Today's date: Thursday October 18, 2018 Vol 51 Issue 42
   
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Municipal 2018
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The Wellington Advertiser encourages letters to the editor.
You may, if you wish, submit your letter online.

Hall of fame fan

Dear Editor:

RE: Inductions to Erin’s Horse Heritage Hall of Fame, Oct. 11.

It was very pleasing to read this story in the Advertiser.

Wellington County is becoming well established as a premier location in the province for horse farms and the Advertiser is already well recognized for providing journalistic expression to this.

By recognizing the initial inductees into the local Hall of Fame, the community is coming of age in realizing the dreams of wonderful  people who have laid and continue to lay the foundation for success with equines here and elsewhere in Ontario.

A “pat on the back” is due to each of the initial inductees: David and Helen Leitch, Gail Wood and Danny O’Callaghan, Fred Cox  as well as 2005 two-year-old Champion and 2006 Queen’s Plate winner Edenwold. Special recognition is also due to Alf Budweth for hosting this event and others who must have provided the impetus for inaugurating this Hall of Fame.

Long may horses and horse people in south Wellington County succeed in their careers and provide similar candidates with which to populate Erin’s Horse Hertitage Hall of Fame!

Jock Buchanan-Smith, PUSLINCH

OPINION: How do we decrease emergency room visits?

You get home after a long day at work and the cough that’s been bugging you just doesn’t seem to be letting up. Your muscles ache, you have chills and you hear a slight wheeze when you breathe out.

Do you head to the local emergency department? A walk-in clinic? Or does your family doctor have an after-hours service?

As a family doctor, I’d like to think you’d call your doctor’s office or go to their after-hours clinic. But chances are, you head to the emergency department.

Canadians use the emergency department far more than people in other high-income countries. In the last two years, 40 per cent of Canadians were seen in the emergency department compared to 24% in the United Kingdom, 20% in the Netherlands and just 11% in Germany.

Canadian governments have wondered whether one way of curbing emergency department use is to improve access to family doctors after hours.

About 15 years ago, Ontario introduced practice models that paid physicians differently, encouraged them to work in groups and take responsibility for a roster of patients. Physicians in these new models were also required to provide a certain number of evening or weekend clinics. The hope was to divert some emergency department visits to family practices.

Unfortunately, it didn’t quite work as planned.

Our recent study found that emergency department use didn’t decrease for patients who joined the new practice models. Between 2003 and 2014, there was actually an increase in the rate of emergency department visits in Ontario, particularly during the day. At the same time, the overall rate of visits to family doctors went down, but family doctors seemed to be providing more after-hours care.

Why didn’t asking family doctors to provide after-hours care reduce emergency department visits? There are a few potential explanations.

First, it may be that an increase in family doctor availability after hours was offset by a decrease in availability during the day. Ontario has a fixed supply of family doctors, many already juggling a demanding workload. Perhaps one way of coping with new requirements was to decrease daytime hours.

Second, providing more services may just increase people’s demand for services. When the U.K. introduced urgent care clinics, people started going there but they also kept going to the emergency department at the same rate they did before.

Or maybe you do see your family doctor and they’re worried about pneumonia so they send you to the emergency department because that’s the only way they can get an X-ray after hours.

Many of our emergency departments are overcrowded - partly because of a shortage of hospital beds but also because of the sheer numbers of people seeking care. Can better access to primary care help us reduce the demand on emergency departments?

Our findings suggest it’s complicated. Just asking family practices to provide more care on the evenings and weekends is likely not enough. Family practices need to have the right resources to provide care after hours, including access to labs and X-rays. Ideally, after-hours coverage is shared by a large group of doctors and other team members who have access to shared electronic patient records.

We also need to improve timely access to primary care during the day. Few Canadians are able to get a timely appointment with their family doctor or nurse practitioner when sick. In a recent survey, 25% said they went to the emergency department because their family doctor wasn’t available.

We can learn from reforms in other countries. For the last 15 years, family doctors in the Netherlands have been organized in large co-operatives, each serving 100,000 to 500,000 patients and featuring a single regional telephone number. In the evenings and on weekends, trained nurses triage calls and, if needed, physicians assess patients on the phone, in clinic or at home. Perhaps it’s not surprising that the Netherlands has one of the lowest emergency department visit rates.

More after-hours care may not necessarily reduce emergency department visits but it’s still an important service for patients.

