EDITOR Program (403); Canadian Blood Services reduces restrictions for blood donation Barbara Tomlin (403); Doctors of BC 2017 awards: Seeking nominations (403); First clinical PROOFREADER guidelines in Canada for pain following spinal cord injury (404); Doctors of BC Ruth Wilson Annual Report survey, winner (404); Seniors with undiagnosed hearing loss can DESIGN AND PRODUCTION become isolated (404); Depression screening tools not accurate for children and Scout Creative adolescents (404); Middle-age memory decline a matter of changing focus (406); COVER CONCEPT Half of patients with depression are inadequately treated (406); Scientists develop & ART DIRECTION microneedle system to monitor drugs (407); Correction: Dr Erik Paterson, 1941– Jerry Wong (407); (407) Peaceful Warrior Arts 2016 Canadian technology uses speech to track Alzheimer disease PRINTING 408 BC Centre for Disease Control Mitchell Press Influenza vaccine in pregnancy: Is it safe?Monika Naus, MD advertising Kashmira Suraliwalla 418 Calendar 604 638-2815 [email protected] 423 Council on Health Promotion Let’s help our children as parents and as doctors. Ron Wilson, MD ISSN: 0007-0556 424 Guidelines for Authors 426 Classifieds 431 Club MD Advertisements and enclosures carry no endorsement of Doctors of BC or BCMJ. © British Columbia Medical Journal, 2016. All rights reserved. No part of this journal may be re- Subscriptions produced, stored in a retrieval system, or transmitted in any form or by any other means—electronic, Single issue ................................................................................................................................. $8.00 mechanical, photocopying, recording, or otherwise—without prior permission in writing from the Canada per year ......................................................................................................................... $60.00 British Columbia Medical Journal. To seek permission to use BCMJ material in any form for any Foreign (surface mail) ............................................................................................................... $75.00 purpose, send an e-mail to [email protected] or call 604 638-2815. The BCMJ is published 10 times per year by Doctors of BC as a vehicle for continuing medical Postage paid at Vancouver, BC. Canadian Publications Mail, Product Sales Agreement #40841036. education and a forum for association news and members’ opinions. The BCMJ is distributed by Return undeliverable copies to BC Medical Journal, 115-1665 West Broadway, Vancouver, BC V6J second-class mail in the second week of each month except January and August. 5A4; tel: 604 638-2815; e-mail: [email protected] Prospective authors should consult the “Guidelines for Authors,” which appears regularly in the Journal, is available at our website at www.bcmj.org, or can be obtained from the BCMJ office. Statements and opinions expressed in the BCMJ reflect the opinions of the authors and not neces- sarily those of Doctors of BC or the institutions they may be assoicated with. Doctors of BC does not assume responsibility or liability for damages arising from errors or omissions, or from the use of information or advice contained in the BCMJ. The BCMJ reserves the right to refuse advertising. BC MEDICAL JOURNAL VOL. 58 NO. 7, SEPTEMBER 2016 bcmj.org 351 editorials Let’s discuss ecently our profession has between reducing prescription drug The ever-increasing use of medic- faced a number of contro- abuse/deaths and alleviation of suf- inal marijuana is also quite polar- R versial issues—physician- fering is difficult indeed. However, in izing. I have had a number of dying assisted dying, narcotic prescribing my over 20 years of clinical practice, patients report that marijuana eased for nonmalignant pain, and the use of suffering and made their last days medicinal marijuana to name a few. more comfortable. However, I now I’m not an expert on any of these is- have patients using medicinal mari- sues so naturally I will tell you how It is an honor juana for fatigue, insomnia, depres- things are. to publish the various sion, fibromyalgia, musculoskeletal The process of legalizing doctors opinions of our discomfort, and more. These prescrip- to aid in the deaths of their patients readers and act as a tions didn’t come from my hand, but has brought forth strong emotions on none of my patients had any trouble vehicle of respectful both sides of the issue. Words such as obtaining them. I am troubled by the “killing,” “murder,” “torture,” “inhu- discourse in all large number of people taking a cen- manity,” and more have been used matters. We might not tral nervous system active substance to bolster one position or the other. I always agree, but we with little scientific evidence to sup- believe most patients, if offered good are definitely in this port its use.
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