Preventative care is disappearing
When you visit your family doctor, there are usually two agendas that require consideration. The first is the problem you’ve planned to discuss. The second is the wide array of topics that your doctor likely has on the preventive medicine agenda that you may not have considered at all.
These topics include:
• Update meds and lab work.
• Update complete immunization status.
• Update any new allergies/reactions.
• Update over-the-counter meds.
• Check new/unseen skin lesions for cancer.
• Update bone densities, Pap smears, breast exams (men too), pelvic exam, mammograms, sleep apnea review, prostate exams, PSA review, colonoscopies, etc.
• Review of health promotion issues like proper diet, ideal weight, stop smoking, exercise prescription, drug and alcohol abuse, dental and eye care, socialization and mental health, sleep history, etc.
In another era, over a number of visits or on a general health review, this material would optimistically be covered. But what family doc now has the time, the inclination, or the payment schedule to achieve this end, and record it? Probably close to no one.
As one of my family-doc colleagues recently lamented: “Traditional anticipatory care is going the way of the dodo bird.”
What a loss. It diminishes the quality of care across the board. Who even notices?
Neil Finnie, MD (retired GP)
Victoria
Top-quality dental care is expensive
Re: “Accessible health care should also include our teeth,” Aug. 5.
The commentary contains some truths, half-truths and non-sequiturs. I practised dentistry for 30 years and retired some years ago.
Preventive dentistry included teaching patients to care properly for their oral health, for example brushing techniques and daily flossing were critically important. Only in dental school did I learn that dental disease was not God’s will and was preventable.
I placed a plaque on the wall above my hygienist’s chair: “You don’t have to floss all your teeth, just the ones you want to keep.”
The writer is correct in stating that oral health and systemic (whole body health) are intimately connected. Dental cavities and periodontal disease can lead to any number of life-altering consequences.
During my career, the dental services provided were quite fragmented: Indian Affairs, Veteran Affairs, Social Services, private insurance, school dental plan for children to age 12, and the working poor with no coverage.
She said that her request for “crown and bridgework” was denied. Much of my daily practice entailed communicating various treatment plans and estimates.
And of course, the wealthy could choose “Cadillac” options such as crowns, implants and bridgework. Others had to choose various options depending on affordability — acrylic partial dentures or cast metal frameworks, root canal or extraction, etc.
Social Services paid for one cleaning per year, root canals only in anterior teeth etc. I don’t believe that a successful partial or full denture for any patient is impossible.
Governments are under tremendous strain with demands from the public for all manner of services. Dental treatment is very expensive. In my last year of practice, my overhead was about $200 an hour due to staff salaries, updated quality equipment and general office expenses.
Top-quality free dental care for everyone will never be possible. Any responsible government has an obligation to provide treatment that alleviates pain and provides function. That is a basic human right.
Cadillac service for everyone at taxpayer expense is not.
John Billett, DMD (retired)
Victoria
B.C. Transit drivers go above and beyond
On Monday morning a bus driver soothed an agitated passenger whose conduct on the bus was causing others to edge away from him.
For more than 10 minutes, the driver conducted a calm and friendly chat with the passenger while also navigating through traffic.
On many occasions I’ve witnessed drivers skilfully coping with challenging passengers with professionalism and humour; their work is much appreciated, and their kindness in assisting passengers who have additional needs is especially valued.
Dr. Heidi Tiedemann Darroch
Oak Bay
Wealth as a measure of hard work?
In an area of Canada where housing is very expensive and difficult to find, I find the letter-writer who resented tax on a second home because he worked hard and is successful, offensive.
Suggesting wealth is the measure of hard work and success is naive at best. It is more a measure of good fortune.
There are many ways of acquiring wealth and many reasons for not acquiring it, and “hard work” is unlikely the main reason. Pay attention and you will see many people who work very hard, including to acquire education as well as in the work they do (from which we all benefit).
It does not guarantee wealth, but should include one home, be it ever so humble.
Deborah Crawford
Saanich
Predatory parking fine is like a radar trap
My wife, a friend and I went to our first HarbourCats game. It was an exciting game with many runs scored so it took longer than normal.
When I returned to my car, parked in the Royal Athletic Park lot, I found that I had been ticketed for overtime parking by the City of Victoria with a $40 fine — $20 if paid by August 30.
When parking at 6 p.m. I paid for three hours and 15 minutes, but the game ran beyond 9:15 p.m. so I was technically parking overtime.
My concern is not the fine, which I can and will pay, but the public impact on baseball fans. It seems someone patrols the parking lot looking for infractions which occur when someone underestimates the time it takes to complete a ball game.
To me, this is akin to a radar trap, and this predatory practice should be discontinued.
Ed White
Cobble Hill
Democracy undermined by handgun decision
On Aug. 6, we read “Ottawa aims to speed up ban on handgun imports.”
Translation: We’re on vacation until fall, but we’ve found a semi-legal way to outlaw such imports through import tariffs without having to deal with those bothersome debates in the Commons and the Senate.
But there is a price to pay for treating our democracy in such a cavalier fashion. On Aug. 7 we read: “Firearm used to kill three people in the Montreal area this past week was acquired illegally.”
Translation: No duty paid.
Do these folks really expect murderers to declare their weapons before they commit their crime?
Kirk Cavanagh
North Saanich
Make speed bump visible to help pedestrians
Recently I was at the Imax, and on my way to the parking lot behind the Royal B.C. Museum, I tripped on a speed bump that I could not see in the dark.
Fortunately, I didn’t fall. Seconds later, a man also tripped on the speed bump and fell to the ground. A number of people including myself, helped him to get up and fortunately, he did not appear to be seriously injured.
However, I expect multiple people have tripped and fallen because the bump has not been painted and accordingly, it cannot be clearly seen.
There was an unpainted speed bump on a laneway in Oak Bay. It could not be seen when the trees around shaded the lane. I tripped and fell once and a neighbour also tripped on the bump and smashed her face.
She had to have dental surgery to repair her injuries. It took about six months after I contacted the municipality before the speed bump was finally painted.
Painting the speed bumps would help prevent people from tripping and falling, which could result in serious injuries including broken bones and concussions. Please get it done.
Christine Leacock
Victoria
Own an automobile? Then take responsibility
The attempts at making our communities more accessible to bikers, walkers and transit takers ignores one fact: Automobile owners have not been required to take responsibility for their own possessions.
Municipalities struggle to squeeze bike lanes and sidewalks into limited spaces while still making parking spaces on streets for cars.
This phenomenon raises some interesting questions, such as:
1. Why are car owners not responsible for providing parking space for their cars on their own property?
2. Why is there seemingly no limit on the number of cars owned by people living in the same residence if they cannot provide off-street parking for them all?
2. Why should all taxpayers be responsible for providing space for on-street parking for those who own cars?
Even though municipalities purport to want to make other modes of transportation more accessible and safer, the fact is that there are many areas where safer sidewalks and bike lanes would be much more possible and economical were it not for political leaders who bend themselves into pretzels muttering about alternate modes of transport while bending over backward trying to accommodate property owners who have not taken responsibility for parking space for vehicles owned by those who live in their houses.
This becomes even more critical as garden suites and other forms of “multi” accommodation become more prevalent.
Meanwhile, Victoria council is allowing more multiple family dwellings to be built with fewer and fewer off-street parking spaces for cars. Most people are not going to give up their cars, although they will certainly be moving to electric vehicles before long. More clogging of streets ensues without off-street facilities.
This is clearly not a popular idea, but it does raise the question of how it is that storage space for privately owned items became a public responsibility. The auto industry has done a good job of conditioning the public and decision-makers to this way of thinking. And our politicians have fallen into the trap.
S.A. McBride
Cordova Bay
Government should take an equity stake
Re: “Catherine Street rental-housing project gets green light despite concerns,” Aug. 5.
I don’t have a strong opinion about the specific pros and cons of the rental development on Catherine Street. However, one sentence in the report caught my eye.
“When the project starts will depend on government financing, as doing a rental project with a traditional lender is not feasible at current rates.”
It is taken as a fact that governments have to finance this project, either from existing revenue or by borrowing at market rates, then subsidizing projects at less-than-market rates.
If taxpayers are funding new rental projects, governments should ask for equity stakes in those projects.
It makes no sense to invest in new rental housing for zero equity, then to talk about contributing millions more to a special fund, so governments (or their agencies) can purchase existing rental properties and provide homes at less-than-market rents.
It is a good idea for governments to become owners of rental property for their citizens — or part owners, in deals with commercial companies.
Why shouldn’t that ownership begin with an equity stake for every dollar invested to finance construction of new rental projects?
George Jamieson
Victoria
Time for rail supporters to get other jobs
I am with Premier John Horgan, who doubts that Island rail service would be viable. I feel that any rail line would be way too costly to be effective.
Larry Stevenson and Island Corridor staff, get another job. Give up your outdated idea that this is a viable rail track.
Start from scratch and pave it for a fast bus service to Langford maybe, but the rest of the line is dead.
Cathy Bhandar
Victoria
Beware the cost of replacing batteries
A recent letter said that “fossil fuels are energy-dense.” The same goes for those who have bought very expensive electric vehicles, thinking they are saving money. The real cost comes when the batteries need to be replaced.
Too expensive to replace, they will end up being a throwaway item.
In years to come, used electric vehicles will be as plentiful as the battery-powered drills, garden equipment, vacuum cleaners etc. that one finds in a thrift store. Perfectly good units with powered-out batteries.
They are a dime a dozen, for good reason.
John Walker
Cobble Hill
Road rot repair a sign of imminent election
Is that a blacktopping machine I see before me — patching Victoria’s rotten roads?
Yes!
It can only mean one thing: There’s an election coming.
Nick Russell
Fernwood
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