CONFERENCE PROGRAM - Pri-MedKeynote credits: 1 Mainpro+ 8:30am - 9:30am 10:15am - 11:15am 10:15am -...

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Table Of Contents

Mainpro+ workshops

Session descriptions

Conference at-a-glance

Certificate of attendance

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pri-med.ca/APP

PROGRAM DEVELOPED BY:

THE INTERNATIONAL CENTRE - HALL 2

MAY 9-11, 2019

CONFERENCE PROGRAM

6900 AIRPORT RD - TORONTO, ON

pri-med.ca/APP2

KEYNOTESCONCURRENT SESSIONS

Thursday, May 9th

8:30am - 9:30am

1:50pm - 2:50pm

10:15am - 11:15am

11:25am - 12:25pm

3:35pm - 4:35pm

4:45pm - 5:45pm

7:00am - 8:00amRoom

2:50pm - 3:35pm

9:30am - 10:15am

12:40pm - 1:40pm

6:00pm - 7:00pm

7:30am - 8:30am

Additional Learning Session

Network/Visit Exhibits


Additional Learning SessionRestaurant/Visit Exhibits


Exhibit Hall & Registration Opens

KEYNOTE IPuff a Day Keeps the Doctor Away?Michael Verbora, MBA, MD, CCFP

KEYNOTE IIDo No Harm, Help Me Die: What if There is No Goldilocks Solution?Sonu Gaind, MD, FRCP(C), FCPA, FAPA

Rashes that KillGeorge Porfiris, MD, CCFP(EM), FCFP

Hot New Topics in Sexual Health Aarti Kapoor, MD, CCFP, BSCH, BA

Burnout Revealed! A Shared Problem in HealthcareJoy Albuquerque, MD, MA, FRCP(C)

Reconciliation without Action to End Poverty and Poor Health, is NOT ReconciliationChief Isadore Day

Mixing and Matching: Layering Psychiatric Medications as Primary Care PractitionersJonathan Davine, MD,CCFP, FRCP(C)

A Practical Approach to Managing the Care of Older Patients in the Extremes of ComplexitySamir Sinha, MD, DPhil, FRCPC, AGSF

Treating Poverty: A Practical Approach to Addressing Social Risks to HealthGary Bloch, MD, CCFP, FCFP

Metacognition and Avoid Clinical Errors in Medical Decision-MakingVu Kiet Tran, MD, FCFP(EM), MHSc(Ed), MBA, CHE

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CCCEP Accreditation:The Canadian Council on Continuing Education in Pharmacy has accredited this program for 15 CEUs

CFPC Accreditation:This Group Learning program

has been certified by the College of Family Physicians of Canada and the Ontario

Chapter for up to 15 Mainpro+ credits.

Department of Family & Community Medicine

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Friday, May 10th Saturday, May 11th

8:30am - 9:30am

11:30am - 12:30pm

1:50pm - 2:50pm

10:15am - 11:15am

8:30am - 9:30am

11:25am - 12:25pm

10:00am - 11:00am

3:35pm - 4:35pm

4:45pm - 5:45pm

7:00am - 8:00am 7:00am - 8:00amRoom Room

2:50pm - 3:35pm

9:30am - 10:15am

9:30am - 10:00am

12:40pm - 1:40pm

12:40pm - 1:40pm

11:00am - 11:30am

6:00pm - 7:00pm

7:30am - 8:30am 7:30am - 8:30am

Additional Learning Session Additional Learning Session





Additional Learning SessionRestaurant/Visit Exhibits



Exhibit Hall & Registration Opens Exhibit Hall & Registration Opens

KEYNOTE IIIManagement of Aortic Valve Disease and Aortopathies: A Primer for Primary Care Subodh Verma, MD, PhD, FRCSC, FAHA

KEYNOTE VMedical Breakthroughs - From Liquid Biopsies to Custom Immune CellsPeter J. Lin, MD, CCFP

KEYNOTE IVIntegrating Palliative Care into Family PracticeSandy Buchman, MD CCFP (PC) FCFP

Using Antibiotics Wisely Campaign: Antimicrobial Stewardship in Community PracticeAllan Grill, MD, CCFP (COE), MPH, FCFP, CCPE

Aortic Aneurysm Management 2019Douglas Wooster, MD FRCSC FACS FSVS RVT RPVI HEPA: Who Needs It, How Is It

Used, And How Do I Prescribe ItLaura Cruz, MSc, MD, CCFP(SEM), Dip Sport Med

Chronic Kidney DiseaseMurray Berall, MD, FRCPC

Approach to Cancer-Related AnemiasKevin Kuo, MD, MSc, FRCPC

Hand and Wrist DisordersOlubukunola Ayeni, MD, MPH, FRCSC

Pacemaker Limbo: How Low Can You Go?Douglas Ng, MD, FRCPC (Cardiology)

Vision and Learning: What this Means at the Primary Care LevelRajvinder Pabla, OD, MSc

Patients Centered Protocols in Rheumatic Diseases and Widespread PainShikha Mittoo, MD MHS FRCPC

Pediatric RashesSaul Greenberg, MD, FRCPC

Updates in the Management of OsteoporosisSandra Kim, MD

The Diagnosis and Management of EndometriosisJamie Kroft, MD, MSc, FRCSC

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pri-med.ca/APP4

A MESSAGE FROM DR. MICHAEL KIDD, PROFESSOR AND CHAIR

As Chair of the University of Toronto Department of Family and Community Medicine, I welcome you to Pri-Med Canada 2019. This is the 17th year that the University of Toronto has been a partner in Pri-Med Canada.

