CMAJ Podcasts – Détails, épisodes et analyse

This episode of the CMAJ Podcast explores how physician identity can influence patient expectations, and how those expectations may contribute to gender, race, and immigration status pay gaps. The discussion builds on the CMAJ article “Family physician pay inequality: a qualitative study exploring how physician responses to perceived patient expectations may explain gender, race, and immigration status pay differences”.

Dr. Monika Dutt, a family physician, public health and preventive medicine specialist, and PhD candidate in health policy at McMaster University, explains how the study’s interviews with 55 family physicians across Ontario revealed patterns linking patient expectations to physician identity. She describes how gender and cultural background influence the types of visits physicians are asked to provide, and how these interactions may affect their earnings under fee-for-service models.

Dr. Meredith Vanstone, professor in the Department of Family Medicine at McMaster University, outlines how physicians adapt to explicit and inferred patient expectations and the income implications that follow. She discusses how these expectations are shaped by identity and why the resulting adjustments in care can lead to financial penalties for some physicians while improving patient relationships and trust.

The guests highlight how remuneration structures can either amplify or mitigate these inequities. They suggest that moving toward salary or time-based models could help reduce the impact of physician identity on income while supporting equitable, patient-centred care.

For more information from our sponsor, go to medicuspensionplan.com

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

A recent article in CMAJ, Mental health service use among Black adolescents in Ontario by sex and stress level: a cross-sectional study, reveals how patterns of mental health service use among Black youth shift with the level of psychological distress. Lead author Mercedes Sobers, a PhD candidate in epidemiology at the Dalla Lana School of Public Health and research coordinator at the Centre for Addiction and Mental Health, joins the podcast to unpack the findings and their implications.

The study found that Black male youth had higher odds of accessing services than white male youth when at low levels of distress but lower odds of accessing services at high levels. Black female youth had lower odds of service use than white female youth at both low and high distress levels. Mercedes explains how these patterns may reflect how behaviour is interpreted: Black boys may be referred to services more often at lower distress levels but steered toward more punitive responses when distress rises. For Black girls, she points to adultification and cultural mismatches in care.

Dr. Amy Gajaria, a psychiatrist at the Centre for Addiction and Mental Health and associate scientist in the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, describes how programs like AMANI aim to provide culturally adapted care and build trust with Black youth. She shares how early encounters with the system can shape future engagement with care.

For physicians, the discussion underscores the importance of culturally sensitive care that embraces and reflects the experiences of Black youth, creating more meaningful and effective pathways to support.

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

On this episode of the CMAJ Podcast, hosts Dr. Mojola Omole and Dr. Blair Bigham speak with two authors of the latest “Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care”

The discussion reflects a shared urgency: despite past successes, Canada’s hypertension control rates are declining. The new guidelines aim to reverse this trend by simplifying diagnosis and treatment for frontline clinicians.

Dr. Rémi Goupil, a nephrologist and clinician researcher at Sacré-Cœur Hospital in Montreal, and Dr. Greg Hundemer, a nephrologist and clinician scientist at The Ottawa Hospital, explain that the updated guideline is deliberately designed for primary care providers. They highlight key shifts: lowering the diagnostic threshold for hypertension to  ≥ 130/80 mm Hg, simplifying blood pressure targets, and emphasizing accurate, standardized measurement techniques both in clinic and at home. The guidelines were created with input from a majority-primary care committee—including family physicians, nurses, pharmacists, and patient partners—to ensure clinical applicability.

Together, the panel outlines a streamlined nine-step treatment algorithm, emphasizing combination therapy as first-line pharmacologic management. They explain the evidence supporting ARB–thiazide combinations, discuss cost considerations for drug selection, and address adherence challenges. They also explore red flags for secondary hypertension and how the algorithm supports—but does not replace—clinical judgment.

For physicians, this guideline offers a clear and practical roadmap: measure blood pressure correctly, aim for systolic pressure below 130 mm Hg, and use the simplified treatment sequence to improve adherence and outcomes. Designed to be easy to implement, the new approach aims to empower primary care providers to act with confidence.

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

Reported gonorrhea cases have more than doubled in recent years. Untreated gonorrhea may occasionally cause potentially fatal conditions, such as infective endocarditis. 

In this episode, Dr. Carl Boodman, infectious disease and medical microbiology fellow at the University of Manitoba, discusses a case of disseminated gonococcal infection in a 54- year old man who presented to ER with a new heart murmur. The case was described in a recent CMAJ article, which explains that the patient had developed an aortic root abscess and a fistula from his right ventricle to the aortic root.

Dr. Boodman tells Dr. Blair Bigham and Dr. Mojola Omole that, while severe cases of disseminated gonococcal infection such as this remain relatively rare, he is seeing more of them in Manitoba. He emphasizes the importance of detecting and treating gonococcal infection before it has a chance to progress.

Gonorrhea is just one of the bacterial STIs on the rise. Drs. Bigham and Omole also speak with Dr. Jason Wong, a Public Health and Preventive Medicine specialist in BC, about what’s behind the rise in STIs and about what lessons can be learned from the relative decline in HIV infections.

