CMAJ Podcasts

Send us a textThis two-part episode of the CMAJ Podcast explores the roots and repercussions of medical mistrust. It begins with a historical lens, revealing echoes of today’s strained relationships between patients and the medical system, then narrows the scope to focus on a pressing clinical example.In part one, Dr. Kenneth Pinnow, a historian of Soviet medicine at Allegheny College and author of the article in CMAJ entitled Soviet medicine and the problem of public trust: 1921–1929, walks through the fraught relationship between physicians and the public in the early Soviet era. He explains how underfunding, class tensions, and unrealistic expectations resulted in widespread hostility toward physicians and fractured trust that proved difficult to repair.Part two narrows in on vaccine hesitancy, a timely example of medical distrust made more urgent by recent measles outbreaks. Dr. Noni MacDonald, a pediatric infectious disease specialist at Dalhousie University and former member of the WHO’s Strategic Advisory Group of Experts on Immunization, describes how trust is built—or lost—between patients and clinicians. She outlines practical strategies for frontline providers, from using presumptive language to engaging in motivational interviewing, and offers tips for addressing vaccine concerns efficiently, even in short appointments. For physicians, this episode is a reminder that trust must be earned repeatedly—through expertise, empathy, and systems that allow both to be seen.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham explore how changes to mifepristone regulation have reshaped abortion access in Ontario. Unlike most other countries, Canada allows the drug to be prescribed by any physician or nurse practitioner and dispensed by any community pharmacy, without additional restrictions or special certifications. The discussion draws on the article Changes in local access to mifepristone dispensed by community pharmacies for medication abortion in Ontario: a population-based repeated cross-sectional study, recently published in CMAJ.Dr. Laura Schummers, reproductive epidemiologist and lead author of the study, explains how the 2017 policy change contributed to a significant shift in abortion access. Before mifepristone, abortion care in Ontario was concentrated in fewer than 100 clinics, most of them in urban centres. Within five years of the regulatory change, the percentage of Ontario abortion service users with local access rose from 37% to 91%. Dr. Schummers also notes that this shift happened even though only one in five pharmacies dispensed the drug. She describes how earlier work demonstrating the safety of medication abortion helped support these policy changes.Dr. Wendy Norman, a professor of family practice at UBC and co-author on the CMAJ study, outlines what clinicians need to know about prescribing mifepristone. She explains that it can be safely offered without ultrasound or lab testing in many cases, and that virtual care is a viable model for appropriate patients. Dr. Norman also provides practical advice on gestational age limits, follow-up requirements, and how to identify patients at risk for ectopic pregnancy.This episode offers physicians a clear picture of how a regulatory approach that treats mifepristone like any other prescription medication has expanded abortion access across Ontario—and what it takes to incorporate this care into practice.For more information from our sponsor, go to MedicusPensionPlan.comJoin us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textThis episode of the CMAJ Podcast examines how recent changes to U.S. federal research funding are affecting the global scientific landscape—and what they could mean for Canada. The discussion focuses on indirect costs, talent retention, and whether Canada is positioned to step into any gaps left behind. The hosts speak with two guests who have written recent articles in CMAJ offering insight into how policymakers and institutions in Canada might respond.Dr. William Ghali, vice president of research at the University of Calgary, outlines how indirect research costs are funded in both countries and explains why the proposed U.S. cuts—though now on hold—would have had severe consequences for American institutions. He also discusses the strength of Canadian research infrastructure, recent federal budget commitments, and the challenges of recruiting U.S.-based researchers without stronger domestic supports.Dr. Kirsten Patrick, editor-in-chief of CMAJ, expands on the policy shifts required to improve Canadian research capacity. She calls for reforms to indirect cost funding and a reassessment of how Canada prioritizes health research—highlighting the gap between identifying systemic problems and investing in studies that offer practical solutions. She also reflects on the broader implications of editorial independence in a politically pressured environment.The episode raises timely questions for policymakers: Is Canada prepared to fill the gap left by a potential U.S. withdrawal from medical research leadership? Are we investing strategically in infrastructure, talent, and funding priorities to meet this moment? And what will it take to ensure Canadian research moves from identifying problems to generating meaningful solutions?Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textIt’s been nearly two decades since the last Canadian clinical practice guideline on managing obesity in children. In that time, the science has advanced, treatment options have expanded, and the need for updated guidance has grown increasingly urgent. On this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with three guests who contributed to or were impacted by the new guideline published in CMAJ. Together, they explore how the recommendations address the complexity of pediatric obesity and what it takes to implement them in real-world settings.Dr. Geoff Ball, chair of the guideline steering committee, explains how the recommendations were shaped by evidence as well as the meaningful participation of parents and youth at every stage of development. He discusses how the panel weighed the benefits and risks of pharmacotherapy and bariatric surgery in the context of limited pediatric data and a rapidly evolving treatment landscape.Dr. Michelle Jackman, a pediatrician and clinical lead at the Pediatric Centre for Wellness and Health in Calgary, shares how her team delivers multi-component behavioural interventions, often in the absence of system-wide supports. She reflects on how the new guideline has prompted her to reconsider referral pathways for bariatric surgery and advocate more strongly for patients.Brenndon Goodman, a long-time patient advocate, offers his own experience navigating childhood obesity, including the emotional dimensions of eating, the impact of stigma, and the life-changing outcome of bariatric surgery. He calls for improved access to care and a stronger commitment to children and youth living with obesity.This episode highlights both the progress and the persistent barriers in treating childhood obesity. The new guideline affirms that obesity is a complex chronic condition and provides much-needed support for physicians caring for children and youth living with it.For more information from our sponsor, go to scotiabank.com/physicians.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textA recent article in CMAJ entitled Effect of emergency department opioid prescribing on health outcomes examines a key concern facing many clinicians: can a single opioid prescription for acute pain lead to long-term harm? This study aimed to clarify the risks and inform safer prescribing practices.Dr. Grant Innes, the study’s senior author, analyzed more than a decade of data from Alberta emergency departments to compare outcomes between patients who did and did not receive an opioid prescription. The study found no significant difference in rates of overdose, opioid use disorder, or death—challenging widely held fears about short-term opioid use. Innes notes that older and opioid-naive patients may be more vulnerable to adverse outcomes and encourages a balanced approach to pain management.Dr. Hance Clarke, director of pain services at Toronto General Hospital, emphasizes the importance of structured follow-up and monitoring, especially for patients at higher risk of persistent use. He outlines practical strategies for safe prescribing and highlights underused and emerging alternatives, including ketamine, IV lidocaine, nerve blocks, and sodium channel blockers now in development. Clarke warns against “opioid phobia” and calls for individualized care supported by systems that can detect early warning signs.The guests encourage physicians to not avoid prescribing opioids when clinically indicated, particularly in cases of severe acute pain. With thoughtful screening and mechanisms for follow-up, opioids can be relatively safe and effective. The goal is not zero prescribing, but safer, smarter prescribing.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textA research article in CMAJ examines mortality risk among people hospitalized for hallucinogen use. The study found that individuals who required acute hospital care for hallucinogen-related issues had a nearly fivefold increase in mortality risk compared to the general population.Dr. Daniel Myran, a public health and preventive medicine physician, family physician, and researcher at the University of Ottawa, discusses the study’s findings and why the growing perception of psychedelics as therapeutic may be influencing increased use. He explains how individuals hospitalized for hallucinogen-related issues often have additional risk factors, including other substance use and underlying health conditions, which may contribute to their elevated mortality risk.Dr. Ishrat Husain, a senior scientist and the scientific head of the clinical trials unit at CAMH in Toronto, explores the controlled medical use of hallucinogens in treatment-resistant depression. He outlines the intensive screening and psychological support involved in clinical trials and compares psilocybin therapy to other treatments such as electroconvulsive therapy (ECT) and ketamine. While early evidence is promising, Husain cautions that psilocybin remains experimental and requires significant resources, raising questions about its future accessibility.The findings highlight the need for clear public health messaging and policy decisions that distinguish between medical and recreational use of hallucinogens.For more information from our sponsor, go to md.ca/tax. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textA new CMAJ study has found that alcohol-related hospitalizations and deaths in Canada surged during the COVID-19 pandemic. While overall alcohol consumption increased only modestly, the toll on the healthcare system was severe, with a 14% rise in hospitalizations and a 24% increase in deaths during the first two years of the pandemic. Researchers suggest that increased access to alcohol—through expanded retail hours and home delivery—contributed to these harms, particularly among heavier drinkers.Dr. Tim Stockwell, a scientist at the Canadian Institute for Substance Use Research and an emeritus professor at the University of Victoria, discusses the study’s findings and why even a small rise in alcohol consumption can lead to a disproportionate increase in harm. He explains how heavier drinkers, already