Established 50 years ago, in 1969, the University of Toronto Department of Family and Community Medicine, includes family doctors and other health care professionals dedicated to education and research, creating and disseminating knowledge in primary care, advancing the discipline of family medicine, and improving health outcomes for all people, including members of diverse and underserved communities in Canada and around the world. This is all made possible through our leadership in education, research, advocacy, scholarship, quality and innovation.

Our Department is one of the largest university departments of family medicine in the world, and includes over 1,700 faculty members, 14 Academic Family Health Teams, many community practices in urban and rural Ontario, more than 10,000 hours annually of undergraduate medical teaching, and over 400 family medicine residents enrolled in our residency training programs in family medicine, palliative care and emergency medicine. Our faculty members practice, teach and conduct research in diverse practice settings, from inner city, urban and suburban to rural, remote and international. In 2018 our Department was recognized by the World Health Organization (WHO) as the WHO Collaborating Centre on Family Medicine and Primary Care, the first of its kind in the world.

Our Department also offers a wide range of Faculty Development opportunities that provide advanced training for our faculty members and others working in family medicine, including programs to develop skills in research, education scholarship, leadership and quality improvement.

If you are interested in joining our Department as a faculty member, or enrolling in one of our certificate or graduate programs, please come and see us at the University of Toronto booth and speak to members of our team about how to get involved.

I hope you will find the next three days at Pri-Med Canada informative, engaging and professionally rewarding.

Dr. Michael Kidd, AM FAHMSProfessor and Chair, Department of Family & Community MedicineUniversity of Toronto

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Declaration Of Potential Conflict Of InterestSpeakers will disclose to the audience any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of this program.

Each evaluation you complete enters you into a draw for 1 of 50 $50 UofT Bookstore gift cards!On your Mobile device:A) Open the Pri-Med AppB) Login on the top right cornerC) Find and click on the session you wish to evaluateD) Click the evaluation button near the top of the session, fill it out then press submit. On your Computer:-Visit www.pri-med.ca/app-Click the laptop image-Follow instruction B through D above

Conference ManagementThe Information Booth is located inside the main entrance beside registration. Our business address and contact information is listed on the back cover.

Learning Objectives

Evaluations - Complete Evaluations and Win!

• Maintain and enhance competence in a wide variety of topics.• Acquire knowledge of new investigations and therapeutic strategies.• Develop practical office-based screening and disease prevention strategies.• Compare patient experiences with your peers and experts.

Accreditation

WELCOME TO PRI-MED CANADA, NOW IN OUR 17TH YEAR!

In a collaborative effort, Pri-Med Canada has assembled another impressive line-up of speakers and relevant topics. Five dynamic keynotes and 25 diverse sessions are delivered by top clinicians in their field. Our unique format maximizes knowledge transfer through clinical updates and will help improve your patient outcomes.

College of Family Physicians of Canada:This Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 15 Mainpro+ credits. Canadian Council on Continuing Education in Pharmacy:The Canadian Council on Continuing Education in Pharmacy has accredited this program for 15 CEUs.The American Medical Association - AMA PRA Category 1 Credit™ designation statement:Members of the American Academy of Family Physicians are eligible to receive up to 15 prescribed credit hours for attendance at Pri-Med Canada 2019 to a reciprocal agreement with the College of Family Physicians of Canada.

CLINICAL UPDATE LECTURES

pri-med.ca/APP6

DermatologySession credits: 1 Mainpro+

Ethical & Legal Issues, Women’s Health, Mental Health, Men’s HealthSession credits: 1 Mainpro+

Endocrinology, Medical MarijuanaKeynote credits: 1 Mainpro+

8:30am - 9:30am

10:15am - 11:15am

10:15am - 11:15am

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LECTURE HALL 1

KEYNOTE IPuff a Day Keeps the Doctor Away?Michael Verbora, MBA, MD, CCFP

Rashes that KillGeorge Porfiris, MD, CCFP(EM), FCFP

Reconciliation without Action to End Poverty and Poor Health, is NOT ReconciliationChief Isadore Day

Review cannabis pharmacology, evidence, contraindication, potential benefits and harms. Address social benefits of cannabis legalization and regulation. Review cases in cannabinoid therapy.

Learning Objectives

• Understand the pharmacology of cannabinoids.• Understand the potential benefits and harms of

cannabinoids.• Review cases in cannabinoid therapy management.

• Identify the basic science regarding the endocannabinoid system, receptors and ingredients that activate it.

• Analyze the evidence on risks and benefits of cannabinoids.• Integrate medical guidance into practice on herbal

cannabis prescribing.• Describe all methods of cannabis consumption.• Interpret data on potential harm reduction opportunities

with cannabinoids.

Rashes are commonly seen in primary care. Most of these are benign and can easily be treated by the primary care provider or can be referred for dermatology opinion. There are however a small percentage that can seriously harm or even kill the patient if not diagnosed in a timely manner. We will cover these conditions in an interactive case based format.

Learning Objectives• Learn to identify and treat life threatening conditions that

present with rash.

• Learn to differentiate rashes that need immediate hospital treatment with those that can be treated safely as an out patient.

• Demystify Drug rashes.

As Former Ontario Regional Chief and chair of the Assembly of First Nations national health portfolio, Isadore will bring into focus a diverse set of experiences from his 15 year political career, taking the audience along a journey with him on the critical issues facing Indigenous communities and Indigenous peoples across the country. Whether it is the issue of food security, mental health challenges, critical gaps in the level of care provided, or the diabetics and opioid epidemic that is facing our peoples, Isadore will bring into focus the problems we face and highlight the solutions we can implement together.

Learning Objectives• Bring awareness to those in attendance of the real

and current issues facing Indigenous peoples and our communities.

• Bring awareness of the numerous Reports commissioned by the federal and provincial governments, and the lack of political commitment to end third world living conditions in Canada.

• Share with the audience the experiences of a local First Nation Chief, and later as a national political figure providing insight into the structural challenges Indigenous people and their communities face based on years of systemic discrimination that directly stems from Canada’s colonial past.

Thursday, May 9th, 2019

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Ethical & Legal Issues, Men’s Health, Women’s Health, Practice Management, Mental Health

Session credits: 1 Mainpro+

Geriatrics, Pain Management, Women’s Health, Mental Health, Men’s HealthSession credits: 1 Mainpro+

11:25am - 12:25pm

11:25am - 12:25pm

LECTURE HALL 1

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Treating Poverty: A Practical Approach to Addressing Social Risks to HealthGary Bloch, MD, CCFP, FCFP

A Practical Approach to Managing the Care of Older Patients in the Extremes of ComplexitySamir Sinha, MD, DPhil, FRCPC, AGSF

The evidence linking adverse social conditions to poor health outcomes is irrefutable. But there is very little guidance for primary care providers to directly influence the social determinants of health. Luckily, this gap in knowledge and skills is now being filled. In this talk, Dr. Bloch will describe health provider interventions, with individual patients and providers, by health teams, in communities, and in society, that can directly impact social risks to health. Canadian primary care teams are at the forefront of this area of exploration, and this talk will offer unique insight into an area of inquiry and clinical innovation that is likely to transform the practice of front line health care.

Learning Objectives

• Examine an evidence-based argument for intervening in poverty and other social determinants of health in primary care.

• Explore practical approaches to addressing the social determinants of health primary health care providers can employ with individual patients and families.

• Introduce health care team-based interventions and advocacy interventions into poverty and other social risks to health.

Some older patients – often those with multiple chronic health conditions – will reach a pre-palliative point of care – where their care becomes extremely complex to manage and we are sometimes not sure how best to proceed in managing their care. In this presentation, we will present a practical way for the primary care provider to identify and prioritize the issues that can be addressed, and a practical approach that can help navigate the patient, family and practitioner out of the woods.

Learning Objectives• Appreciate that the pre-palliative state is an often

challenging phase for health care providers to manage the multiple issues facing their frail older patients.

• Understand a practical approach to identifying and managing the major issues that sometimes get classified as a “failure to thrive.”

• Recognize when and who to refer your patients to a relevant specialist for additional guidance and support.

Ethical & Legal Issues, Geriatrics, Palliative careKeynote credits: 1 Mainpro+

1:50pm - 2:50pm LECTURE HALL 2KEYNOTE IIDo No Harm, Help Me Die: What if There is No Goldilocks Solution?Sonu Gaind, MD, FRCP(C), FCPA, FAPA

We have now had nearly 3 years of experience since assisted dying legislation and policies were introduced in Canada. While opinions on Medical Assistance in Dying (MAiD) have changed over the years, controversy continues to surround the topic, with some arguing that elements of current policy are too restrictive, and others arguing against expansion of eligibility criteria. This session will review the Canadian experience and relevant international data, explore current controversies surrounding MAiD, and ask the tough question – if there is no “perfect solution”, which mistakes do we want to make?

Learning Objectives• Understand the evolution of Medical Assistance in Dying

(MAiD) policies in Canada, and the Canadian experience with MAiD.

• Appreciate the nature of suffering that can lead to MAiD requests.

• Appreciate the implications of expanding or not expanding eligibility criteria for MAiD.



pri-med.ca/APP8

PsychiatrySession credits: 1 Mainpro+

Men’s Health, Women’s Health, Genitourinary, Screening & Prevention

Session credits: 1 Mainpro+

Mental Health, Practice Management, Screening & PreventionSession credits: 1 Mainpro+

3:35pm - 4:35pm

3:35pm - 4:35pm

4:45pm to 5:45pm

LECTURE HALL 2

LECTURE HALL 1

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Mixing and Matching: Layering Psychiatric Medications as Primary Care PractitionersJonathan Davine, MD,CCFP, FRCP(C)

Hot New Topics in Sexual HealthAarti Kapoor, MD, CCFP, BSCH, BA

Burnout Revealed! A Shared Problem in HealthcareJoy Albuquerque, MD, MA, FRCP(C)

Often, psychopharmacologic treatment of psychiatric conditions involves combining medications in an appropriate manner. In this workshop, we will discuss a number of scenarios where this occurs. Treating depression is very common in the primary care setting. We will discuss proper dosing of antidepressants, optimizing antidepressants, augmenting a partial response to antidepressants, dealing with treatment resistant depressions, and dealing with insomnia in the depressed patient. We will also discuss when it is important not to combine certain psychiatric medications. We will also present data on the treatment of certain anxiety disorders, where combining psychiatric medication may also be part of the treatment plan.

Learning Objectives

• Describe psychopharmacological augmenting techniques when dealing with partial responses to antidepressants.

• Describe the use of different combinations of hypnotics to treat insomnia.

• Describe using different combinations of drugs when treating anxiety disorders.

There have been many advances in the world of sexual health in the past year. Progress was made not only in terms of testing and treatment but also in regards to destigmatisation and inclusion. This lecture will aim to provide community practitioners with up-to-date information to meet the growing sexual health needs of their patients.

Learning Objectives

• Review Public Health Ontario’s new Gonorrhea Testing and Treatment Guidelines.

• Learn when to suspect, how to test for and treat Ontario’s two new emerging STIs: Mycoplasma and LGV.

• Highlight Hot New Topics in Sexual Health: New Highly Sensitive Testing for Trichomonas and Gender Neutral Health Cards.

Burnout is a serious issue in health care impacting all members of the health care team. This presentation will review the syndrome of burnout and research in the context of physician health. The impact of burnout on healthcare professionals correlates with personal and professional outcomes. Burnout is seen increasingly as a systems issue, a cultural issue associated with transformative changes in the delivery of health care, organizational strains and rising professional expectations.Yet there is reason to be optimistic for change, which include wellness programs and initiatives to address engagement and satisfaction of health care providers while improving the bottom line, patient care.

Learning Objectives• Be able to describe the three components of burnout and at

least three negative impacts on an individual.

• To be able to differentiate between the responsibilities of the healthcare system and those of an individual with regards to burnout.

• To list several approaches to decrease burnout at an individual level and at an organizational level.


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Ethical & Legal Issues, Practice Management, Mental HealthSession credits: 1 Mainpro+

4:45pm to 5:45pm LECTURE HALL 2Metacognition and Avoid Clinical Errors in Medical Decision-MakingVu Kiet Tran, MD, CCFP(EM), MHSc, MBA, CHE

As front line professionals, one of our most significant roles is that of diagnosis and initial management. But many factors contribute to errors. Medical knowledge is not the primary cause of errors, but cognitive biases. How do they impact our thinking? That is the science of Metacognition. So, do you know what is unconsciously impacting your medical decision-making? How do you recognize them? Can you change to improve your error rate? Come see and understand what has been plaguing you all this time.

Learning Objectives• List the cognitive biases.

• How to recognize cognitive biases.

• Prevent cognitive biases from negatively impacting your medical decision.


Friday, May 10th, 2019

Cardiovascular MedicineKeynote credits: 1 Mainpro+

8:30am - 9:30am LECTURE HALL 2KEYNOTE IIIManagement of Aortic Valve Disease and Aortopathies: A Primer for Primary CareSubodh Verma, MD, PhD, FRCSC, FAHA

Diseases of the aortic valve and ascending aorta remain an important cause of morbidity and mortality, particularly among, the aging population. the purpose of this presentation is to provide a primer on the diagnosis, and management options for these two important diseases with a focus on newer approaches and clinical practice guidelines.

Learning Objectives• At the end of the lecture, participants should be able to

discuss the pathophysiology, natural history and indications to intervene on aortic valve diseae or ascending aortic aneurysms.

• At the end of the lecture, participants should be able to discuss the various modalities available to treat aortic valve and ascending aortic aneurysms.

• To understand when to refer and what complications to watch for with respect to these two conditions.

Oncology & Hematology, Screening & PreventionSession credits: 1 Mainpro+

10:15am - 11:15am LECTURE HALL 1Approach to Cancer-Related AnemiasKevin Kuo, MD, MSc, FRCPC

Anemia is a common occurrence in cancer patients. Etiology is often multi-factorial, stemming from both the disease and complications from treatment. Elucidating the tempo and kinetics of the anemia, the association (or the lack of) with other cell lines, and distinguishing between underproduction and hemolysis, using commonly accessible tests, are key steps in determining the underlying cause(s) of the anemia. Anemias that require urgent stabilization and referral to specialized centres for management, such as thrombotic microangiopathy and disseminated intravascular coagulation, will be discussed in the presentation.

Learning Objectives• Outline a practical diagnostic approach to common anemia

scenarios in cancer.

• Discuss variants in transfusion practices thresholds.

• Discuss circumstances that warrant an urgent referral.


pri-med.ca/APP10

Screening & Prevention, Ophthalmology, PediatricsSession credits: 1 Mainpro+

Dermatology, PediatricsSession credits: 1 Mainpro+

11:25am - 12:25pm

11:25am - 12:25pm

LECTURE HALL 1

LECTURE HALL 2

Vision and Learning: What this Means at the Primary Care LevelRajvinder Pabla, OD, MSc

Pediatric RashesSaul Greenberg, MD, FRCPC

With 80 percent of learning being visual, this presentation will explain how comprehensive eye exams play an important role in unlocking a child’s potential to succeed in the classroom. Attendees will learn how vision and learning are intertwined and what testing techniques can be used at the primary care level to improve the early detection and treatment of vision disorders. The components of comprehensive pediatric eye exams and vision screenings will be explored.

Learning Objectives• Attendees will learn what necessary steps can be taken to

help detect vision disorders in children and when to refer to an eye care professional.

• Attendees will understand the pivotal role vision plays in children’s’ academic and social outcomes.

• Attendees will understand the difference between a comprehensive eye exam and vision screening.

Viral rashes in children take on many forms and can be difficult to diagnose. This program will help the physician diagnose these rashes based on morphology and clinical presentation. A brief description of the course and treatment of these rashes will be presented. Both common and rarer viral rashes will be discussed allowing family doctors to feel more confident in specifying the cause and treatment of the viral rashes they encounter.

Learning Objectives• Identify and classify viral rashes based on morphology and

clinical presentation.

• Differentiate between similar looking viral rashes.

• Manage coarse and treatment of viral exanthems.


Infectious Disease, Screening & PreventionSession credits: 1 Mainpro+

10:15am - 11:15am LECTURE HALL 2Using Antibiotics Wisely Campaign: Antimicrobial Stewardship in Community PracticeAllan Grill, MD, CCFP (COE), MPH, FCFP, CCPE

Choosing Wisely Canada (CWC) is a national organization to help clinicians and patients engage in conversations about reducing unnecessary tests and treatments to support effective care choices. Over the past two years, CWC has partnered with the College of Family Physicians of Canada to advance a campaign focusing on antibiotic overuse in primary care. Two major contributors include unnecessary antibiotic prescriptions for upper respiratory tract infections, as well as asymptomatic bacteriuria in long-term care. In partnership with the Public Health Agency of Canada, the ‘Using Antibiotics Wisely’ campaign was created to integrate evidence-based approaches into practice that support principles of antimicrobial stewardship to reduce antibiotic resistance and adverse events. This presentation will focus on the development and

dissemination of practice statements and knowledge translation tools related to the above campaign to support continuing professional development for primary care providers. Resources to enhance patient education and engagement will also be shared. Learning Objectives

• To reflect on the barriers influencing inappropriate use of antibiotics to treat viral upper respiratory tract infections and/or asymptomatic bacteriuria.

• To appreciate the consequences of antibiotic overuse in primary care and the important role clinicians can play to influence practice change.

• To incorporate evidence-based tools at the point of care that support antimicrobial stewardship.

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Palliative care, Ethical & Legal Issues, Practice ManagementKeynote credits: 1 Mainpro+

1:50pm - 2:50pm LECTURE HALL 2

KEYNOTE IVIntegrating Palliative Care into Family PracticeSandy Buchman, MD CCFP (PC) FCFP

This keynote lecture will make the case that Family Physicians/Primary Care Providers should incorporate a palliative care approach into their practices. The argument will be made that not only should palliative care be fully integrated into a family practice, but FPs/PCPs need to take ownership of palliative care much like they did when they assumed ownership of diabetes care and chronic disease management. Palliative care is core to the practice of family medicine in 2019. When patients are living with life-limiting illness, they and their families want to receive this kind of care from their most trusted and intimate health care provider – their FP/PCP. This is readily do-able and

so important for patients and their loved ones. And the rewards that the FP/PCP who provides palliative care brings great satisfaction and meaning back to the practice of medicine.Learning Objectives• Discuss the recommended palliative care approach/model for

FP/PCPs in 2019.• Embrace the critical role of the FP/PCP in collaborating with an

inter-professional team to provide palliative care in the primary care setting.

• Describe the palliative care skill sets/competencies required by the FP/PCP to provide primary palliative care to their patients.

Screening & Prevention, Sports MedicineSession credits: 1 Mainpro+

Cardiovascular MedicineSession credits: 1 Mainpro+

3:35pm - 4:35pm

3:35pm - 4:35pm

LECTURE HALL 2

LECTURE HALL 1

HEPA: Who Needs It, How Is It Used, And How Do I Prescribe ItLaura Cruz, MSc, MD, CCFP(SEM), Dip Sport Med

Pacemaker Limbo: How Low Can You Go?Douglas Ng, MD, FRCPC (Cardiology)

Non-communicable diseases can be prevented and managed by regular physical activity, particularly in those who are not meeting internationally recognized weekly physical activity recommendations. Primary care providers are optimally positioned to explore physical activity benefits and goals with patients. Interview skills already in use can be readily applied to the prescription of exercise. In this lecture, strategies that have been successful in Europe will be reviewed, in the context of applying them to the Canadian health care environment. Straightforward, practical tips that help patients adapt a healthier more active lifestyle will be reviewed and shared.

Learning Objectives• Following this presentation attendees will be able to

discuss strategies that have been shown to increase patient adoption of healthier, more active lifestyles in other countries.

• Be readily able to discuss healthy lifestyle goals that include physical activity with their patients.

• Know how to develop a manageable, achievable plan with patients that helps promote sustained behaviour change without overburdening the office practice schedule.

Discussion on bradycardia, including management, classification, and diagnosis.

Learning Objectives• Develop an approach to the classification and diagnosis of

bradycardia.

• Understand and apply the indications for pacemaker implantation in bradycardia.

• Review of new and emerging technologies for the diagnosis and treatment of arrhythmia.


pri-med.ca/APP12


Nephrology, GeriatricsSession credits: 1 Mainpro+

Women’s Health, Endocrinology, Pain ManagementSession credits: 1 Mainpro+

4:45pm - 5:45pm

4:45pm - 5:45pm

LECTURE HALL 2

LECTURE HALL 1

Chronic Kidney DiseaseMurray Berall, MD, FRCPC

The Diagnosis and Management of EndometriosisJamie Kroft, MD, MSc, FRCSC

Who with CKD is at risk of progression? Did I sleep through the prior lectures on this? Who does my local nephrologist need to see? After today, where can I find the information?

Learning Objectives• Appreciate the importance of measuring urinary ACR to

predict future risk of CKD progression.

• Appreciate the importance of looking for and treating sleep apnea with CKD.

• Appreciate the online tools available from our national guideline bodies to help in achieving targets.

This lecture will provide an up-to-date, practical summary on the management of endometriosis for the primary care physician. This important condition affects about 10% of reproductive-aged women and can cause significant pain and infertility, negatively impacting quality of life and productivity. The average time to diagnosis is unfortunately about 9-10 years. The aim of this lecture will be to improve patient care by outlining the key components on history, physical exam, bloodwork and imaging for the diagnosis of endometriosis as well as to provide an evidence-based management strategy.

Learning Objectives• To be able to better identify patients that may have

endometriosis, choose the appropriate initial diagnostic tests and know when to refer to a gynecologist.

• Participants will be able to classify the medical treatment options available for endometriosis and initiate treatment.

• To understand the impact of endometriosis on fertility and the management strategies available.

Saturday, May 11th, 2019

Screening & Prevention, Vascular diseaseSession credits: 1 Mainpro+

8:30am - 9:30am LECTURE HALL 1Aortic Aneurysm Management 2019Douglas Wooster, MD FRCSC FACS FSVS RVT RPVI

This presentation will include a discussion of the importance and natural history of abdominal aortic aneurysms (AAA) and associated vascular pathology. AAA represent a significant population health issue and are treatable to avoid death from rupture. The new aneurysm screening guidelines (2018) from the CSVS and SVS will be presented and strategies for implementation identified. Previous studies have shown low uptake on AAA screening in Canada; a mini practice audit tool will be introduced to facilitate guideline implementation. The importance of genetic and family clusters of AAA will be noted. Appropriate assessment for diagnosis and surveillance will be discussed. Medical management, as well as, operative and

endovascular intervention will be reviewed. Controversies in AAA management will be discussed. Future directions will be explored.

Learning Objectives• Recognize the natural history of AAA and the importance of

appropriate management.

• Discuss appropriate medical and interventional management of AAA and identify care gaps in screening, surveillance and intervention for AAA.

• Present strategies to implement screening and management for AAA to improve care in a family practice setting.

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Rheumatology, Screening & Prevention, Pain ManagementSession credits: 1 Mainpro+

OrthopedicsSession credits: 1 Mainpro+

10:00am - 11:00am

8:30am - 9:30am

LECTURE HALL 1

LECTURE HALL 2

Patients Centered Protocols in Rheumatic Diseases and Widespread PainShikha Mittoo, MD MHS FRCPC

Hand and Wrist DisordersOlubukunola Ayeni, MD, MPH, FRCSC

This lecture would be an introduction to different pain syndromes, Fibromyalgia (FM), and interplay with Systemic Conditions. Besides an explanation regarding the burden of pain in RA and OA, It also provides the differentiating clues between FM and Inflammatory Arthritis (RA, PsA, AS, Late-Onset RA syndrome of PMR, OA). Also an integrated framework and suggested treatment pathways for the identification of Inflammatory Arthritis would be introduced and for a better application of the presented framework different cases are going to be discussed.

Learning Objectives• To describe Pain Syndromes, Fibromyalgia (FM), and

interplay with Systemic Conditions.

• To introduce Differentiating Clues Between FM and Inflammatory Arthritis (RA, PsA, AS, Late-Onset RA syndrome of PMR, OA).

• To discuss potential therapeutic approaches to rheumatic diseases and widespread pain.

Management of common hand and wrist injuries.

Learning Objectives• To better assess common hand and wrist injuries.

• To learn best evidence based practice for management of common hand injuries.

• To expand knowledge of options for hand conditions.


Men’s Health, Women’s Health, Immunization Keynote credits: 1 Mainpro+

11:30am - 12:30pm LECTURE HALL 1KEYNOTE VMedical Breakthroughs - From Liquid Biopsies to Custom Immune CellsPeter Lin, MD, CCFP

A glimpse into the future of medicine. This lecture will discuss all the upcoming technologies and platforms that will change how we practice medicine. Things like liquid biopsies and custom made killer cells for cancer. Our practice of medicine will be very different so lets embrace it grow with it.

Learning Objectives• Understand the cutting edge developments in oncology.• Understand the latest in robotic surgery.• Understand the future diagnostic tests that we will be using.

Endocrinology, Women’s Health, Men’s HealthSession credits: 1 Mainpro+

10:00am - 11:00am LECTURE HALL 2Updates in the Management of OsteoporosisSandra Kim, MD, MSc, FRCPC

There continues to be a large care gap in the management of patients at high risk for osteoporotic fractures. This has been compounded by confusion and controversy over issues related to fracture risk assessment, duration of osteoporosis treatment, drug holiday, and concerns of harms associated with long-term pharmacotherapy. This presentation will identify best practice evidence, as well as highlight current gaps in knowledge and quality on the management of osteoporosis in primary care.

Learning Objectives• Compare fracture risk assessment strategies in identifying

those who may benefit from osteoporosis treatment.

• Explain absolute benefits and harms of osteoporosis treatment.

• Identify when an osteoporosis drug holiday may be appropriate or inappropriate.

MAINPRO+ WORKSHOPS

pri-med.ca/APP14

Thursday, May 9th, 2019MAINPRO+ WORKSHOPS

Identifying Opportunities For Improvement In Primary Care Practice - Where Do I Begin?Patricia O’Brien, RN, MScCH

Learning Objectives• Explore primary care case scenarios that demonstrate

applicability for QI as an approach to positive change.• Reflect on your work environment and community to

identify opportunities for improving quality.• Develop an action plan for improving one of the identified

opportunities for change.

Ten-Minute CBT: A Three-Credit-Per-Hour WorkshopGreg Dubord, MD

Learning Objectives• Learn to break patients away from their “empathy

addictions.• Learn to structure ten-minute appointments to maximize

impact.• Learn the vital importance of not working harder than

most patients.

Ultra-brief CBT for Worries & Fears: A Three-Credit-Per-Hour WorkshopGreg Dubord, MD

Learning Objectives• Learn to pinpoint key anxiety-causing beliefs.• Learn highly-modular treatment protocols.• Learn to match interventions to individual patients.

PBSG AdHoc Workshop: Type 2 Diabetes & Autism Spectrum Disorder in ChildrenJames Faught, BSc, MSc, M.D, CCFP, FCFP

Learning Objectives• This module will enable clinicians to appropriately screen

patients for T2D; implement evidence-based treatment and prevention strategies; use appropriate metabolic targets and develop office-based strategies for effective ongoing monitoring; and counsel patients on self-management.

• This module will help clinicians to identify risk factors, developmental red flags and symptoms that may be early signs of ASD; use and interpret screening/case finding tools to identify children who may have ASD; provide guidance and resources to parents regarding effective management strategies for challenging behaviours while waiting for specialty referral, including dispelling myths; and counsel parents about the evidence for effective ASD treatment and prognosis.

PBSG AdHoc Workshop: Cardiovascular Disease: Primary Prevention & Prescribing Physical Activity: Using a Vital Signs ApproachDeanna Telner, MD, MEd, CCFP, FCFP

Learning Objectives• This module will enable the clinician to assess

cardiovascular risk for the purposes of primary prevention using a patient-centered, primary care-based approach; utilize strategies that promote and encourage lifestyle change for CVD risk reduction reflecting on available regional community resources; and discuss the benefits, risks and role of pharmacotherapy to reduce individual CVD risk while promoting informed patient decision-making.

• This module will enable clinicians to effectively engage in an assessment of patient physical activity levels; confidently apply a variety of strategies to raise awareness of and encourage an increase in physical activity in patients; and provide evidence-based recommendations for physical activity for patients both with and without specific medical conditions (examples featured in this module include osteoarthritis and coronary artery disease).

Interpersonal Psychotherapy (IPT) for the Treatment of Major Depressive DisorderMichael Pare, B.SC. M.SC. M.ED. M.D; Howard Schneider, MD, MDPAC(C), CCFP; Joel Shapiro, MD, FRCP(C); James Whyte, B.SC.N., MD, CCFP; Chase Everett MCMURREN, BA, BED, MD, CCFP

Learning Objectives• Describe the theoretical foundations of Interpersonal

Psychotherapy (IPT).• Describe the four foci of treatment in Interpersonal

Psychotherapy for Depression (IPT).• Describe the beginning, middle and ending treatment

phases of IPT.

9:00

am -

12:0

0pm

1:00

pm -

4:00

pmPrice: $450 + HST

Price: $495 + HSTPrice: $495 + HST

Price: $350 + HST

Price: $350 + HST

Price: $350 + HSTRoom: 103 Credits: 9 Mainpro+

Room: 102 Credits: 9 Mainpro+ Room: 102 Credits: 9 Mainpro+

Room: 103 Credits: 8 Mainpro+



15


Child Health Nutrition - Hidden SugarLuisa Barton, NP-PHC, BScN, MN, DNP; Viola Antao, MD, CCFP, MHSc, FCFP; Behnaz Abedi, BSc, MScCH, RD, CDE; Nicole Bourgeois, MSc, RD; Daniel Sellen, Professoriate Tn-Strm

Learning Objectives• Recognize challenges with healthy eating.• Describe discrepancies about perceptions of healthy

versus unhealthy foods.• Review current WHO guidelines for sugar intake.• Use physical activity reports to identify personal level

of activity.

PBSG AdHoc Workshop: Hepatitis C: Update on Testing and Management in Primary Care & Travel Medicine: Pre-Travel ConsultationJames Faught, BSc, MSc, M.D, CCFP, FCFP

Learning Objectives• This module will enable clinicians to appropriately test

for HCV; order follow-up diagnostic investigations and refer for hepatitis C treatment; and counsel patients regarding prevention, harm reduction, diagnosis and available treatment options.

• This module will enable clinicians to take a thorough medical travel history and identify high risk travellers who would benefit from more detailed travel medicine expertise, including consultation where available and accessible; provide education and preventive counselling, recommend vaccinations and prescribe prophylactic medications as appropriate for travellers; and provide preventive advice in specific populations such as those visiting friends and relatives in high risk areas, those engaging in high risk activities, and pregnant women.

PBSG AdHoc Workshop: Dementia: A Stepwise Approach to Investigation and Prevention & Syncope in AdultsMary Manno, BScN, MD, CCFP

Learning Objectives• This module will enable clinicians to develop a stepwise

approach to assessment of memory concerns and dementia diagnosis; choose and utilize appropriate tools to assess for cognitive impairment; and discuss evidence for dementia prevention strategies with patients.

• This module will enable clinicians to identify syncope and differentiate benign from potentially life-threatening causes; appropriately investigate a patient presenting after syncope; and manage common causes of benign syncope.

Family Doctor LeadershipDanielle Martin, MD; David White, MD; Michael Kidd, MDLearning Objectives• Enhance authentic leadership abilities.• Identify and develop the natural assets we bring as

family doctors to leadership in healthcare.• Practice leadership skills, including presentation, self-

assessment and feedback.

Keeping Good Professional Boundaries in Medical Practice Michael Pare, B.Sc. M.Sc. M.Ed. M.D; Gail Erlick Robinson, MD, FRCP (C)

Learning Objectives• The different between Boundary Crossings and Boundary

Violations.• What do we mean by a “boundary” in a doctor-patient

relationship?• What is the therapeutic frame?

PBSG AdHoc Workshop: Pediatric Snapshots: GI Issues & Anxiety in Children and Adolescents: Assessment, Treatment and PreventionDeanna Telner, MD, MEd, CCFP, FCFP

Learning Objectives• This module will enable clinicians to evaluate and

manage rectal bleeding in the otherwise well infant (including cow’s milk allergy); manage functional constipation in the older child; and diagnose and manage gastroesophageal reflux (GER) versus gastroesophageal reflux disease (GERD) in infants.

• This module will enable clinicians to consider prevention and early intervention strategies in children or adolescents at risk for anxiety disorders; recognize and assess a child or adolescent with anxiety; and manage social, generalized and separation anxiety disorders – including non-pharmacologic and pharmacologic treatment approaches, and patient/parent/family dynamics.

9:00

am -

12:0

0pm

1:00

pm -

4:00

pmPrice: $300 + HST

Price: $350 + HST

Price: $350 + HST

Price: $250 + HST

Price: $300 + HST

Price: $350 + HST







MAINPRO+ WORKSHOPS

pri-med.ca/APP16


PBSG AdHoc Workshop: Managing Multimorbidity in Primary Care & Hair Loss in AdultsMary Manno, BScN, MD, CCFP

Learning Objectives• This module will enable clinicians to engage in shared

decision-making with patients with multimorbidity to define and develop specific approaches to meet their goals of care; balance multiple practice guidelines and best evidence with goals of care and clinical prognosis in order to enhance patient well-being and functional status; and organize community-based care (office, home) and systems to support patients with multimorbidity.

• This module will help clinicians to prioritize a differential diagnosis and perform an appropriate work-up for hair loss; provide evidence-based treatment options and information/support for patients who are concerned about hair loss; and initiate appropriate specialist referral.

Practical Consideration of Transference & Countertransference in Medical Practice (Especially With Regard To The Difficult Doctor Patient Encounter)Michael Pare, B.Sc. M.Sc. M.Ed. M.D; Mel Borins, MD, FCFP, MGPPA

Learning Objectives• Know what is meant by Transference and what is meant

by Countertransference.• Define the concept of transference as false distortions

and/or true perceptions in regard to the patient’s feelings and thoughts and attitudes from other important relationships.

• Define the concept of countertransference as a false distortion or a correct perception. It can be that the physician recognizes something about the patient that the patient is unaware of.

• Discussion of the difficult-doctor patient encounter.

Spirometry Interpretation: The Challenge of Distinguishing Between Asthma and COPDAnthony D’Urzo, MSc, BHPE, CCFP, FCFP

Learning Objectives• Recognize the spirometric overlap between asthma and

COPD.• Correctly interpret spirometry cases applying a user-

friendly spirometry interpretation guide.• Understand the measurements of lung function and

their application to spirometry interpretation.

9:00

am -

12:0

0pm

9:00

am -

12:0

0pmPrice: $350 + HST

Price: $300 + HST

Price: $100 + HSTRoom: 103 Credits: 8 Mainpro+



17 www.pri-med.ca

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CONFERENCE PROGRAM - Pri-MedKeynote credits: 1 Mainpro+ 8:30am - 9:30am 10:15am - 11:15am 10:15am -...

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