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Comment: Looking after your health without a family doctor

Tips for how to keep yourself healthy even if you don't have a regular family physician.
A smoker puts out a cigarette in a public ashtray. Physician Stephen Sullivan writes that about half of all causes of death are preventable and due to risk factors such as smoking, excessive alcohol and obesity. SEAN KILPATRICK, THE CANADIAN PRESS

A commentary by a clinical associate ­professor emeritus at UBC and UVic.

It’s a poorly guarded secret that British Columbia has never trained sufficient health-care providers to meet our needs. Some years we have imported more than we have trained at home.

B.C. didn’t even have a medical school until 1950, and when I graduated in 1972 there were only 66 in my class. The B.C. government is trying hard to catch up, but it’s going to be years before this crisis settles. But while we are waiting, there are health-related things we should all be doing for ourselves:

1. Minimize risk factors — sloth, obesity, smoking, poor diet, excess alcohol and other risky behaviours. About half of all causes of death, disability and dementia are preventable. Everybody dies, but you don’t want to die of your own stupidity, carelessness or ignorance.

2. Make sure that your blood pressure is around 130/80 or below. Check it at your gym or pharmacy. Buy an automatic digital BP machine. They are not expensive. Share it with your friends. High blood pressure is a major risk factor for heart attacks, heart failure, stroke, dementia and kidney failure.

3. Make sure that you are not diabetic or prediabetic. Some pharmacies can help you. If you know somebody who is diabetic and has a glucometer, ask them to measure your fasting blood sugar and again two hours after you share a good meal. Alternatively you could buy your own glucometer and share it with your friends and family. Diabetes is a major risk factor for lots of things.

4. If you are over 50, get screened for colon cancer. This is done every two years with a simple stool test called a FIT (fecal immunochemical test). You may need a requisition. Colon cancer is the second commonest cause of death from cancer in men and third in women.

5. If you are a woman, check the recommendations on mammography (breast cancer) and PAP smears (cervical cancer). In Victoria these can be arranged through Vancouver Island Women’s Clinic and the B.C. Cancer Screening website.

6. If you are a man beyond middle age with trouble peeing or have a family history of prostate cancer you might get your prostate specific antigen (PSA) checked.

7. Make sure your vaccinations are up to date. You can find the Canadian recommendations online at Your local pharmacist can do the vaccinations. You may have to pay for some of them.

8. As for your kids, if they are behaving “normally” and growing properly not much needs to be checked. Growth charts and other information can be found online. Make sure your child’s vaccinations are up to date. Read to them. Teach them to swim. Feed them a healthy diet, minimize screen time, make sure they socialize, run around outdoors and get enough sleep. Childproof the house. Buy a thermometer and change the batteries in the smoke alarm. Finally, children are mimics. They learn by example, so set a very good example.

9. Depending on your health and medications, there are some blood tests that may be worth doing every now and again. These include hemoglobin A1c for monitoring diabetes, TSH for monitoring thyroid medication, electrolytes for monitoring side-effects of some medications and creatinine for those who have conditions or are taking medications that might affect kidney function. Sadly, few medical labs will do them without a doctor’s requisition. Several ­telehealth providers can help you.

10. Set up internet accounts with Island Health and Life Labs so you can access your laboratory results online.

11. Create an up-to-date digital medical record for yourself and for each family member. Include: Current health issues, past health issues and surgeries, current medications and allergies, vaccinations, family health history, bad habits, good habits, interests/social activities/lifestyle etcetera. Print a copy whenever you seek medical care.

12. Depending on your health issues, see an alternate health-care provider: nurse practitioner, pharmacist, physiotherapist, midwife, dentist, audiologist, optometrist, podiatrist, chiropractor, acupuncturist, clinical psychologist or maybe a rabbi, minister, priest or imam.

13. Use a telehealth service. Most bill the Medical Services Plan. Telehealth doctors can make diagnoses and give advice. They can also arrange to examine you, order tests, write or renew prescriptions and make referrals to specialists.

14. Educate yourself on serious health conditions and call 911 for emergencies such as heart attacks, strokes, intestinal bleeding, severe shortness of breath, passing out and severe new pains.

15. Educate yourself and know how to recognize and self-treat common conditions such as: COVID, flu, the common cold, constipation, diarrhea, indigestion, problems peeing, headaches, et cetera. For non-emergencies call 811 or use the HealthLink B.C. website.

16. Consult reliable internet sites such as MedlinePlus, PubMed, Mayo Clinic, Health Canada, HealthLink B.C., etc.

17. If you have a chronic health condition, join a support group.

18. Help train a family doctor. Volunteer as a “patient” in the UVic Island Medical Program.

19. Help advance medical science. ­Volunteer for a research study.

20. Finally, whenever you leave Canada, buy medical travel insurance!

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