at risk, were pushed beyond critical health thresholds, contributing to the sharp rise in hospitalizations and deaths.Dr. Adam Sherk, a senior scientist at the Canadian Centre on Substance Use and Addiction, examines the policy decisions that shaped alcohol access during the pandemic. While economic considerations played a role, he notes that governments were also reluctant to introduce new restrictions on alcohol at a time when the public was already under significant strain. He argues that a more balanced approach is needed in future public health crises—one that allows reasonable access to alcohol but uses measures like increased pricing and decreased availability to moderate its impact on the healthcare system.The findings underscore the need to rethink how alcohol policy is handled during public health emergencies—not just in terms of balancing health and economic interests, but also in managing public willingness to accept restrictions in times of crisis.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textAn article in CMAJ, "Move more, age well: prescribing physical activity for older adults," found that regular physical activity can reduce all-cause mortality by 31%. As Canada’s population ages, maintaining physical activity is becoming an increasingly critical factor in healthy aging. On this episode, Dr. Samir Sinha, a geriatrician at Sinai Health and the University Health Network and co-author of the CMAJ article, explains the evidence supporting exercise as a tool for preventing frailty, cognitive decline, and chronic disease in older adults. He addresses common misconceptions about aging and physical activity, emphasizing that even small, progressive increases in movement can help people stay independent longer.Physiotherapist Steve Di Ciacca, program manager at the Canadian Centre for Activity and Aging at Western University, outlines practical ways clinicians can help older patients build movement into their daily routines. He discusses the role of social engagement, personalized goal-setting, and structured exercise programs in improving adherence. He also highlights evidence showing that a simple written prescription for physical activity can increase adherence by up to 10%.This episode provides evidence-based insights to help clinicians encourage physical activity in older patients, promoting better long-term health outcomes.​​For more information from our sponsor, go to md.ca/tax. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textMedicine remains frequently inaccessible to people with disabilities, despite their higher-than-average need for healthcare services. On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle the systemic barriers that patients with disabilities face, from inaccessible clinic spaces to discriminatory attitudes.The discussion is inspired by the CMAJ practice article, "Five ways to support people who use wheelchairs," authored by Dr. Lisa Freeman. Dr. Freeman, a public health and preventative medicine physician who uses a wheelchair, shares her lived experiences navigating a healthcare system riddled with obstacles. She introduces practical steps that physicians can take to make their practices more inclusive, such as improving communication, ensuring referrals are effective, and addressing physical accessibility.David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, explains the legal obligations that healthcare providers must meet to comply with human rights and accessibility laws. He offers actionable guidance on how physicians can reduce barriers, from small changes like posting signage to long-term planning for accessible infrastructure.This episode underscores that accessibility is both a legal requirement and a fundamental part of equitable patient care. It challenges physicians to take immediate steps toward making their practices more inclusive for patients with disabilities.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Send us a textOn this episode of the CMAJ Podcast, Dr. Mojola Omole and Dr. Blair Bigham discuss necrotizing fasciitis, a diagnosis that can strike fear into the hearts of clinicians due to its rapid progression and devastating consequences. The discussion builds on insights from the CMAJ practice article, “Necrotizing soft tissue infections caused by invasive group A Streptococcus,” co-authored by Dr. Saswata Deb and Dr. Stephanie Mason.Dr. Deb, an emergency physician and clinician scientist at Sunnybrook Health Sciences Centre in Toronto, outlines the key clinical signs of necrotizing fasciitis, including pain out of proportion to physical findings and rapid hemodynamic deterioration. He emphasizes the importance of considering NSTI in the differential diagnosis for cellulitis and the need for prompt surgical consultation when red flags arise. Crucially, Dr. Deb explains that no imaging or laboratory tests can definitively rule in or rule out the diagnosis—only surgical exploration can confirm it.Dr. Mason, a burn and general surgeon at Sunnybrook’s Ross Tilley Burn Centre, provides a surgeon’s perspective on managing these infections. She addresses common missteps in diagnosis, the need for aggressive surgical debridement, and the role of multidisciplinary care in saving patients’ lives. She also discusses how surgeons can overcome their fear of creating extensive wounds, reassuring listeners that reconstruction is possible once the patient is stabilized.Together, the guests and hosts explore practical solutions to reduce delays in care, including the potential for institutional protocols—possibly a "code nec fasc"—to streamline decision-making and improve outcomes.For more information from our sponsor, go to md.ca/tax. Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions