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Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint Contributors Lucas Aykroyd Dr. Peter Brindley Michael DeFreitas Janet Gyenes Lisa Kadane Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Cover photo iStock/Bartosz Hadyniak

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Senior Account Executive Monique Nguyen Account Executives Janice Frome Wing-Yee Kwong

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Just For Canadian Doctors is published four times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian doctors. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications.

FEATURES

14 A capital time in Ottawa 21 Journey into India and a new mindset COLUMNS

DEPARTMENTS

9 photo prescription

5 summer mix 20 in the news 25 CME calendar 37 sudoku 38 small talk

Photography gold in the Galápagos

11 pay it forward A doctor’s haunting story in Bangladesh

12 motoring 18 the thirsty doctor Things are bubbling over

In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

32 the wealthy doctor

www.justforcanadiandoctors.com

36 doctor on a soapbox

Printed in Canada.

Dr. Brett Belchetz

The car-sharing revolution

7 tax-saving tips We’ll all be patients some day

cover photo Going deep into India and Nepal confronts all the senses, as one doctor discovers on his journey through the vibrant culture and colour…including immersion (quite literally) in the hues of the Holi festival (page 21).

Summer 2018 Just For Canadian doctors

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from the editor taste of

A taste of Ottawa: the Grapefruits of Wrath cocktail from Riviera restaurant; the Peace Tower, Parliament Hill (page 14).

ottawa tour

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WINTER WoN dERlANd

at Adventuraid. the most fun It’s ever have in theyou’ll snow. aventuraid.qc.ca

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ca lg a ry

singapore

Januar

Vallée des Fantômes It may be or Valley of Québec’s the Phanto best-ke wonderland ms. in Parc nationapt secret, this snowb com/pq/mva) ound l des Montsin (saguenaylacsaintjethe Saguenay-Lac-Sain Valin (sepaq. an.ca). A t-Jean the visitor centre brings 45-minute snowcat region ride from then don snowshoes you to the trailhea d, where you and hike three metres. The trail (“the best snows kilometres up 320 overheard en route, hoeing anywh up, past warmin and one must agree) goes ere” is g huts, to Dubuc, the up, up, a 360-de highest point gree view From here you can see in the park at 984 at Pic metres. the Mont far to the Valin massif Saguenay north, as well as the stretch Lowlands Piedmont to the south, Hills town of Sague the fjord and and nay on a clear, guide, Robert even , simply smilesbluebird day. Up top, the new day.” local and says It is. With “everyday one of the anywhere is a highes snow blanke in Canada, the fantast t annual snowfalls ting trees ical change consta formations of iterations of snow ghosts ntly, creatin fluffy stuff, . And if you g it’s a rather fall into the new soft spot do in Québec deep, to land.

play with wolves

fish on the Saguenay fjord in La Baie, amidst thousan of fishing huts—o ds ice. pecheaventures-n saguenay.com

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in the winter,

go to quebeco

y/Febru

ry 2017

Just for Canadian Doctors

For more on what to riginal.com. —B.S.

FEB 2018

ry 2017 Just For

Summer 2018

mix

POWDER

January/Februa

41/6 Vertical Just : For doctors 2.25”wCanadian x 4.875” h

ary

HOUND

stay in a snowbound 1950s-er a log cabin, the AntoineDubuc Lodge on Canots in Parc Lac aux des Monts-Valin.national sepaq. com/pq /mva

January/Februa

>>

snow day!

n Québec, there are people here embraceno winter blues. Rather, the cold, snow revel in it—goin g ice fishing (accompand ice and some piping-h anied by ot poutine and crisp, local microbre followed by snowsho w), right) and frolickin eing through snow ghosts (see g with wolves way to play in the snow?). All (is there any better this winter fun the Saguenay-Lac-Sa is found in int-Jean region an easy drive in eastern Québec, from activities while Québec City. Here are three must-do here. calling… saguena Winter is here, and Québec is ylacsaintjean.ca — Barb Sligl

Comments or questions? Reach us at feedback@ InPrintPublications.com.

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Doctors

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from top: Eric Vance; ottawa tourism; barb sligl (2)

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THE REVOLUTIONARY

In India, Dr. Peter Brindley went on his own taste tour—a version of Eat Pray Love. And, although that now-cliché book may conjure up entitled and self-absorbed westerners on privileged pilgrimages to “find themselves,” it still shares an important message. If you have the means and mindset (read: open), travel can be the best classroom, therapy session, retreat. Dr. Brindley took a sabbatical from his intense practice and travelled far—and farther still—on a much-needed journey… all the way to Nepal and India, where he chased wildlife in national parks and practised his “namaste” (page 21). From the temples of Siem Reap (page 5) to the shores of the St. Lawrence in Charlevoix (page 25), where Canada greets the world at this year’s G7 Summit, locals welcome visitors by sharing food, drink and culture. Québec will be doing it with cheese (L’Hercule, Le Migneron, Le Ciel de Charlevoix…), maple syrup, microbrasseries and local delicacies (from poutine to pets de soeur or “nun’s farts,” a must-try pastry that sometimes adorns traditional sugar pie). There’s also a range of Canadian bubbly with which to greet your own guests (page 18)—perfect for summer celebrating. As we’re doing here at the magazine… Another feature story and photograph, both published last year, have won more awards. Two bronzes from the Canadian Chapter of SATW (Society of American Travel Writers) for photography (below) and writing, including Best Canadian story for “Into and Out of the Northwest Passage” (Winter 2017; cover at right). For that we give a hearty mix “cheers!” and say thank you for continuing to support and WINTER BREAK read this publication. Feast I well this summer!

barb sligl

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ood and drink in a destination make an impression. Or they should. Whether a sophisticated cocktail (see the Grapefruits of Wrath at right, served at Riviera restaurant in Ottawa) or a humble chai (sampled on the streets of India), sipping at an of-the-moment bar or streetfood stand is a way to dig a bit deeper into the essence of a place. Savour. In Ottawa, our writer does that with gusto (page 14), from fancy tipples and microbrews to tarragon ice cream and thrice-fried fries. Some of it comes with stellar views of that iconic Peace Tower, or in a funked-up school bus with its own charm (on a brew tour that “kicks ass”). And, preand post-indulging, there is, of course, more of the capital city to check out, whether you’re an art or hockey lover—or both.

winter 2017

Dish it out


what/when/where > summer

style | food | drink | festivals | places | getaways | gear…

light + shadow in

siem reap

mix

Far east

S

janet gyenes

temple tripping

treaks of sunlight draws strange shapes on the voluptuous bas-relief apsaras adorning the walls before me inside Angkor Wat. Are those lotus flowers on the heads of those bare-breasted celestial maidens? My musings on this interplay of light and shadow are suddenly abstracted by more recent—and much darker—remnants of Cambodia’s complicated history. Five angry welts, unmistakable bullet impacts, scar the sandstone. They’re brutal reminders of the Khmer Rouge’s genocidal regime, which terrorized this Southeast Asian country from 1975 to 1979 in its failed attempt to create an agrarian utopia. Khmer temples such as Angkor Wat and Ta Prohm, among others, riddle the jungles surrounding Siem Reap, some 320 kilometres northwest of Cambodia’s capital, Phnom Penh. These religious edifices, however, were not constructed for worshippers. Rather, they were sacred residences built for the gods and characterized by a series of shrines, often linked to or surrounded by galleries. >>

Young Theravada monks sit by one of Angkor Wat’s four water basins

Summer 2018 Just For Canadian doctors

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mix

east bound

summer

go + see

shadow play

Getting lost (and found) amid the temples of Siem Reap

T i n to i a b od Cam

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site and was designed as a microcosm of the Hindu universe. Built during the reign of King Suryavarmen II (1113–1150), the city itself spans 200 hectares and is framed by a moat. I cross the floating walkway to reach the rectangular temple’s atypically west-facing gopura (Khmer temples are usually oriented to the east), or entrance pavilion. The 82-hectare temple’s five gopuras are set in a cruciform—one at each corner and the tallest in the centre representing Mount Maru whose summit is the home of the gods. I lose myself in Angkor Wat’s darkened corridors; its walls are pictorial pages that form a mythical memoir with a labyrinthine narrative I can’t begin to decipher. Intricate scenes carved in stone depict sinners roasting in the hell of Avīci, the military procession of Suryavarmen II, and the Churning of the Ocean of Milk, where amrita the elixir of immortality was produced. Visiting the Angkor National Museum in downtown Siem Reap primed me for pinpointing deities, such as fourarmed Vishnu and motifs like nāga, a multi-headed serpent. Leaving the sanctuary of the shadows, I step into the sultry afternoon heat and approach one of the temple’s four water basins. A rivulet of sweat trickles down my back as I watch Buddhists kneeling in prayer before a shrine. Across the bonedry basin, young Theravada monks with shaved heads and enigmatic faces sit swathed in burntorange robes, the folds of fabric radiant against the steely bands of stone. One monk gazes my way and our eyes meet for an ethereal instance. Or maybe it was my mind playing tricks, seeking a glimmer of certainty in this unknowable realm. When I arrive at Ta Prohm, the Khmer templemonastery (of Lara Croft: Tomb Raider fame; the 2018 reboot is filmed in South Africa and the UK), the sun had started its journey from heaven to earth, bathing the stone with a golden glow. Ta Prohm’s huddled structures were constructed during the reign of King Jayavarman VII (1181–1220). Their outward appearance—crumbling bricks flecked with a patina of age and moss—is that of being left in ruins. In actuality, it’s more a détente between humankind and nature. The jungle’s silk-cotton trees and strangler figs squeeze their roots into the masonry, clinging to bas-reliefs and taking up residence on rooftops, simultaneously breaking it apart and gently securing the structures to ensure this sacred residence for the gods endures. — Janet Gyenes

Angkor Wat at sunrise

Posing monkey at Angkor Wat

Giant roots at Ta Prohm

Temple offerings

Cambodian colour

if you go To discover Siem Reap’s ancient temples, go to siemreap.net.

Just For Canadian doctors Summer 2018

janet gyenes

hallowed ground

>> Angkor Wat is the world’s largest religious


warming trend

summer w or th y c a u se

mix

editor’s

pick

su n se e k e r

get shady

sun Make a statement with your shades… like supermodel Gigi Hadid, who’s been papped wearing Alfons octagon-frame sunglasses in electric blue (we like groovy orange, above, and also the chic Chen from the White Heat collection). Handcrafted in Austria, Andy Wolf (the company’s name comes from two of its founders, Andreas and Wolfgang) specs are so fashion-forward, Lupita Nyong’o recently wore a cat-eye version as she presented an Oscar. $510 (Chen), Andy Wolf; andy-wolf.com

cabin chic

dig into down dog Have bag, will travel. And yoga this may be the travel/yoga/ all-purpose bag. Lolë’s Lily is Feel good, do a bestseller (thanks to its padded good, look computer pocket, straps that turn [event] Partake in the Lolë White it into a backpack, plus a bevy of good… Tour this summer, when people compartments for a yoga mat, water ­by Barb Sligl (as in 65,000!) come together bottle, shoes, smartphone…). And it for a communal meditation and comes in fresh, fun hues like this powdery yoga session: July 26 in Toronto blue. Pair it with the Piper jacket (in (sunset session); August 16 in Montréal (morning session). bright, summery white), a packable Om. lolewhitetour.com raincoat with stylish details like a back vent. $140 (Lily), $135 (Piper); Lolë, lolewomen.com

xxxxxxx

Get in on some pattern play. Up-and-coming Canadian brand Muttonhead (everything is designed and made in North America) brings a touch of Canadiana and the great outdoors to camp its products, from cabin spray (in a woods scent) to T-shirts that picture camping motifs. Camping hoodies, named after beloved Canadian places where you’d happily wear such a fleece pullover—like the Tofino (pictured). Plus…pockets! Then there’s the wool-blend cottage blanket (the turquoise is below but we also like the sunset version). All you need now is a campfire. $140 (Tofino Camping Hoodie), $124 (Cottage Blanket); Muttonhead, muttonheadstore.com

wild gift This 18k rose-gold Elephant Brooch (with a diamond gift held in its tusk) is part of the Tiffany Save the Wild collection. It’s lovely enough on its own but what makes this piece most precious: 100% of the profits go to the Elephant Crisis Fund, an initiative of Save the Elephants and the Wildlife Conservation Network (supporting antipoaching, anti-trafficking and ivory demand reduction projects worldwide). Even better, Tiffany & Co. has committed to a minimum donation to the Elephant Crisis Fund of USD $1,000,000 by January 31, 2019. $2,450; tiffany.ca

Summer 2018 Just For Canadian doctors

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p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.