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

Operative vaginal delivery (OVD) is considered safe if carried out by trained personnel; however, the rate of maternal trauma following OVD in Canada greatly exceeds that of any other OECD country. In Canada, maternal trauma occurred in more than one-quarter of deliveries with forceps, whereas in the UK, the rate is 8%-12%, and in Australia, it sits at ​​9.3%-14.1%.

A research study published in CMAJ found that rates of trauma following OVD in Canada are higher than previously reported, irrespective of region, level of obstetric care and volume of instrument use among hospitals. The authors argue these results support a reassessment of OVD safety in Canada. 

In this episode, Dr. Bigham and Blair and Dr. Mojola Omole speak with Dr. Giulia Muraca, the lead author of Maternal and neonatal trauma following operative vaginal delivery: a national cohort study. They explore possible causes for these troubling findings.

They then speak with Dr. Nirmala Chandrasekaran, an OB/GYN and Maternal-Fetal-Medicine specialist at St. Michael’s hospital in Toronto. Dr. Chandrasakan trained in the UK, and she describes how exposure to OVD during residency differs in the two countries. She also discusses the vital role OVD plays in safe deliveries.

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

People with kidney failure who live in rural and remote areas of Canada do not have the same access to the full suite of dialysis modalities as urban dwellers. Many need to relocate for life-sustaining renal replacement therapy. Often this means moving hours away from their home communities for months, sometimes years, at a time.

In this episode, hosts Drs. Mojola Omole and Blair Bigham speak with Dr. Aaron Trachtenberg, a nephrologist at the University of Manitoba about his commentary in CMAJ, in which he and coauthors argued that patients who must leave their home communities for dialysis should be prioritized for the allocation of deceased donor kidney transplants.

They also speak with Vanessa Tait whose father needed to relocate to Winnipeg, twelve hours away from his home community of O-pipon-na-piwin Cree Nation, for dialysis. Ms. Tait became a living donor to her father in an effort to bring him back home. She talks about the toll relocation takes on patients from remote communities.

Commentary in CMAJ
CMAJ

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

The CMAJ podcast is taking a break for one episode as everyone enjoys their holidays and gets prepared for the year ahead. In this brief chat, Mojola and Blair preview some of the upcoming episodes and wish all our listeners a happy and safe holiday.

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

One simple question can offer clinicians a powerful insight into the lives of their vulnerable patients. Asking, “Do you ever have trouble making ends meet at the end of the month” can help physicians identify significant barriers to restoring the health of their patients.

The link between the social conditions in which we live and health outcomes is well-known. However, health provider action to address the social determinants of health is an emerging area of practice innovation and research. This episode looks at what social prescribing looks like in action and what the evidence tells us about its effectiveness.

Drs. Mojola Omole and Blair Bigham speak with Janet Rodriguez, a patient at St. Michael’s Family Health Care Clinic in Toronto. She describes the profound impact social interventions had on her physical and mental health.  

They also speak with Dr. Gary Bloch, a family physician at St. Michael’s Family Health Care Clinic and a co-author of the analysis published in CMAJ titled “An Evidence-Based Guide to Social Interventions in Primary Care.”

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

The pandemic recovery period presents an opportunity to address health inequities that have led to an unfair distribution of the burden and harms of COVID-19. 

New guidance for policy published in CMAJ  proposes 13 practical ways to address inequities exposed and worsened by COVID-19 in the pandemic recovery period, based on evidence that was accumulating before the pandemic.

In this special episode of the podcast, CMAJ interim editor-in-chief Dr. Kirsten Patrick talks to Dr. Nav Persaud, lead author on the new guideline, about its genesis, the evidence underpinning its recommendations, and the importance of positioning equity at the centre of policy-making as Canada emerges from the pandemic.

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions

Pain is one of the most common complaints among patients visiting the ER, and pain management has become a quality of care indicator. But the options available for the treatment of acute pain that isn’t controlled by over-the-counter medications are limited. 

With the opioid epidemic leading physicians to avoid prescribing narcotics, the anaesthetic drug, ketamine, is being reconsidered for the treatment of pain, as well as other indications. 

A practice article  in CMAJ argues that ketamine is an underutilized and effective analgesic and a safer alternative to opioids for the management of acute pain, with reported adverse effects at low doses occurring at the same frequency as placebo. 

In this episode, Blair and Mojola speak to Dr. William Silverstein, a co-author of the practice article “Five things to know about the use of ketamine in the treatment of acute pain” about ketamine’s indications and contraindications, how to prescribe it in the ambulatory care setting, and practical steps physicians can take to add ketamine to their pain-busting arsenal.

They also speak with Dr. Marshall Ross, a physician who also uses ketamine as an emergency physician, but has also pioneered its use in patients with treatment-resistant depression, using cutting edge techniques.

Comments or questions? Text us.

Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.

You can find Blair and Mojola on X  @BlairBigham and @Drmojolaomole

X (in English):  @CMAJ
X (en français): @JAMC
Facebook
Instagram: @CMAJ.ca

The CMAJ Podcast is produced by PodCraft Productions