We need to better understand patient values and rethink how we’ve designed our system for those with acute health complaints in the evenings or on weekends. Let’s learn from other countries and evaluate related reforms in Canada.

Tara Kiran is a family physician at the St. Michael’s Hospital Academic Family Health Team, adjunct scientist at ICES, and the Fidani Chair in Innovation and Improvement at the University of Toronto. She is a contributor with EvidenceNetwork.ca, based at the University of Winnipeg.

Tara Kiran,

OPINION: Medical marijuana - fact or fiction? Health team has answers

With marijuana set to become more accessible through legalization this week, and increasing claims of benefits appearing in the media, it’s no wonder there are more questions than ever around the safety and effectiveness of medical marijuana for a number of health conditions.

With different sources quoting differing information, it’s hard to know what’s fact and what’s fiction.

Test your knowledge on medical marijuana by answering the questions below.

FACT OR FICTION? There is good, scientific evidence that medical marijuana is effective for a variety of common conditions, such as anxiety, migraines and chronic pain.

FICTION: Few medical conditions currently have good proof that medical marijuana may be of benefit. This is in part due to the challenges of studying marijuana while it was an illegal substance, and in part due to poor results in many studies conducted. In the majority of cases, medical marijuana is not recommended as a medical treatment unless other medication options have first been tried, due to the fact that they are better studied and may be more effective. Very few common conditions for which claims of benefit have been made have good proof of benefit for marijuana use. Conditions such as fibromyalgia, migraines, low back pain and anxiety have shown no benefit with medical marijuana treatment thus far. There is some proof of benefit in those with nerve pain that has not responded to other medications. However, in most people with nerve pain, medication options have shown an overall greater benefit.

FACT OR FICTION? Smoking marijuana comes with many of the same health risks as smoking cigarettes.

FACT: Studies have shown that marijuana smoke contains many of the same cancer-causing compounds, called carcinogens, found in cigarette smoke. As well, because marijuana smoke tends to be breathed deeper into the lungs and held in the lungs for longer, the overall exposure may be the same for many people, even if used less often than cigarettes. It is recommended that if inhaling marijuana, to do so by vaporization (“vaping”) as opposed to smoking as this avoids the creation of some carcinogens. However, vaporization can still irritate the lungs and the long-term effects of inhaling marijuana vapor or smoke has not been well studied.

FACT OR FICTION: It is safe to drive a vehicle after smoking or ingesting (eating, drinking, etc.) medical marijuana if you don’t feel “high”.

FICTION: Even if you do not feel “high” you should avoid driving for at least four hours after smoking marijuana and six hours if ingesting. If you do feel “high,” you should refrain from driving for at least eight and up to 24 hours. How this may affect your lifestyle should be taken into account before starting medical marijuana treatment.

FACT OR FICTION? Medical marijuana is less expensive than most prescription medication options.

FICTION: Medical marijuana is currently not covered under any government drug coverage plan, as well as most private insurance plans. Depending on the amount you need to consume, the cost of medical marijuana can be about $15 a day, or about $450 a month. In contrast, many prescription medications are covered under government or private insurance plans, and therefore many people may pay nothing or very little for prescription options. Even if required to pay the full cost of their prescription medications, many are cents or dollars a day.

FACT OR FICTION?  There is no danger in using medical marijuana without informing your health care provider.

FICTION: It is always a good idea to talk to your doctor or another health care provider before starting any new treatments, including medical marijuana. There are some people for whom medical marijuana may not be the safest or the most effective treatment based on their medical history, conditions they are trying to treat, and the other medications they are taking.

Those with certain heart conditions, high blood pressure, lung diseases (or who are at risk of lung disease), and those with a personal or family history of certain mental health disorders should always consult with a health care provider before starting medical marijuana as they may be at increased risk of complications. Lastly, your health care provider can give you accurate information about medical marijuana use for yourself and your individual health concerns.

FACT OR FICTION? Even though medical marijuana is “natural,” it can still have side effects.

FACT: Medical marijuana, like any medical treatment, comes with risks. The short-term side effects of marijuana are well recognized and include memory impairment, numbness, inability to concentrate, dizziness, sleepiness, euphoria (feeling “high”) or dysphoria (feeling “low”), and trouble speaking.

The long-term side effects of marijuana are less well studied but may include increased anxiety, effects on mood, lung disease if inhaled, long-term memory impairment, and others not yet known. Any potential benefits of medical marijuana should always be weighed against its potential harms.