Don’t step on the wildlife

destination photography

The animals are otherworldly, fearless and seem to pose in the Galápagos

Exploring the Galápagos Islands should be on every photographer’s bucket list

wing it

michael defreitas

W

isps of mysterious fine spray, backlit by the low morning sun, fill the air along the black rocky shoreline of Isla Fernandina. As our zodiac nears shore, we see the reason for the spray. Blanketing the rocks are thousands of marine iguanas “sneezing” spray into the air to eject salt water from their bodies. Our guide picks a “clear” landing spot between the iguanas and as we step ashore she warns, “be careful on the sharp rocks and try not to step on the iguanas.” Easier said than done. After a few unflattering shots of black iguanas on dark rocks, I search for lighter backgrounds that would help highlight these prehistoric-looking creatures. Shooting low using the bright sky and light sand as backgrounds help, but nothing jumps out at me until I find one basking in a small tidal pool. Using my 80–200mm zoom set at 120mm, I shoot at 1/500 second and frame tightly, including the animal’s reflection. Later that day, we venture inland to find some of the island’s golden-coloured land iguanas. Except for perhaps the Antarctic, no place on earth offers such spectacular and easily accessible wildlife experiences as the Galápagos. Most of the animals are fearless of humans, so wide-angle and mediumtelephoto zooms give the best results unless you need to isolate a particular subject or when photographing tiny finches and flamingoes (a 200mm will suffice). You can approach most animals within touching distance, but never initiate contact. It’s okay if they touch you, but you doing so will get you sent back to the ship. A few days into our trip, we visit Isla Santa Maria to snorkel with sea turtles and visit a flamingo colony. Flamingoes are probably the shyest animals in the Galápagos. They feed in their lagoons, but usually get close enough to the shoreline that you can photograph them with a 200mm telephoto. The key here is to stay low, still and wait for them to approach you. I use a tripod and a wide f-stop of f11 at 1/250 second. A really good flamingo shot showcases its long curved neck; wait until it lifts its head from feeding or while it’s walking and capture its reflection in the water.

Waved albatrosses make landfall every couple of years on Isla Española (between April to August) to mate and raise their young. These majestic flyers have three-metre wingspans, so use a 70mm telephoto lens to capture portraits while they’re nesting or in flight, returning from feeding. For portraits use f11 and 1/250 second. Try 1/500 second and f8 for flying shots, making sure to pan the bird and compose with those three-metre wings along a diagonal.

if you go

galapagosislands.com Tour operators: bigfive.com AdventureSmith Explorations.com

Summer 2018 Just For Canadian doctors

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Sea lions are found on every island and even resting on the sidewalks of Puerto Ayora, the main town, but the best place to

photograph them is on beautiful Gardner Beach on the east coast of Isla Española. In this close-up situation I like to use a 16mm fisheye lens at f8 with 1/60 second. Its curved-and-distorted perspective produces unexpected images.

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On the west side of Isla Española are the Nazca, red-footed and blue-footed booby colonies. Of the three, the blue-footed is the most photogenic. The male finds a viewing rock and waves his blue feet to attract a mate. When I find a male in a suitable lighting position, I use a 14–24mm wide-angle zoom, switch off auto focus and manually set the focus to one metre. Using 1/200 second and f16, I hold the camera with one hand extended towards the bird so as not to disturb its dance. I recheck my framing and composition after each shot until I find the best focal length. No trip to the Galápagos would be complete without photographing the giant tortoises that can weigh 500 pounds and live for 150 years. You can spot wild ones in the lush damp highlands of Isla San Cristóbal and Isla Isabela and captive ones in pens at the Charles Darwin Research Station in Puerto Ayora on Isla Santa Cruz. Over the years, whalers and sailors decimated the tortoises for food, but local guides can help you find the few

Just For Canadian doctors Summer 2018

remaining wild ones. Or you can always photograph the ones at the research station. The rugged volcanic landscape of the Galápagos Islands makes for some great photography. If your itinerary permits, climb to the top of Isla Bartolomé’s tallest cinder cone in the late afternoon to witness (and photograph, of course) to-die-for panoramas of neighbouring islands and the famous Pinnacle Rock. The only way to see the islands is by boat and a number of tour companies offer 8- to 10-day cruises on small vessels (most carry 16 to 50 passengers). You’ll visit six to eight islands and the knowledgeable park rangers (assigned to each vessel) escort all shore excursions to provide valuable information and make sure you don’t break any rules. You’ll experience the famous bluefooted booby two-step within touching distance, mockingbirds pecking at your shoelaces, iguanas crawling over your feet and playful sea lions performing figure eights around you when snorkeling. In the Galápagos, you won’t have to sneak up on the wildlife…but you will have to be careful where you step.

michael defreitas

photo prescription [continued]


pay i t f o r w a r d

r o b e r ta s ta l e y

Roberta Staley is a Vancouver-based magazine writer, editor and documentary filmmaker.

Haunting memories

A doctor’s ongoing philanthropic efforts are partly in remembrance of a tragic refugee child

courtesy of Dr. fozia Alvi

O

ne tiny, doomed child haunts Dr. Fozia Alvi. His name was Bilal and he had been born to a young mother with two other toddlers in a Rohingya refugee camp in Bangladesh, which sits on the border of the Southeast Asian nation of Myanmar. Starting last August, hundreds of thousands of ethnic Muslim minority Rohingya, who had been living in Myanmar for generations, fled slaughter, looting and rape by security forces and Buddhist mobs, ending up in neighbouring countries like Bangladesh in a desperate search for sanctuary. The refugee camp was where Alvi first met Bilal. The Airdrie, Alberta-based general practitioner, working with the Islamic Circle of North America (ICNA) Canadian chapter, travelled to the country last October to provide volunteer medical care to 850,000 Rohingya refugees in a camp in the Bangladeshi municipality of Cox’s Bazar. Only 38 days old, Bilal weighed about one kilogram and was severely dehydrated, with sunken eyes and fontanelle, recalls Alvi. He barely flinched when she touched him and was incapable of nursing—his starving mother had little, if any, milk anyway. Bilal was on the brink of death. If there was to be any chance of survival, the mother would have to take him immediately to a nearby Médecins Sans Frontières (MSF) medical camp, where staff could possibly transfer him to a nearby hospital. But the young woman had left her other two small children by themselves in a tent, and an official was coming that afternoon to register the small family, which meant they would begin receiving emergency food rations. The choice was bleak: sustenance for her and the toddlers, or take Bilal to the MSF facility, on the off chance he might survive. Alvi doesn’t know for sure the fate of Bilal, although the outcome is easy to guess. The baby’s fate torments her. “It penetrated my core,” Alvi says. “It feels like he won’t take his eyes off me.” It isn’t just the memory of Bilal that haunts Alvi. It is the vast inequalities and enormous cruelties suffered by countless

people around the world that drives her to try to make a difference where and when she can. Alvi grew up in a rural area of Pakistan’s Punjab region, obtained her medical degree, then immigrated to the United States to undertake her residency. She worked as a family practitioner in Wisconsin before moving to Alberta, which offered her petroleum-engineer husband work in the oil fields. About seven years ago, Alvi travelled to one of the more remote areas of her native country, Pakistan. While there, she discovered that there were only private hospitals—no government clinics—which meant that poor people were deprived of medical care. Upon further investigation, Alvi discovered that one in three women died from obstetrical complications. A skyhigh infant mortality rate couldn’t even be tallied. “I said, ‘I have to do something.’” So Alvi worked overtime for seven years, saving the extra money she earned, holding fundraisers and collecting used equipment, such as surgical lights, from Alberta Health. Finally, last Dr. Fozia Alvi at December 24, she officially a Rohingya refugee opened the $1.3-million, camp in Bangladesh, 60-bed Iman Hospital in where she’s volunteered Long-term planning Talagang in the Chakwal with the Islamic Circle for Iman Hospital is onDistrict of Punjab, Pakistan. of North America going. Alvi, who will be The hospital is named after (ICNA) to provide returning to the facility her 12-year-old daughter. “I medical care later this year, is considtold her, ‘One day you are going ering expanding care to to make this a 600-bed hospital.’” include oncology, ears, nose and Iman Hospital has both a maternity throat, ophthalmology and internal mediward and a neo-natal unit. It also has a cine. Alvi’s medical colleagues and friends in trauma centre, which means that severely Pakistan, Canada and the US will assist with injured people won’t have to make the training the local doctors, she adds. dangerous and often-fatal journey of many But the dark memories of Bilal—and hundreds of kilometres to a government the other refugees—will always stay with hospital. Alvi has also trained the doctors Alvi, who is uncertain if she will be able to who work at her hospital. As a result, the return to Bangladesh to help the Rohingya. facility now offers the highest quality care in the district. This has meant it is becoming “I still have the nightmares and I still feel we need to do more to help those people,” self-sustaining, as wealthy local residents says Alvi, who faced lineups of up to 500 are willing to pay a professional fee for sick and dying people as soon as she came care at Iman. Alvi also created a $100,000 operating fund to ensure all bills, such as to the emergency ICNA medical clinic each doctors’ salaries, are paid on time. And she’s morning. “These small acts of kindness can convinced local businessmen to contribute hopefully collectively bring about true and regularly to the fund. lasting changes for them.” Summer 2018 Just For Canadian doctors

11


motoring

D r . k e l l e n s i lv e r t h o r n Dr. Kellen Silverthorn is Just For Canadian Doctors’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

Shared rides

I

first explored fractional ownership approaches to exotic sport cars a decade ago. The shine has faded from that business model. But that’s okay, as a whole new alternative universe to individual car ownership is unfolding today. Granted, it’s unfolding primarily for Canadians in the three largest metropolitan centres. The rest of us will have to wait for champions to emerge and expand across the land. The various forms of car sharing are highest among the urban and underage-30 set. And if paying for car use by the hour and kilometre satisfies millennials, they

of all types serving 18,000 owner-members. Return-to-start trips only permitted. The British Columbia Automobile Association’s Evo car-sharing business model is only slightly more capitalist. Evo’s scale is 1,250 cars from 123 Vancouver locations. BCAA membership is not required. Reflecting their youth target market, each Evo is a hybrid Toyota Prius equipped with bike/ski racks. Evo also allows one-way trips within defined geographical areas. Further into capitalism’s realm, multinational car rental companies have divisions rebranded as major players in urban car sharing. Zipcar is owned by Avis-Budget. Enterprise CarShare is owned by the eponymous car rental folks. Enterprise has roughly 400 vehicles across 200 locations in Ontario’s Golden Triangle. Car manufacturers are also increasingly moving to their own car-sharing operations. Daimler, the parent firm to Smart cars, has operated car2go since 2009, with 14,000 car sharing vehicles in major cities The blue-and-white of the world. Since car2go Smart cars are 2017 car2go has added becoming ubiquitous in downtown Montréal smaller models from (here), Vancouver and another of Daimler’s Sm ar t sh ar in g. . . Calgary brands, MercedesBenz. Vancouver has the may never join us boomers as car owners. largest membership base of Surprisingly, the modern car-sharing 11 North American car2go operations at era in Canada is coming up to its 25th 137,000 for their fleet of 1,100 cars. One-way anniversary. The first efforts were grassroots trips within certain boundaries are allowed. co-op type structures. Many never achieved Maven is GM’s big jump into the carscale—though progenitor Communauto sharing field, recently opening up Canada’s today boasts 2,000 economy cars across first branch in Toronto. Expect big things. southern Québec, southern Ontario and Toyota, another car-company colossus is reHalifax. Membership exceeds 50,000 with branding itself as a “Mobility” provider, so 600 fixed locations, plus 700 “floating cars.” expect them soon as a car-sharing player. One-way trips are allowed in Québec City Competition on price and car numbers and Montréal. will be somewhat less central to the entries Modo, almost as long-standing, serves of Porsche, BMW and Cadillac—each have Vancouver and Victoria. It has 600 vehicles pilot subscription programs in US metro

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Just For Canadian doctors Summer 2018

areas. These programs allow subscribers to cycle through numerous different models from their own brand. I’m intrigued by where dealer groups will take car sharing. There are hundreds of dealer groups across North America. Many groups represent multiple premium brands. If I wanted a steady diet of different premium vehicles from as many brands as possible, how might they service that want? We are still in early days with this, but check out Dallas’ Park Place Select (parkplaceselect.com). Uber, Lyft and other ride-hailing apps provide an alternative to car sharing. Car hailing in Canada, for now at least, still comes with a driver. Uber is available in Edmonton, Toronto, Ottawa, Montréal, Québec City and Halifax, while Lyft is found across much of southern Ontario. GM and Ford both have Lyft partnerships. Turo is a San Francisco-based firm that promises to do for private car owners what airbnb did for underutilized accommodation assets. The firm describes itself as operating a peer-to-peer carsharing marketplace. Turo has small operations in Toronto, Montréal and Vancouver. Getaround has a similar but, for now, USA-only business model. The holy grail at the end of all this car-sharing activity is the public-access autonomous vehicle. Ride-hailing without an actual human driver…because artificial intelligence within and between cars will eventually render drivers obsolete. This endgame is where the financial titans are focused—Google, Apple, Facebook, Amazon, Alibaba and TenCent. Each is eyeing the grand prize of having its own brand’s autonomous pods transporting its many subscribers ad hoc to wherever they need to go. I’m all for maximizing the efficient use of roads, parking spaces and cars. I also understand the attraction of letting HAL drive at times. I’m just hoping the future universe of alternatives to individual car ownership addresses those of us who actually enjoy driving a powerful, responsive thoroughbred down a deserted, twisty road.

car2go

There’s an alternative universe to individual car ownership…think communal


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travel at home

There’s a tantalizing range of food and drink that complements the capital’s many other attractions by

I

’m devouring a delectable braised lamb shank with celery root purée at the upscale Riviera restaurant. It’s just steps from Ottawa’s new Lord Stanley’s Gift monument, which commemorates the 1893 creation of hockey’s Stanley Cup. What a dream lunch spot for any NHL fan! Although my mouth is full, I’m smiling inside. Granted, it’s partly because I just finished a Grapefruits of Wrath cocktail (Tromba

14

Lucas Aykroyd

Tequila Blanco, Campari, IPA lemon, simple syrup, Bittermens Hopped Grapefruit Bitters) at this high-ceilinged former bank, named one of Canada’s top 10 new restaurants of 2017 by enRoute magazine. Yet I’m also stoked because the dining scene in our nation’s capital is exceeding my expectations. Fifty years ago, the joke went: “If you want a good meal in Ottawa, go to Montréal.” How times have changed. Today in Ottawa, if the squabbling between

Just For Canadian doctors Summer 2018

politicians—or millionaire hockey stars and billionaire owners—leaves a bad taste in your mouth, there’s a cornucopia of flavours for every palate and budget to help you move on. I decide to spice up top local attractions during my visit by pairing them with exceptional eateries. For instance, after enjoying the panoramic view of this city (and larger National Capital Region that’s home to 1.3 million) from the 92-metre-


travel at home

ottawa tourism

Biking on the Québec side of the Ottawa-Gatineau region, where some of the best views of Parliament Hill are found along bike paths (some 800 km of them!)

high Peace Tower at Parliament, I stroll to The Albion Rooms at the four-star Novotel Ottawa hotel. Gastropub chef Peter Saunders’ farm-totable philosophy rewards me with appetizers like the Scotch egg with fruit ketchup, roast cauliflower, and thrice-fried fries. After that, I figure polishing off the signature elk burger with old cheddar and molasses bacon can’t hurt my quest for Justin Trudeauworthy abs too much. (Elk is lean, right?)

I savour walking up the long, naturally lit ramp to the granite-and-glass Colonnade at the National Gallery of Canada. Viewing artwork from Impressionist master Camille Pissarro’s Hay Harvest at Éragny to Inuit innovator Kenojuak Ashevak’s Birds Feeding Among Spring Flowers puts me in an even lighter mood. Just down Sussex Drive, I go to the dark side at the Moscow Tea Room. In the opulent, intimately lit lounge, servers

in slinky red dresses entice me with the infamous “Vladimir” perogies with goat cheese and sliced beets and keep the Baltika #7 beers coming. It’s one tasty stealth operation. The next day, I’m still ruminating over enigmatic former Russian Ottawa Senators like Alexei Yashin and Alexei Kovalev when I head to Rideau Hall. The residence of every Governor General since 1867 abounds with classic echoes of Canada’s hockey legacy.

Summer 2018 Just For Canadian doctors

15


From the stately ballroom where Maurice “Rocket” Richard received the Order of Canada in 1967 to the solid-nickel Canada Cup trophy from 1991, I feel awe in the pit of my stomach. Afterwards, I take a quick Uber to the belly-pleasing Fraser Café. Operated by brothers Ross and Simon Fraser, it celebrates its 10th anniversary in 2018. At this homey New Edinburgh establishment with exposed brick walls, I warm up with scrumptious tomato and curry soup and thyme lemonade as “Oh, Pretty Woman” and “California Dreamin’” play in the background. I feel like singing when my fried chicken sandwich with pickles and spicy mayo arrives. The tarragon ice cream for dessert provides a world-class encore. As this is Canada, my thoughts gravitate back to hockey. I imagine local fans were driven to drink after the Senators got within one game of the 2017 Stanley Cup final— and then missed the 2018 NHL playoffs. The following day, I too am driven to drink on Brew Donkey’s six-hour, bus-based Rideau Rally craft beer tour. “This will not be a leisurely tour,” owneroperator Brad Campeau gleefully proclaims. Guests sample at least three beers at five area breweries, plus SuzyQ’s maple bacon and salty caramel doughnuts. I guzzle everything from Dominion City’s best-selling Two Flags (a hoppy 7% IPA) to Broken Stick’s Star Wars-inspired Cherrybacca (a 5.3% cherry-flavoured Belgian blonde ale). By the end, I can barely spell “Alexei Kovalev,” and I feel great. I mosey over to the Hintonburg Public House for some post-imbibing comfort food. And this Wellington West pub delivers with its housemade sour cream and onion potato chips and shepherd’s pie with smoked ham hock. Candle-lit mason jars and polished wooden benches enhance the relaxed ambience and encourage me to settle in. On my last day in town, I visit the Canada Science and Technology Museum. At this newly renovated, 80,000-square-foot venue, it’s the gloriously retro exhibits that pique my fancy, like the monochrome AES Plus 103 computer built in Montréal in 1987, and the Crazy Kitchen, whose 1960s-style top Beers on tap in the cozy Hintonburg Public House middle row from left One of the signature dishes (Charred Leeks) at The Albion Rooms, a cool spot with the bonus of stellar views of Parliament; the Peace Tower on Parliament Hill rises high above the city bottom The National Gallery of Canada, where you can see masterpieces that range from Impressionist to contemporary Inuit art

from top, left to right: Dwayne Brown; the albion rooms; ottawa tourism; Destination Canada

travel at home


from top: Eric Vance; Sofie Sharom; Lessard Images

travel at home

decor is designed to mess with your spatial perceptions. It all just makes me hungrier. By now, I’m a bona fide Ottawa food believer. I sign up for C’est Bon Cooking’s Lowertown Tour. This 2.5-hour afternoon walking tour of gourmet destinations around the historic ByWard Market neighbourhood takes my taste buds to new heights. Each year, the heavenly-smelling Stubbe Chocolates handcrafts 120,000 mouthwatering truffles, with flavours like RaspberryChampagne and Irish Coffee. German For more on what’s master chocolatier happening in Ottawa and its Heinrich Stubbe many food + drink offerings is passionate (including info on all the spots mentioned here): about purity and ottawatourism.ca. quality, sourcing his sustainable cocoa beans from Belgium’s Callebaut. “I don’t follow trends, I set them,” he adds. Who am I to argue? Especially with a mouth full of chocolate. At Brothers Beer Bistro, I’d be happy just to expand my palate with such colourfully titled Ontario brews as Bellwoods’ Motley Cru (a barrel-aged wild 8% ale with Gewürztraminer) and Sawdust City’s The Princess Wears Girl Pants (a hoppy 9% saison). Yet after wolfing down the hearty house burger, plus raspberry mint sherbet and blueberry ice cream for dessert, my pleasure peaks when I learn that legendary retired Senators captain Daniel Alfredsson also comes here. Fortunately, I’ve left some room, because this tour ain’t over. From Fiazza’s artisan wood-fired pizzas to the SmoQue Shack’s pulled pork sliders and baby back ribs, from Pili Pili’s spicy grilled African chicken to tiramisu and Neapolitan coffee at Mantovani, my esteem for Ottawa’s outstanding cuisine keeps growing—as does my waistline. (Abs can wait.) Oh, Ottawa. Who knows when you’ll win your first Stanley Cup since 1929? And who knows what bonehead move the politicians gathered here from across the country will pull next? But when it comes to food and drink, you’ve got my vote. top Grapefruits of Wrath cocktail at Riviera, named one of the best new restaurants in Canada in 2017 middle The newly renovated Canada Science and Technology Museum bottom Aboard Brew Donkey’s six-hour, bus-based Rideau Rally craft beer tour, which takes in five area breweries (sample sip: Broken Stick’s Star Wars-inspired Cherrybacca, a fruity Belgian blonde ale)


the thirsty doctor lisa kadane Lisa Kadane is a newspaper and magazine writer who likes to travel and partake in the destination’s preferred tipple, whether it’s rum, wine, a margarita or whisky sour. She’s been sharing her thoughts on spirits and cocktails since 2010.

Pop goes the cork (or can) In BC, more wineries are getting fizzy with it

“L

ook at the pearls going up,” says Jennifer Molgat, entranced by her glass. I peer into my full flute inside The View Winery in southeast Kelowna and see what the French call perlage—a delicate procession of bubbles rising from the bottom like a strand of tiny pearls. These bitsy beads of effervescence are, in fact, what give the 2016 Traditional Pearls Brut, released this spring, its name. It’s a dry, crisp sparkling wine with apple notes and limey citrus up front, and a rich mousse finish that comes from

perhaps the world is ready for carbonated wine-in-a-can. “We have women ride up on their horses and fill their panniers with Bling,” says Molgat, president of The View Winery. Calling BC’s Okanagan Valley the Wild West of sparkling wine is apropos—winemakers here are definitely playing around with how a bubbly is made (and sold), with delightful and delectable results. In fact, BC leads the country in sparkling wine production, where nearly 75 wineries (of 270 in the province) make a sparkling or frizzante (semi-sparkling) product. I haven’t always Su m m er ti m e sippin g: been a bubbly buff, but a visit to a bu bb ly. . . in a ca n Champagne house several years ago turned me on to the fizz. The gold standard from France isn’t exactly wallet-friendly, however, so I’ve sought out Canadian sparkling on this side of the pond. Turns out, sparkling wine has been seducing more wine drinkers than just me. No longer reserved for special occasions, people now pop a encapsulated yeast that ferments the cork to welcome friends into their home or bubbly right in the bottle, where it rests order a glass to kick off an evening out. And on lees (the dead yeast cells that spark as the days lengthen and the temperatures fermentation in the bottle) for nine months. rise, a crisp, dry sparkling or frizzante rosé Pearls is made from a blend of Riesling and makes a fantastic patio spritzer. White Pinotage grapes, which grow well on “It’s one of the fastest-growing The View’s 50 acres of vineyards. It works categories, and it’s starting to be available beautifully, and demonstrates the terroirat a more reasonable price point,” says driven trend that’s reflected in releases Mike Anderson, The View’s winemaker. from a growing number of wineries that are Indeed, within Canada, sparkling wine sales getting fizzy with it. outpace still. The View also makes a sparkling rosé and As a result, wineries are having a hard six-pack cans of sparkling wine called Bling, time keeping up with demand. Kelowna’s available in pink or white, that are insanely Tantalus Vineyards, for example, sold out of popular for poolside sipping. Fun fact: in its 2014 Old Vines Riesling Brut and its 2014 the past two years, The View has seen a Traditional Method Blanc de Noir (made 900% increase in sales of Bling, proving that from 100% Pinot Noir grapes) months ago.

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Just For Canadian doctors Summer 2018

Fortunately, there’s still a lot to go around, with more being released this spring. Sparkling leader Summerhill Pyramid Winery, which pioneered bubbly in the valley with its award-winning Cipes Brut, makes a range of sparkling wines including a traditional method sparkling from 100% Cabernet Franc and a sparkling icewine that delivers fizzy mouthfuls of ripe strawberry and raspberry. Farther south, Bella Wines in Naramata has dedicated itself solely to sparkling, including a traditional method Blanc de Blancs (100% Chardonnay) from various vineyards, and a 2015 Methode Ancestrale portfolio, where both the Rosé and Brut wine fermentation starts in a barrel and finishes in the bottle with bubbles. “People really are dabbling in sparkling,” confirms Sarah Bain, winemaker at Fitzpatrick Family Vineyards between Peachland and Summerland. “Everyone’s figuring out what varieties work here.” Part of what makes Canada a good country for growing grapes destined for bubbly—from Chardonnay to Riesling—is its cool climate. Long summer days and cool nights allow the fruit to ripen slowly and hold on to the acidity necessary to make a good sparkling backbone. That’s what makes Bain so excited about the grapes growing at Fitzpatrick Family Vineyards. The winery is isolated between Okanagan Lake and Mt. Eneas, which shades the grapes from the scorching late-afternoon sun. They’ve had success with the traditional Chardonnay and Pinot Noir grapes, which make up the 2014 Fitz Brut and the reserve sparklings—a 2014 Blanc de Blancs and a 2014 Sparkling Rosé, released this spring. They’re also making bubbly in the style of Champagne, referred to as the traditional method, where wine ages on lees for at least 24 months. No sparkling wine in a can here. But what I love about BC bubbly is the fact that you can ride your horse right up to the vineyard to buy cans of Bling for your pool party, if it suits. Or, you can uncork a more traditional bottle and watch the perlage dance in your glass. In the Okanagan Valley, anything goes.


in the news in the office

New horizons

These tech savvy products are at the forefront of medicine software

talking point

The next major leap forward in speech recognition is here. Speakeasy Solutions (provider of almost two decades’ worth of software, microphones, recorders, support and training) has a new version of Dragon Medical that’s now accompanied by Google Chrome support. Medical practitioners using web-based EMRs can seamlessly edit, correct and employ simple to complex templates directly in the Google Chrome web browser. It’s a major boost in accuracy: technology wrapped in Dragon Medical’s core, plus improved accent support. So go ahead, call an audible. speakeasysolutions.ca

engage + connect

cloud

Patient engagement is a good thing. And Innomar Strategies’ and iMD Health Global’s strategic partnership brings further connection to patients. As of May 2018, iMD’s cloud-based patient engagement software platform will be used by InnomarClinics across Canada to educate and train patients about their condition and medication, increasing health literacy. This enhanced Patient Support Program—content that includes professionally vetted diagrams, brochures and videos on over 1,500+ conditions, anatomical categories and treatment options—is another example of iMD solutions already being used by private practices, large medical centres, pharmacy stores and hospitals. Power to the patient! imdhealth.ca

cyber MD

web

There’s a new resource for patients who want to chat with a physician while they’re in their pyjamas…or while at the cottage or on lunch break. It’s a new concept called Maple: online medical care that patients can access via their smartphone, tablet or computer. The live chat and video platform virtually connects a patient with a doctor across the country—anywhere, anytime. The revelatory cyber clinic is co-founded by practising emergency-room physician Brett Belchetz (read more about Dr. Belchetz on page 38) with a mission to provide “access to highly regarded Canadian licensed physicians who are available to see you at any time, 24/7.” This access does come with a fee (from $45/virtual visit or $30/month for membership) but opens up a new network of ER and family physicians who can provide consultations, sick notes, prescription renewals… Welcome to the new medical clinic. Where the doctor might be in pjs too… getmaple.ca

tech tool

super simple

Last year, Health Canada approved SeeMore Imaging Canada to market SiMPLi™ Series linear and convex electronic array probes, making it possible (and affordable!) to get images that rival traditional point-of-care ultrasound systems on your Windows PC. Lightweight and handheld, the probes (designed and manufactured in the USA by Interson Corporation) are easily carried to any point-of-care location, even bedside. Simply connect the USB probe cable to a Windows laptop, desktop or netbook to view real-time, high-resolution ultrasound images. And these SiMPLi™ probes are user-friendly (there’s even an auto-scan mode) and features found on higherend systems—such as measurements and calculations, annotations, pointers, cine loop, and zoom—are built-in. As they say, plug and play. seemore.ca

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Just For Canadian doctors Summer 2018


travel the world

Indescribable

INDIA

A journey into a land of colour, chaos, wildlife, national parks and many namastes Dr. Peter Brindley

istock/henry georgi

by

Summer 2018 Just For Canadian doctors

21


I

f you try to summarize India in a few words, you will fail. After all, this was a sophisticated culture when the West was scratching its collective backside with an animal bone. India produced the Kama Sutra and traded silk while we promulgated sin and tried not to die from the Plague. Fastforward, and this solo traveller set forth to the land beyond the Indus: the world’s second-most populous country (a mere 1.3 billion souls) and most populous democracy (more than 50 registered political parties) of stunning diversity (more than 20 official languages and the birthplace of at least four major religions). It’s a place of contrast, from the majesty of tigers to the tragedy of poverty, and offers a therapeutic shake. To borrow an English expression, it can be a “marmite” experience: you love it or hate it.

This trip was the first part of my version of Eat Pray Love. With deference to Elizabeth Gilbert’s book, I had secured a mini-sabbatical and divided it into thirds: time to “Travel, Learn, Reconnect” free of university and clinical demands in the ICU. Part one meant getting lost in India and Nepal. And that also meant avoiding the usual tourist traps. The Taj Mahal may be “sublime,” and perhaps it’s true that “you haven’t seen India without seeing Varinasi,” but I was taking the (dirt) road less travelled and was seeking a proverbial kick in the pants (albeit an indulgent one). I landed in Delhi at 2am local time and the place was heaving. Following a paltry two hours in the immigration line (insert

22

Just For Canadian doctors Summer 2018

exclamation mark), I set up my first base at the ludicrously luxurious and exotic Lodhi Hotel (insert many exclamation marks). While auto rickshaws beeped away, I retreated to a room with square footage to match my house and its own swimming pool. After the best sleep that Imovane can buy, I scoffed chai masala tea, fresh fruit and spicy dosa, and embarked into the streets of India’s capital. Little prepares you for the first time that you see cows crossing the road, wild dogs in the street and five lanes of traffic where there should be two. Life here is lived in public. This includes washing, eating, playing and more public urination than you can shake a stick at (excuse the pun). Just as shocking is how it all becomes normal, including the continual clamour. It seems to me that Indians recognize an encyclopedic variety of car horns: a beep that signals “I’m coming through,” a “hey, watch out” honk and one that likely means top “Namaste” sign “I haven’t made noise for 10 seconds, in Kathmandu, Nepal so I thought I should.” Yet I never bottom Luxurious heard a horn in anger, nor saw any homebase in Delhi at collisions. the Lodhi Hotel opposite page, top row from left As a sucker for all things “British Sampling the food in Raj,” I loved the madness of Delhi’s India and Nepal is an train stations, the majesty of India ongoing pleasure… Gate and the tranquility of Gandhi’s here, a spread at shrine. Old Delhi delivered the Meghauli Serai, a Taj Safari Lodge in Chitwan most gob-smacking experiences. National Park, Nepal; The walled inner city dates back to the lobby of Baghvan long before “the Britishers,” back to Jungle Lodge near Moghuls and Persians. Each invasion Pench National Park left a mark and somehow it all works. in central India middle row from left Safari Twisting streets took me to spice experience in India’s markets, boutiques, teashops and Kanha National Park eateries. This commercial mêlée of with Taj Safaris Banjaar Old Delhi then led to gorgeous forts, Tola; at Dwarika’s temples, and mosques, where even Hotel in Kathmandu, a heritage property this secularist was moved to reconthat preserves and sider the existence of divinity. Back showcases some of at the lavish Lodhi, I recouped with the finest local art and an unspecified number of Kingfisher architecture bottom row beers and cautiously notched off from left The majesty of India Gate in Delhi; another spice level. Dining in the woods From Delhi, I flew to the equally near Bandhavgarh Tiger ancient kingdom of Nepal. “Base Reserve and National camp” here was the restored Park with Mahua Kothi Dwarika’s Hotel (a heritage property Taj Wilderness Lodge previous page Mosque whose first patrons were Indian and Jama Masjid in Delhi, Nepali pilgrims visiting temples) in which opened in 1656 the dilapidated city of Kathmandu. and is one of the largest Amid traffic and dust, I visited the mosques in India. serene shrines of little Tibet, busy readying for the new Dalai Lama (no small issue given that China and Nepal have, um, rather different succession plans). The devastating earthquake three years ago left still-ubiquitous rubble and several wiped-out shrines. All restoration work is being done by hand, and not only because it is intricate— this is one of the world’s poorest nations. Still, Nepal had a calming affect. I even made a serious attempt at meditation and found myself Namaste-ing freely. And then I took a Himalayan flight around Everest…as you do… across the “roof of the world” to get to my first safari lodge, an hour from Kathmandu on a game reserve in Nepal’s Chitwan National Park. At the lodge here, Meghauli Serai, further culinary marvels

this page, from top: istock; lodhi hotel; opposite page, clockwise from top left: Taj Hotels Resorts and Palaces (2); Dwarika’s Hotel; Taj Hotels Resorts and Palaces; istock; Taj Hotels Resorts and Palaces

travel the world


travel the world

if you go

Taj Safari Lodges are a fivestar experience in the wilds of India and Nepal: tajhotels.com/ en-in/taj-safaris/. Dwarika’s Hotel offers high-end history and culture in Kathmandu: dwarikas.com. The Lodhi makes an ultra-luxurious base in New Delhi: thelodhi.com.


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Just For Canadian doctors Summer 2018

were punctuated with game drives and boat rides to see crocodiles, rhinos, peacocks and sloth bears. Everywhere were signs of tiger activity, whether they were claw marks in trees, fur-filled scat or bone-chilling roars. There’s an adage that even if you don’t see a tiger, it’s seen you 100 times. I was unsure whether this was meant to comfort or terrify. Then, deep in the land of Kipling’s The Jungle Book, I travelled from national park to national park in India and stayed at three more Taj Safari Lodges—the next always seemingly more remarkable than the last. Amidst these, I thought that perhaps this is what relaxation feels like. While other guests bemoaned spotty internet service, I was delighted to unplug with a gin-andtonic close at hand. I visited Mahua Kothi Jungle Lodge in Bandhavgarh National Park, Baghvan Jungle Lodge in Pench National Park and Banjaar Tola in Kanha National Park. Each one became my new favourite, and between them I saw all the beasts and birds of the forest. It was in Madhya Pradesh, a state known as the “heart of India” and home to Bandhavgarh and Kanha parks as well as ancient temples, that my tiger “hunt” began in earnest. And it wasn’t long before a beautiful tigress wandered yards from the jeep I was perched in. It was obvious why: delicious deer everywhere. I returned to Kathmandu for the first day of Holi. During this seven-day festival, brightly coloured powders are liberally thrown, booze is almost as liberally consumed and little work is done. To the refrain of “Happy Holi,” I went from red to purple to green to blue and reveled in every shade. More solemnly, I also witnessed outdoor cremations, and, more cheerily, was chased by the world’s boldest monkeys. All in a day’s travel here—vivid, somber, wild… sexy. After I saw the erotic sculptures of the 10th-century Khajuraho temples, a UNESCO World Heritage Site in Madhya Pradesh, I thought it might be time to return home to the Mrs. India and Nepal gave me back the sense of wonder and gratitude that I had somehow misplaced in suburban Canadian life. It was hot, dusty and ludicrous. It was also reinvigorating, peaceful and provocative. But don’t take my word for it. Peter Brindley MD is a Professor of Critical Care Medicine, Medical Ethics and Anesthesiology at the University of Alberta. When not gallivanting around the world he is a full-time intensive-care doctor. He is a lucky man and would do well to remember that.


charlevoix / kansas city / london / brisbane / toronto … | c a l e n d a r

cMe

A n intern ation a l guide to c ontinuing medical Education

summe r 2018 + beyond

charlevoix

Tiny roadside chapel on Isleaux-Coudres

Bike stand, Cidrerie et Vergers Pedneault on Isle-aux-Coudres

Le Migneron de Charlevoix

Sugar pie Vignette off the main street in Baie-Saint-Paul

Flying over the UNESCO recognized Charlevoix Biosphere Reserve

Local wine, Le Charlevoyou

T-shirt at Parc national des HautesGorgesde-laRivièreMalbaie

charlevoix: There’s a spotlight on this region east of Montréal and Québec City (CME events in Montréal + Québec City are highlighted in blue.)

barb sligl

“I

ntoxicating like champagne without the next day’s hangover.” This was how US President William Howard Taft described the air of Murray Bay in La Malbaie, a town on the edge of the St. Lawrence River. Today, La Malbaie looks much like it did a century ago, when Taft and other American luminaries made this village in the Charlevoix region of Québec their summer playground. Stately old mansions still overlook the grand waterway and clapboard cottages dot the shoreline. And this pretty-as-a-postcard place is where Canada is hosting the 2018 G7 Summit, June 8–9 (g7.gc.ca/en/). The region will be under a bright spotlight as foreign dignitaries and world leaders convene at Le Manoir Richelieu (fairmont.com/Richelieu). The chateau-like hotel (part of the Fairmont chain) is the hotel in the area, and while it won’t be accessible to the public during the G7, this year-round retreat (about 80 km east of Québec City and 380 km from Montréal) is a posh base from which to explore Charlevoix’s “champagne” character. First, there’s cheese. Ciel de Charlevoix (ah, a blue like the sky), Le Migneron (buttery and hazelnut-like), L’Hercule (strong like its namesake), 1608 (named for the

only-here Canadienne cow that dates back to that same year). Agritourism is a big deal here (not only cheese, but beer, cider, wine…all part of the so-called “Flavour Trail of Charlevoix”; routedessaveurs.com). Bon appétit! And then there’s the surprising art scene. Something in the scenery and light has attracted artists since the days of Taft et al. West of La Malbaie is Baie-Saint-Paul, which is said to have the most art galleries per capita in Canada. A stroll down the main street, rue Saint-JeanBaptiste, takes you past artists’ busts (the Group of Seven were among past painters here), galleries (there’s even a modern-art museum, Musée d’art contemporain de BaieSaint-Paul), gift shops, cafés and charming vignettes like fluttering garments on a clothesline. Just about every corner could be framed. And each fall, the town brings in artists from around the world as part of Rêves d’Automne, a festival of painting (revesdautomne.com). This is also where the world-famous Cirque du Soleil was hatched, one of the founders of which went on to convert a local monastery into a chic resort hotel that’s now Le Germain Hotel & Spa Charlevoix. At lunch in the hotel’s Restaurant Le Bercail it’s all about terroir

[more] Check out tourismecharlevoix.com

products: local microbrew (La Vache Folle), wine (Le Charlevoyou) and, of course, cheese (Le Migneron, s’il te plait et merci). Then, right outside, take the Train de Charlevoix that skirts the St. Lawrence (some 125 km between Québec City and La Malbaie) to Saint-Joseph-de-la-Rive, where a ferry crosses the river to Isle-aux-Coudres. The island, with its scenic 23 km circuit, is a popular bike destination. Rent and ride (velocoudres.com), coasting past sweet little chapels and orchards, stopping to refuel for cider at Cidrerie et Vergers Pedneault (vergerspedneault.com) and then sugar pie at Boulangerie Bouchard (boulangeriebouchard.com). It’s all bucolic to the Nth degree. This region does, after all, contain a UNESCO Biosphere Reserve. La Réserve de la biosphère de Charlevoix, rising from the shores of the St. Lawrence to dramatic gorges and plateaus at 1,150 metres, is best seen by venturing deep within the reserve in Hautes-Gorges-de-la-Rivière-Malbaie park. It’s as a T-shirt in the park’s gift shop says: La vie en plein air: ma seconde nature. “Outdoor life: my second nature.” Must be that champagne air… — Barb Sligl

Summer 2018 Just For Canadian doctors

25


c M e calendar

Diabetes

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Anesthesia

Alternative Medicine

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MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

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Aug 29Sep 01

Darwin Australia

Society For Paediatric Anaesthesia In New Zealand And Australia (SPANZA) 2018 Annual Conference

Will Organise

61-2-49736573

spanza.org.au

Sep 12-15

Dublin Ireland

37th Annual European Society Of Regional Anaesthesia & Pain Therapy Congress: ESRA 2018

Kenes Group on Behalf of ESRA

41-31-5280432

go.evvnt.com/ 168376-0

Nov 15

St. Petersburg Florida

Blended Ultrasound-Guided Nerve Blocks For The Emergency Physician

Gulfcoast Ultrasound Institute

727-363-4500

gcus.com

Dec 17-20

Miami Florida

Current Topics In Anesthesia

Northwest Anaesthesia Seminars

800-222-6927

nwas.com

Jul 12-15

Grapevine Texas

13th Annual Scientific Meeting Of The Society Of Cardiovascular Computed Tomography

Society of Cardiovascular Computed Tomography

703-766-1706

scct.org

Jul 22-26

Orlando Florida

6th Scientific Meeting Of The World Society For Pediatric & Congenital Heart Surgery 18th International Symposium On Congenital Heart Disease

Johns Hopkins All Children’s Hospital

727-767-2565

hopkinsall childrens.org

Oct 03-05

Paris France

12th International Symposium On Catheter Ablation Techniques

Overcome

011-33-14192-0127

iscat.net

Nov 05-08

Las Vegas Nevada

VIVA 18 (Vascular InterVentional Advances)

VIVA Physicians

888-513-8482

vivaphysicians. org

Oct 12-26 2019

Japan, Korea & China Cruise

Essential Topics In Cardiology And Pulmonology: 2019 Update

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingedu cation.net

Jul 11-14

Lake Tahoe California

43rd Annual Meeting Of The Society For Pediatric Dermatology

Society for Pediatric Dermatology

317-202-0224

pedsderm.net

Aug 02-05

Cabo San Lucas Mexico

70th Annual Meeting Of The Pacific Dermatologic Association (PDA)

Pacific Dermatologic Association

888-388-8815

pacificderm. org

Jul 26-29

Kuching Malaysia

Diabetes Asia 2018 Conference

National Diabetes Institute Malaysia

60-3-78761676

diabetesma laysia.com.my

Sep 30Oct 03

Kanagawa (Tokyo) Japan

18th International Society For Pediatric & Adolescent Diabetes Science School For Physicians

K.I.T. Group GmbH

011-49-302460-3210

ispad.org

Dec 01-04

Cape Town South Africa

18th International Congress Of Endocrinology: 53rd Annual Society For Endocrinology, Metabolism & Diabetes Of South Africa Congress

Scatterlings Conference & Events

011-27-21422-2402

ice2018.org

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Just For Canadian doctors Summer 2018


MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

General & Family Medicine

Gastroenterology

Endocrinology

Emergency Medicine

cme when where

calendar

cMe

topic

sponsor

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website

Aug 04

Long Beach California

Hospitalist And Emergency Procedures Course

Hospital Procedures Consultants

805-339-0225

hospitalproce dures.org

Oct 24-27

Oahu Hawaii

34th Annual Fall Conference On Pediatric Emergencies

Symposia Medicus

800-327-3161

symposiamedi cus.org

Jul 15-18

Toronto Ontario

22nd Annual Meeting Of The Society For Behavioral Neuroendocrinology: Joint Meeting With ICN

Society for Behavioral Neuroendocrinology

847-517-7225

sbn.org

Jul 30Aug 01

San Diego California

31st Annual In Vitro Fertilization & Embryo Transfer

UC San Diego

858-534-3940

ucsd.edu

Oct 17-20

Wrocław Poland

18th European Neuroendocrine Association Congress

EndoScience Service GmbH

011-49-918797-42411

eneassoc.org

Sep 16-19

Vienna Austria

16th World Congress Of The International Society For Diseases Of The Esophagus (ISDE)

International Conference Services

604-681-2153

isde2018.org

Oct 05

Glasgow Scotland

Glasgow Gastro Conference 2018

Royal College of Physicians and Surgeons of Glasgow

44-0-141221-6072

rcpsg.ac.uk

Nov 07

Toronto Ontario

International HBV Cure Workshop 2018

Virology Education

debora@ vironet.com

virology-edu cation.com

Oct 13-20

Tahiti & Bora Bora

Treatment Considerations In Isolated Communities / Seminar At Sea On The Paul Gauguin

877-737-7005

pestravel.com

Oct 21-24

Las Vegas Nevada

800-458-4779

go.evvnt. com/1655380

Oct 21-28

Society new CE to placed 17th Annual National Family Medicinebe Board Center for Medical

Professional Education

Review

Education

Southern France River Cruise

Medical Symposium Confronting Healthcare Needs / 7-Night Uniworld River Cruise Avignon To Lyon

Professional Education Society

877-737-7005 See Ad Page 37

pestravel.com

Nov 08-11

Miami Florida

19th Annual Fall Scientific Meeting Of Sexual Medicine Society Of North America (SMSNA)

Sexual Medicine Society of North America

952-683-1917

smsna.org

Jan 17-31 2019

New Zealand & Australia Cruise

Current Medical Health Issues And Updates In Travel Medicine / 14-Night Cruise On Celebrity Solstice

Professional Education Society

877-737-7005 See Ad Page 37

pestravel.com

Jan 20Feb 01 2019

Rio to Buenos Aires Cruise

Medical Healthcare Delivery In Challenging Environments / Brazil, Uruguay & Argentina On Regent Explorer

Professional Education Society

877-737-7005

pestravel.com

May 17-27 2019

Croatia & Montenegro

The Balkans 2019 Medical Conference

Unconventional Conventions

61280114711 See Ad Page 2

uncon-conv. com

Jul 06-15 2019

Mongolia & China

Mongolia And Silk Road Medical Conference

Unconventional Conventions

61280114711 See Ad Page 2

uncon-conv. com

NYU Radiology CME Presents

37th Annual Head to Toe Imaging Conference December 17-21, 2018 • The New York Hilton Midtown • New York City

Earn over 40 AMA PRA Category I Credits www.med.nyu.edu/courses/cme/h2t18

Summer 2018 Just For Canadian doctors

27


c M e calendar

Mental Health

Internal Medicine

Infectious & Chronic Diseases

Hepatology

Hematology

Geriatrics

cme when where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

topic

sponsor

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website

Aug 08-10

Toronto Ontario

14th Global Conference On Ageing

International Federation on Ageing

416-342-1655

ifa2018.com

Sep 13-14

New York New York

9th International Workshop On HIV & Aging

Virology Education

31-30-2307142

virology-edu cation.com

Jul 16-20

Maui Hawaii

2018 Pan Pacific Lymphoma Conference

University of Nebraska Medical Center

402-559-9250

unmc.edu

Aug 23-26

Los Angeles California

47th Annual Scientific Meeting Of The International Society For Experimental Hematology

International Society for Experimental Hematology

312-321-5114

iseh.org

Oct 24-26

San Diego California

Musculoskeletal Ultrasound In Hemophilia

UC San Diego

858-534-3940

ucsd.edu

Sep 04-07

Geneva Switzerland

IHPBA 13th World Congress

International HepatoPancreato Biliary Association

ihpba2018@ mci-group.com

ihpba2018. com

Sep 06-09

Chicago Illinois

2018 Gastroenterology & Hepatology Board Review Course

Mayo Clinic

800-323-2688

ce.mayo.edu

Oct 24-27

Hollywood Florida

NASPGHAN Annual Meeting, Single Topic Symposium and Postgraduate Course

North American Society for Pediatric Gastroenterology, Hepatology & Nutrition

215-6419800

naspghan.org

Expiry Jan 19 2019

Online

Adult Pneumococcal Vaccination: Do You Know The New Recommendations?

416-488-5500

goo.gl/ M8Fe5A

Feb 11-24 2019

Australia and New Zealand Cruise

Infectious Diseases: 2019 Update

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingedu cation.net

Jul 04-05

London England

Adolescent Health

Imperial College London

44-20-75895111

imperial.ac.uk

Jul 16-19

Kiawah Island South Carolina

2018 Focus On Women’s Health CME Conference

Southern Medical Association

800-423-4992

sma.org

Sep 12-14

Rome Italy

20th Annual Meeting Of The European Pressure Ulcer Advisory Panel

European Pressure Ulcer Advisory Panel

420-251019-379

epuap2018. org

Jun 22-23

Miami Beach Florida

14th International Regional Stress & Behavior Neuroscience & Biopsychiatry Conference (North America)

International Stress And Behavior Society

240-899-9571

stressandbe havior.com

Jul 16-18

Banff Alberta (Rimrock Resort)

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228

cbt.ca

Dec 27-29

Disney World (Yacht Club Resort)

Medical CBT Tools: Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228

cbt.ca

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KEEPYOUREDGE Hockey Sports Medicine2018 Hilton Toronto, Toronto, ON Canada August 17-19, 2018

Learn more & register at sportsmed.org 28

Just For Canadian doctors Summer 2018


MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

calendar

cMe

sponsor

contact

website

French Polynesia Cruise (m/s Paul Gauguin)

Medical CBT For Stress And Anxiety: Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228 See Ad Page 24

cbt.ca

Aug 04-15 2019

Japanese Festivals Cruise (Diamond Princess)

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228 See Ad Page 24

cbt.ca

Jul 12-15

Lake Buena Vista Florida

Headache Update 2018

Diamond Headache Clinic

312-867-9104 See Ad Page 19

dhc-fdn.org

Jul 23-27

San Francisco California

Society Of NeuroInterventional Surgery 15th Annual Meeting

Society of NeuroInterventional Surgery

703-691-2272

snisonline.org

Aug 14-15

London Ontario

See The Line Concussion And Awareness

Schulich Medicine and Dentistry

519-661-2111

schulich.uwo. ca

Aug 27-31

Brisbane Australia

14th International Congress Of Neuroimmunology / 2nd Global Schools Of Neuroimmunology Pre-Course

International Society of Neuroimmunology

011-39-6519-4009

isniweb.org

Oct 10-13

Bologna Italy

53rd Annual Scoliosis Research Society Meeting & Course

Scoliosis Research Society

414-289-9107

srs.org

Nov 17

Chicago Illinois

Update In Headache 2018

312-867-9104 See Ad Page 19

dhc-fdn.org

Sep 24-25

Montreal QuĂŠbec

new Diamond CE toHeadache Clinic be placed Society Of Obstetricians & Gynaecologists Of Society of Obstetricians Canada 2018 Quebec CME Program (French only)

and Gynaecologists of Canada

800-561-2416

sogc.org

Oct 03-06

San Diego California

2018 North American Menopause Society (NAMS) Annual Meeting

North American Menopause Society

440-442-7550

menopause. org

Oct 06-09

Amsterdam Netherlands

Joint Meeting Of The Congress Of The International Society For The Study Of Hypertension In Pregnancy And The International Society For Obstetric Medicine

Groningen Congres Bureau

011-31-50316-8877

isshp2018.nl

Mar 20-23 2019

Vienna Austria

St.Gallen International Breast Cancer Conference: Primary Therapy Of Early Breast Cancer - Evidence, Controversies, Consensus

St.Gallen Oncology Conferences

41-71-2430032

oncoconfer ences.ch

Jul 02-04

Liverpool England

2018 UK Radiological & Radiation Oncology Congress: Disease & Diversity

Profile Productions

44-20-37255840

ukrco.org.uk

Aug 15-18

Sydney Australia

17th World Congress On Cancers Of The Skin

The Skin Care Foundation

wccs2018@ arinex.com.au

wccs2018.com

Jul 02-06

Utrecht Netherlands

29th Annual Arthroscopy & Arthroplasty Utrecht Courses

Arthroscopy & Arthroplasty Utrecht

31-30-2769174

shoulder-el bow-knee.nl

Aug 17-19

Toronto Ontario

Keep Your Edge: Hockey Sports Medicine 2018

American Orthopaedic Society For Sports Medicine

877-321-3500 See Ad Page 28

sportsmed.org

Obstetrics & Gynecology

Neurology

Mental Health

Apr 13-27 2019

Oncology

topic

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Grow Your Career with the LGCFHT We are currently seeking a dynamic Primary Health Care Provider in Brockville, Ontario. Blended Salary Model | Excellent BeneďŹ ts & Pension | No Overhead Driving Distance from Ottawa, Montreal, Toronto and USA

Learn more and apply. 613-342-4076 ext. 2007 info@lgcfht.ca www.lgcfht.ca

Summer 2018 Just For Canadian doctors

29


c M e calendar

sponsor

contact

website

Oct 02-05

Montreal Québec

22nd International Congress On Palliative Care

O’Donoughue & Associates Event Management

450-292-3456

palliativecare. ca

Nov 19-23

Victoria British Columbia

Palliative Care: Medical Intensive Course 2018

Victoria Hospice Society

250-370-8715

victoria hospice.org

Ongoing

Online

Type 2 Diabetes In Children And Adolescents With Obesity: Screening, Diagnosis, And Management

National Association of Pediatric Nurse Practitioners

267-364-0556

healio.com

Jul 31Aug 02

Houston Texas

Innovations In Neonatal Care Conference

Pediatrix Medical Group

See Website

innovations conference. com

Jul 10-12

London England

47th Annual Scientific Meeting Of The Society For Academic Primary Care

Society for Academic Primary Care

44-18-65331839

sapc.ac.uk

Sep 30Oct 14

Holy Land & Ancient Kingdoms Cruise

Primary Care And Women’s Health Key Topics And Core Strategies

Continuing Education, Inc./University at Sea

800-422-0711

continuingedu cation.net

Oct 15-19

Maui Hawaii

8th Annual Primary Care Fall Conference

Continuing Education Company

800-3274502

cmemeeting. org

Oct 24-27

Lihue Hawaii

Meeting The Challenge Of Primary Care

David Geffen School of Medicine at UCLA

310-7942620

medschool. ucla.edu

Jul 07-08

London England

Royal Society of Medicine

44-20-72903947

rsm.ac.uk

Nov 14-15

San Antonio Texas

21st World Congress On Psychology And Human Behaviour

Pulsus Group

234-567-8900

positivepsy chology.cme society.com

Oct 01-05

Santa Barbara California

NYU’s Fall Radiology Symposium In Santa Barbara

New York University Department of Radiology

212-263-3936 See Ad Page 27

med.nyu.edu

Dec 17-21

New York New York

NYU’s 37th Annual Head To Toe Imaging Conference

New York University Department of Radiology

212-263-3936 See Ad Page 27

med.nyu.edu

Jan 21-25 2019

Culebra Costa Rica

NYU’s Clinical Imaging Symposium In Costa Rica

New York University Department of Radiology

212-263-3936

med.nyu.edu

Sep 25-26

Kansas City Missouri

2018 Rural Health Clinic Conference

National Rural Health Association

816-756-3140

ruralhealth web.org

Oct 21Nov 01

Bangkok Thailand

Bhutan For The Active Traveller Wilderness Medicine CME Conference

Bio Bio Expeditions

800-246-7238

wildernessmedicine.com

Wilderness and Travel

Radiology

Psychiatry/ Psychology

Primary Care

Palliative Care

topic

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cme when where

MORE CME Full-access CME calendar and destinations at justforcanadiandoctors.com/cme/

new CE to be placed The Hypnosis & Psychosomatic Medicine Section Annual Conference 2018: Bringing Academics And Clinicians Together

For feedback, requests or to have your course featured please email cme@inprintpublications.com or submit your course via www.justforcanadiandoctors.com

Having a facial difference can create barriers to opportunities and aspirations. It affects over 1.5 Million Canadians. AboutFace promotes positive mental and emotional well-being of individuals with facial differences and their families through social & peer support, information and educational programs. We work to encourage, empower and educate. For more information on how you can get involved, visit www.aboutface.ca “It was the first time in my life that I met people who had facial differences, as I did. It was also one of the few times in which I walked into a room full of strangers and did not feel even the tiniest air of judgment.” -Samantha Loucks, 23

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Just For Canadian doctors Summer 2018


2018 Federal Budget – How It Affects You Andc Your a l e n Practice dar c M e NICK KORHONEN

T

he 2018 federal budget: Equality and Growth for a Strong Middle Class, marks the culmination of a tumultuous year in which we saw the proposal of the most significant tax changes in the last 45 years, many of them specifically targeted at professionals, including physicians. It confirmed that the government would be moving forward with changes regarding income sprinkling that were re-released on December 13, 2017, and included draft legislation regarding the taxation of passive income earned by private corporations. TAX ON SPLIT INCOME (A.K.A. “INCOME SPRINKLING”) The simplified rules surrounding the tax on split income (TOSI) were released on December 13, 2017, and took effect on January 1, 2018. Under these rules, income paid from a private corporation to a Canadian resident family member will be subject to the highest rate of tax, unless certain exclusions are met. This applies to dividends, interest and conferred benefits from a private corporation, but notably, not to salaries. The December 2017 proposals introduced several “bright-line” exclusions. If a taxpayer qualifies for an exclusion, the new TOSI rules would not apply, and you would be able to continue paying income to family members who would then pay graduated rates of tax on the amounts received. Two exclusions that are most likely to be applicable to physicians are: Age Test Under the revised rules, if the practice owner is age 65 or older, they will generally be able to pay dividends to their spouse without the new TOSI rules applying.

20 hours per week throughout the year, or any prior five years. There are several other exclusions that may be applicable depending on your specific facts and circumstances. It will be important to review your situation with a tax specialist to determine if there are any opportunities for you to continue income splitting. HOLDING PASSIVE INVESTMENTS INSIDE A PRIVATE CORPORATION Active business income earned by a Canadian controlled private corporation (CCPC) is generally eligible for the Small Business Deduction. The first $500,000 of income is subject to reduced tax rates – these rates are significantly lower than the top personal rates in all jurisdictions. If funds are not reinvested into your practice and are instead invested passively, owners of CCPCs will have significantly more after-tax cash to invest than an individual who earned their income personally and paid high personal rates of tax. The Government sees this as an unfair advantage and has proposed rules to curtail some of the tax savings that are available. Business Limit Reduction The first measure proposes to reduce the small business deduction limit for any associated group of companies that has annual passive income in excess of $50,000. Under this measure, the business limit will be reduced by $5 for every $1 of investment income in excess of $50,000. The result is that the small business deduction (SBD) will no longer be available once investment income for the associated group exceeds $150,000 per year. The loss of the SBD does increase the corporate tax rate but there is still a significant deferral of tax compared to a taxpayer in the highest marginal tax bracket. It is important to note that lost access to the small business deduction reduces a corporation’s ability to defer income tax as more corporate income tax is paid up front. However, income that is subject to the higher general corporate tax rate can be distributed as “eligible” dividends, which attract a lower level of personal tax.

Excluded Business Where a family member is actively engaged in the business on a regular and continuous basis, they will be able to continue to receive income from the private corporation without being subject to the new TOSI rules. Whether they are engaged on a regular and continuous basis will be a question of fact. To provide greater certainty to taxpayers, the legislation includes a brightRefundability of Taxes on line test that states family members will Investment Income be deemed to be engaged on a regular and Under the current tax regime, passive continuous basis if they work an average of investment income earned by a CCPC Advertising Feature

is subject to tax at approximately the top personal marginal tax rate. A portion of this tax is added to the CCPC’s refundable dividend tax on hand (RDTOH) account and is refundable at a rate of $38.33 for every $100 of taxable dividends paid to shareholders. Dividends paid by corporations are classified as either “eligible”, or “noneligible”. Income that is taxed at the higher general corporate tax rate and eligible dividends received by a CCPC are added to the corporation’s general rate income pool (GRIP) and can be paid out as eligible dividends, which are subject to a lower personal tax rate. All other sources of income, including business income eligible for the small business deduction, and passive income, need to be distributed as non-eligible dividends, which attract a higher personal tax rate. Currently, a CCPC will receive a refund of its RDTOH regardless of what type of dividend is declared. Budget 2018 proposes that a dividend refund will only be available where non-eligible dividends are paid. This is intended to better align the taxes paid on passive income with the payment of dividends that were sourced from passive income. One exception will be provided in respect of RDTOH that arises from the receipt of eligible dividends by a CCPC, in which case the corporation will still be able to obtain a refund of that RDTOH upon the payment of eligible dividends. The result of these rule changes is that it is more important than ever to revisit your remuneration plan. Proper planning will ensure that you maximize your dividend refund in a given year, have a plan for your compensation and therefore minimize your tax obligation. Obtaining the best advice for your personal situation will be key this year in developing a revised strategy that takes the new rules into account.

Nick Korhonen, CPA, CA, is the National Tax Leader for MNP’s Professional Services team. Nick works closely with professionals in the dental, medical, and other industries, delivering advice to help clients navigate the ever-changing Canadian tax landscape. You can reach him at 613.691.4245 or by email Nick.Korhonen@mnp.ca.


t h e w e a lt h y d o c t o r M a n f r e d p u r t z k i Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

Multiply your savings by 7 The top 7 tax planning tips for the incorporated doctor

W

ith the government severely restricting income splitting and imposing penalties on corporate investment income, there are still some great tax reduction strategies you should consider. 1 Since salaries are exempt from the income-splitting restrictions, your medical corporation can pay a reasonable salary to family members for services rendered. The basic test for reasonableness is a salary that you would pay for services rendered by a person not related to you. 2 If a family member is at least 18 years of age and works at least 20 hours per week for the practice, you can pay any amount of dividends. It’s important that the family member works at least 20 hours per week on average during the calendar year. If the individual has met the 20-hour-per-week test for any five calendar years then dividends can be paid in subsequent calendar years even if the individual does no work in the subsequent year. 3 Consider converting the dividends received from your corporation into a capital gain. The tax savings are significant as you can see in the table below. 4 Consider working past the age of 65 (like our “doctor on a soapbox” columnist; page 36). The income splitting rules will no longer apply. The age of your spouse does not matter. 5 If you have a family member who qualifies for the Disability Tax Credit, then the new rules do not apply. You can use the family

tax

savings

sudoku 1 easier solution 8 1 6 9 3 4 2 5 7 5 7 9 8 2 6 1 3 4 2 4 3 5 1 7 9 8 6 9 5 2 4 6 8 3 7 1 7 6 4 1 9 3 8 2 5 1 3 8 7 5 2 6 4 9 4 9 5 3 8 1 7 6 2 3 2 1 6 7 5 4 9 8 6 8 7 2 4 9 5 1 3

Puzzle by websudoku.com

Just For Canadian doctors Summer 2018

Savings $ 7,431 $ 30,789 $ 54,261 $ 75,093 $ 94,158 $112,989

solution from Winter 2018 contest

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32

via capital gain

Income Tax Savings (BC rates) Dividends Capital gains $ 15,622 $ 8,191 $ 54,191 $ 23,402 $ 97,922 $ 43,661 $ 141,654 $ 66,561 $ 185,386 $ 91,228 $ 229,117 $116,128

solution from page 37

classifieds

Payout $ 100,000 $ 200,000 $ 300,000 $ 400,000 $ 500,000 $ 600,000

trust to split income with any disabled family member regardless of age. 6 You can income split by lending money to a low-income family member and charge interest at the current CRA-prescribed rate of 2%. You can fix this 2% interest over the term of the loan. For instance, you lend the family member $100,000, which generates a return of 7% or $7,000. The family member pays you the interest of $2,000, which is deductible from the $7,000 of investment income. As a result you shift $5,000 of investment income to family members in the lower tax bracket. 7 Consider strategies to avoid the clawback of the Small Business Deduction because of the corporate investment income rules. If your medical corporation or holding company earns more than $50,000 of investment income in the year, you start losing the 12% tax rate (in BC) on the first $500,000 of active business income. The reduction is $5 for each $1 of investment income that exceeds the $50,000 threshold. If the investment income is $150,000 or more you no longer have the coveted Small Business Deduction, which means that you are now paying 27% on your medical income. If all your investments are in your holding company, the easiest remedy is to disassociate yourself from the holding company. This can be achieved by eliminating cross ownership between the medical corporation and the holding company.

sudoku 2 harder solution 7 4 2 9 8 5 6 3 1 6 8 3 4 1 2 7 5 9 5 1 9 7 3 6 2 8 4 8 7 1 6 4 3 5 9 2 3 2 4 5 7 9 8 1 6 9 6 5 8 2 1 3 4 7 1 5 7 3 6 4 9 2 8 2 3 8 1 9 7 4 6 5 4 9 6 2 5 8 1 7 3

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FAMILY PHYSICIANS AND/OR INTERNISTS AND LOCUM OPPORTUNITIES FOR HOSPITALIST PROGRAM Pembroke Regional Hospital, Pembroke, Ontario Located one and a half hours west of Ottawa, the Pembroke Regional Hospital (PRH) delivers a broad range of acute, post-acute, outpatient and diagnostic services to a mixed urban and rural population of approximately 100,000 residents in the Upper Ottawa Valley. PRH is recruiting Family Physicians and/or Internists to provide comprehensive care for inpatients within our Hospitalist Program. Our hospitalists are MRP for all admitted patients outside of the obstetrics department. There are also locum opportunities available. The hospital is situated on the shores of the Ottawa River close to Algonquin Park and provides an array of diagnostic and specialist services including CT, MRI, anaesthesia, internal medicine, surgery, psychiatry, Ob/Gyn, Orthopedics and an inpatient rehabilitation program. Program Description • • • • • • • • •

5 Hospitalist Teams rounding per day 1 in 5 call Appropriate daily workload Provide inpatient care for medical, surgical, rehab, ICU and acute mental health patients Provide outpatient care in a follow up clinic 24/7 subspecialty support Established links with tertiary care centres 1.5 hours away in Ottawa Collegial hospitalist group Opportunities to teach Medical Residents

Position Requirements • •

Fully independent registration (or eligible for) with College of Physicians and Surgeons of Ontario (CPSO) or Certified by the Royal College of Physicians and Surgeons of Canada – FRCP(C) in Internal Medicine Experience working with teams and possessing strong interpersonal and collaborative skills

There is the potential to have a robust, full-time, rewarding career working in a collegial environment. Remuneration would be based on a blended model of daily stipend and fee for service billings plus HOCC (Hospital On Call Coverage) stipend. We invite you to join our team of skilled and dedicated healthcare professionals. Only those candidates chosen for an interview will be contacted. For more information about this practice opportunity, please contact: Medical Affairs (613) 732 - 2811 ext 8109 nancy.schroeder@pemreghos.org


FULL TIME INTERNIST AND LOCUM OPPORTUNITIES Pembroke Regional Hospital Located one and a half hours west of Ottawa, the Pembroke Regional Hospital (PRH) delivers a broad range of acute, post-acute, outpatient and diagnostic services to a mixed urban and rural population of approximately 100,000 residents in the Upper Ottawa Valley. PRH is recruiting 2 Internists who would have a community based practice and in addition provide clinical care for outpatients and inpatients. The hospital is situated on the shores of the Ottawa River close to Algonquin Park and provides an array of diagnostic laboratory services including Nuclear Medicine, CT and MRI. Full specialist support including a Hospitalist program, Anaesthesia, Internal Medicine, Surgery, Ob/Gyn, Psychiatry, Otolaryngology, Orthopedics, Physiatry and Urology. Pembroke Regional is a referral hospital supporting smaller hospitals in the Ottawa Valley. Our Hospital is a designated District Stroke Center and we have a 7 bed ICU that is staffed by a multi-disciplinary team of nurses, physicians, and respiratory therapists; as well as access to social workers, speech, occupational and physio therapists. We have a well established referral protocol with local tertiary care centres 1.5 hour away in Ottawa. Position Requirements • • • •

Fully independent registration (or eligible for) with College of Physicians and Surgeons of Ontario (CPSO) Certified by the Royal College of Physicians and Surgeons of Canada – FRCP(C) in Internal Medicine Willing to relocate to the area Experience working with teams and possessing strong interpersonal and collaborative skills.

We are interested in expanding our services by recruiting two full-time Internists. This position would include office practice as well as providing hospital inpatient and outpatient care including on call coverage. Interest and additional training in cardiology, rheumatology, hematology or infectious disease would be an asset. While recruiting, we also need locums to provide service on weekends and several weeks throughout the year on a flexible time schedule. There is the potential to have a robust, full-time, rewarding career working in a collegial environment. Remuneration would be based on fee-for-service and on call stipend through the Hospital On Call Coverage Program (HOCC). We invite you to join our team of skilled and dedicated healthcare professionals. Only those candidates chosen for an interview will be contacted. For more information about this practice opportunity, please contact: Medical Affairs (613) 732 - 2811 ext 8109 nancy.schroeder@pemreghos.org


Four weeks paid vacation

HOOPP pension plan

CME days and allowance

37.5 hour work week

Health, vision & dental beneďŹ ts

Paid sick days

For more information or to apply, please contact Mayo Hawco: mayo.hawco@wellfort.ca or (416) 858-0939 WellFort Community Health Services is a non-profit, values based organization that provides primary health care, health promotion and prevention programs. We are committed to providing inclusive, accessible and sustainable programs and services to a diversely rich community through its service delivery philosophy; Open Focused Care.

Summer 2018 Just For Canadian doctors

35

o p p o r t u n i t ies

Our physicians receive the following beneďŹ ts:

e mploy me n t

Here at WellFort we have a long history of excellent inter-disciplinary care, which benefits each of our clients specifically and uniquely. As a member of our staff, physicians are given the opportunity to maintain and develop new skills due to the medically interesting workload; while exercising innovation in addressing individual, population and community health issues.


d o c t o r o n a s o a p b o x d r . c h r i s p e n g i l ly Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him via his website at drpeng.ca.

The patient doctor Treat patients with deference…you’ll be one someday

T

at your

service

his year, 2018, is quite a pivotal year for me. At last it’s payback time. In other words, I have to start drawing on my RRIF to pay back that income tax which has been deferred. To the younger reader the RRIF is something that is on a far horizon. My more senior readers will deduce that I have turned 72. Psychologically, to me, this is more significant than sailing past 65 when I continued to work full-time as much for the job satisfaction as financial need.

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Just For Canadian doctors Summer 2018

Respect …it’s super simple and it works

It’s also the year that I have abandoned clinical medicine. Fortunately I can continue as a peer assessor for one more year. Altogether a gentle landing. And enormous change. Another change: I am now approaching medicine from the other end of the stethoscope. My wife and I are now patients—facing patients’ difficulties of telephone contacts and waiting times. I am sensitive to this latest change because as an infant I had congenital cataracts that were treated by “needling.” I bet there is not a physician under the age of 60 who has ever heard of this procedure (Google it). I had to see the ophthalmologist once or twice a week for months on end. Each time, my mother and I had to wait one, two and even three hours for a five-minute consultation. Now when I hear a specialist’s receptionist telling me to plan two and a half hours for a 15-minute consultation, it suggests that there is something wrong with the scheduling. Likewise the staff of another specialist group in town routinely tells patients to bring a novel—leaving the patient feeling that their time is considered less important than that of the physician. So it was a refreshing change recently when I accompanied my wife for three follow-up appointments (hip replacement) with a relatively young orthopedic surgeon. On one occasion she was seen early, another time punctually and the longest wait was 10 minutes— for which we received an apology. We felt treated with respect. The surgeon tells me he achieved this punctuality by brainstorming with his colleagues and optimizing the use of his office staff. A patient who feels that they are treated with deference will be less likely to lodge a complaint, spurious or otherwise, to the provincial licensing college. That patient is less likely to be angry and hostile towards the medical office assistant whose job is stressful enough already. A better experience for the patient, the staff and the doctor can be achieved with relatively minor adjustments. How to do this? By forming organized groups of at least four physicians to enable a good division of labour amongst support staff. This translates to the phone being answered early in the morning, through lunchtime and until a reasonable end-of-day (5 pm), which can be achieved by overlapping shifts for the office staff. Longer phone hours will lead to less congestion and the consequent unwelcome, “doctor’s office—please hold.” The very nature of our job means that no physician can avoid emergency and callouts. Nonetheless there’s the 15/80 rule: the waiting time for a patient should be 15 minutes or less 80% or more of the time. It requires realistic appointment times—that is, 10 or 15 minutes per visit with no “fit in” patients. And the corollary to this: an adequate number of open-access appointments that allow the physician a chance to catch up once or twice each session. Several years ago, when I attempted to meet these parameters, life became less stressful for me and for my staff. The praise and the positive feedback from patients were almost deafening. Okay…slight hyperbole, but the positive comments were loud and clear. Patient overload and physician shortage doesn’t help anyone but minimizing angry and discontented patients helps everybody.


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Sudoku Contest entry form (solve + send in sudoku!)

Yes, I would like to receive the CME newsletter & updates by e-mail. NB: Information collected will not be shared with any third party.

Name: __________________________________________________________ Address: ________________________________________________________ City, Province, Postal Code: _________________________________________

E-mail: _________________________________________________________ Tel: ____________________________ Fax: ____________________________ sudoku Contest Rules:

1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles entered into random draw. 2. Send puzzle + entry form to Just For Canadian Doctors, 200 – 896 Cambie St., Vancouver, BC, V6B 2P6 or fax 604-681-0456. Entries must be received by August 24, 2018. 3. Prize: $50 Amazon gift card. 4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications. 6. Employees of In Print Publications and its affliates are not eligible to participate. 7. In Print Publications is not responsible for lost or stolen prizes.

Summer 2018 Just For Canadian doctors

37


s m a l l ta l k

doctors’ picks + pleasures dr. brett belchetz is a practising ER physician in Toronto. But that’s just his day job. He’s also the CEO and co-founder of Maple (getmaple.ca; see page 20 for more), a national telemedicine provider connecting Canadian patients and doctors for online medical visits. And there’s more: Senior Fellow at the Fraser Institute, on-air medical expert for CTV and Global News, writer for the National Post and other newspapers…all tied to his passion for healthcare policy, which spurs him to lead the way in this field—much like another (Mars-seeking) innovator.

I live, practise in: Toronto, Ontario My training: BSc, MD, CCFP Why I was drawn to medicine: It’s a silly story, but after watching the movie The Fugitive with Harrison Ford as a kid, where he played a cardiac

with: Bagels and cream cheese

medicine, due to its variety and fast pace.

A favourite place that I keep returning to: Italy

Favourite film: The Empire Strikes Back

My last trip: Tulum, Mexico

Must-see TV: Westworld

My guilty pleasure: New Zealand white wine

Most exotic place I’ve travelled to: Mala Mala Game Reserve in South Africa

Can’t believe I’ve never been to: So much of Canada— I haven’t seen nearly enough of our beautiful country.

My first job: Newspaper carrier

My go-to exercise: Running

Dream vacation: Seychelles or Maldives or Bora Bora

A talent I wish I had: Playing the guitar or piano

Memorable restaurant: Le Casadelmar Gourmet

Gadget or gear I can’t do without: My iPhone—as the founder of a virtual care company I can’t live without it. I’d describe my

A big challenge I’ve faced: Founding my company, Maple, a national

Dr. Belchetz is passionate about healthcare policy, serving as a medical expert onair (above) and co-founding a new telemedicine provider (Maple, above right). Some of his other passions include sci-fi (whether in film, TV or book form, left)… surgeon, I decided I wanted to be not only a doctor, but a heart surgeon. Unfortunately, it took only two days of working with a real cardiac surgeon in med school for me to realize it wasn’t for me. I eventually became drawn to emergency

38

restaurant PortoVecchio Corsica. Breathtaking views of the Mediterranean on the island of Corsica coupled with unbeatable food. A “wow” hotel/ resort I’d happily stay at again: St. Regis Hotel Rome

I always travel with: My kindle. Vacations are my time to catch up on reading. Favourite city: My home—Toronto Favourite book: The Foundation Trilogy by Isaac Asimov

Just For Canadian doctors Summer 2018

home as: An oasis from the big city Most-frequented store: Does Loblaws count? I love to cook. I have too many: Dog toys scattered across my living room. My fridge is always stocked

provider of telemedicine services to Canadians. We’ve had to overcome countless obstacles, such as the lack of government funding and Canadians’ resistance to a technology they haven’t experienced before.

I’m inspired by: Elon Musk. I love his never-ending ambition to push the boundaries of what technology can do, when he could have easily chosen to retire on his fortune. A cause that’s close to my heart: Improving healthcare accessibility in Canada. We have

g o- to te c h

the worst wait times for medical care in the developed world, and we can do better. If I wasn’t a doctor, I’d be: An entrepreneur. There’s never been a better time to bring one’s dreams to life in the business world.

photos courtesy of brett Belchetz

My name: Brett Belchetz


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Profile for Just For Canadian Doctors

Just For Canadian Doctors Summer 2018  

Ottawa Heats Up Finding Oneself in India & Nepal

Just For Canadian Doctors Summer 2018  

Ottawa Heats Up Finding Oneself in India & Nepal

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