If you’re thinking about starting medical marijuana treatment for your condition, it is important to consider the impact it may have on you, your health, and your daily life.  It is also important to talk to your doctor if you use or are thinking of using marijuana to make sure you do so safely. Be safe, be in the know!

Your local Family Health Team is a great resource for managing chronic conditions. For more information about any of the free services offered by your Family Health Team ask your doctor or nurse practitioner during your next visit, visit www.afhto.ca or google ‘family health team locations’.

Gillian Haigh, is a pharmacist with the Upper Grand Family Health Team.

 

Gillian Haigh,

‘Humane community’

Dear Editor:

Five AM is a time I love; dawn, quietness and early morning bird song. Alas an hour later there are 30 internet messages, including pleas to save victims of war and other inhumane circumstances.

Our world has changed radically and has become a series of giant nightmarish merry-go-rounds of horrendous wars to benefit arms dealers, oligarchs and corporations  with genocide and climactic tragedies caused by our lack of respect for everything, creating a fertile ground for “charities” who are begging us to save children, animals, rescue activists, and provide water to those who are without, mainly due to governmental corruption.  

If we correct the foundations of our world, beginning with Centre  Wellington where there is a desperate need for support for youth, the elderly and those with “lower” incomes, we could resolve many issues by passing on a continuing respect for others.

Our present mayor believes in “smart growth, progress and economic prosperity,” a title which benefits only a small percentage of our population and is disastrous for most, taking away affordable rental/new housing  for local people,  ignoring the needs of youth and undermining our true community. Likewise universally/globally.

With the impending election let’s start thinking about this issue from the microcosm, i.e. here, to the macrocosm of the globe, as our actions will reverberate to other townships. We can demand that we do not indulge in the wrong form of “smart growth” - yes, we are told that we have to, but that is a fallacy.

Think of the story of Castlemore, who refused to join amalgamation; we must have the courage to speak out and demand an environment that is not subjected to developer’s desires, and within which we can live and our children and grandchildren can have a hope of owning their own home and not becoming yet another family where two parents commute and a family meal is limited to Thanksgiving and Christmas.

This is a country of free speech, and even if your friends do not agree, take the risk and feel good about your actions. We have all been fed the “smart growth” fairytale without the unhappy ending; the discovery that the subdivision next to us was the last strip on which to grow food, preserve reserves of water for residents and where birds sang.

There are alternatives to our present situation. During the last two years council paid over $1 million “consultants.” Many of these fees were not necessary; monies were squandered and habitable houses were unnecessarily demolished. Added to this we had a 4% tax increase per year.

Let us follow the theory of respect as proffered by one of the mayoral candidates and we will certainly be several steps closer to living in a more humane community.

Carol Williams, ELORA

‘Vote strategically’

Dear Editor:

To vote is a privilege and a responsibility.

It is a privilege because we have a voice in choosing who will represent us in the next four years at council. It is a responsibility because we must educate ourselves on who we feel will be the best candidates for council.

For the Town of Erin, the 2014 election was a momentous election. It demonstrated that voters had enough of a dysfunctional and ineffective council. Voters had a grand choice of 17 candidates; unfortunately, most were unknown first-time candidates. There were too many choices with too little time and opportunity for voters to appraise each candidate individually and collectively.

This Oct. 22 election is critical in determining the future of the Town of Erin. We are at a pivotal point. Who we vote in will define and determine the direction and future of the town. We must vote in an effective council.

We must bring in a council that is transparent, responsive and accountable in its actions. We need a council that works as a team for the betterment of all Town of Erin residents. We need a council that is inclusive and is not village of Erincentric or Hillsburghcentric. We need a council that will listen to the people it represents through open, honest two-way communication.

This time round, we have many viable candidates. There have been many meet and greet meetings. Hopefully, residents took advantage of them and were able to educate themselves on their candidate options.

I would encourage my rural neighbours to come out in force, vote and be heard. We are the majority residential taxpayers. In the past, the urban centres have exercised their choices clearly and council composition reflects that. Now, it’s time for the rural residents to do the same.

Please vote. Please vote strategically. Vote for only those candidates who you believe will represent you well at council. It could be one candidate, it could be three. You aren’t required to vote for four.

Your vote is your voice. Your voice is important in determining our future. Collectively, we can make the Town of Erin a better place to live.

See you at the poll on Oct. 22. Voting closes at 8pm. Visit erinvotes.ca or call the town office for more information.

Anna Spiteri, ERIN

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