Shayleah Funk, Author at Choosing Wisely Manitoba

Choosing Wisely Manitoba is proud to announce, Dr. AbdulRazaq Sokoro, PhD, FCACB, FADLM. Chief Operating Officer, Provincial Diagnostic Services, Shared Health, was awarded the Clinical Excellence in Choosing Wisely Award at the national Choosing Wisely Conference held in Montreal on April 15, 2024. This award, recognizes a clinician (physician, nursing, pharmacist, allied health) who has exhibited exceptional leadership and commitment to resource stewardship within their clinical practice, with a dedication to reducing unnecessary tests and treatments while enhancing patient care.

Dr. Sokoro has contributed to Manitoba’s health system for 14 years serving in a variety of roles including Shared Health’s Executive Director of Provincial Laboratory Operations, and Associate Head of the Department of Pathology at the University of Manitoba’s Max Rady College of Medicine

As noted in his nomination, Dr. Sokoro has supported a large number of initiatives in Manitoba, which have resulted in the following changes and improvements:

Streamlined and sustainably reduced Vitamin D testing in Manitoba by 90%
Embedded Choosing Wisely/ Resource Stewardship into curriculum with International Medical Graduate students and Post Graduate Medical Student Education
Championed the development and implementation of Manitoba Endocrine Guidelines including guidance on screening and adding reflex testing for Free T3 and T4
Introduced Provincial guidelines to reduce FOB testing of inpatients by 74%
Supported provincial guidelines for hospital labs to require a positive urinalysis prior to a urine culture, to encourage appropriate testing.

Dr. Sokoro holds a BSc (Hons) in Biochemistry and Zoology from Egerton University in Njoro, Kenya as well as a PhD in Toxicology from the University of Saskatchewan and a post-doctoral residency in Clinical Biochemistry from the Max Rady College of Medicine at the University of Manitoba. He is a fellow of the Canadian Academy of Clinical Biochemistry, Canada and the Association for Diagnostics and Laboratory Medicine in the United States.

His recent professional accomplishments beyond Choosing Wisely range from the standardization of quality oversight of point of care testing in a partnership with First Nations & Inuit Health Branch, development of a red blood cell utilization/transfusion strategy that brought Manitoba in line with the rest of Canada, to ongoing efforts to train, recruit and retain laboratory staff. Dr. Sokoro’s collaborative approach and passionate advocacy for communities, partner organizations and staff are valued assets as part of any team he is part of.

Congratulations Dr. Sokoro, your efforts and perseverance have assisted Manitoba’s current and future health providers to choose more wisely.

Patient sitting and talking with a doctor

Meeting with your healthcare provider can sometimes be stressful and anxiety inducing. Being told you require a test, treatment, surgery, or other procedure can cause a lot of emotion and confusion, especially if they’re using new vocabulary you don’t understand. Before you move forward with your provider’s proposed plans, there are four important questions you can (and should) ask.

Do I really need this test, treatment, or procedure?

This can be a difficult question to ask but knowing the potential benefits of pursuing any medical option is your right. If it’s a test, find out what information you and the team will receive from the results. If it’s a surgery or procedure, learn what improvements on your quality of life you’re going to gain. Getting details on the ‘why’s’ of potential actions can help you make informed decisions and lead to you being a better authority on your own health.

What are the risks or challenges?

These are important to know. You may be required to temporarily halt current medications you’re taking, or have side effects from new prescriptions. Additionally, there may be missed time from work or family, required travel, need for a mobility aid, or someone needed to look after you in the hours and days after a surgery. Tests may not directly impact physical health, but there is a chance of findings that may cause further testing and impact your mental health. Procedures come with possibilities of complications and follow-up appointments or actions. These factors need to be considered and potentially planned for ahead of time.

Are there safer, simpler options?

This might seem like an odd thing to ask, but it can spark a conversation with your doctor about the pros and cons of different alternatives and how they relate to your health goals. You may find the original plan is what’s best for you, or you and your team may discover that there’s a route that works better for your situation or lifestyle. This could mean choosing medication over surgery, or even simple lifestyle changes instead of medications or procedures. The goal should be to find the path that provides results that fit your needs, while minimizing risks and costs to you.

What happens if I do nothing?

Sometimes the best course of action is no action at all. Find out of your condition could get worse – or better – if you choose to remain as-is for the time being. Ask what the downsides and potential effects of that decision could be. If they’re acceptable to you, taking the extra time may allow you to pursue additional options or simply prepare for future actions, whether that’s notifying work or arranging for assistance. Additionally, you may decide the effects of inaction work better for you than the risks and benefits of the procedure overall.

It’s important to remember that you are the authority of your own health. It is both your right and your responsibility to know as much as you can when making decisions. Asking your provider these questions may help you navigate difficult, painful, or scary situations, knowing you’ve done as much as you can to be an advocate for yourself.

During the cold and flu season, common viruses like Respiratory Syncytial Virus (RSV) can lead to bronchiolitis, a lung infection primarily affecting children under the age of two. While diagnosis typically relies on physical exams, many children receive unnecessary tests and treatments, like X-rays or antibiotics, in the management of bronchiolitis.

Join Choosing Wisely Talks on January 31 at 12 p.m. ET for a discussion on why less is best when it comes to bronchiolitis. Speakers will share practical guidance in managing bronchiolitis, sharing tools and resources from the recently released Choosing Wisely Canada toolkit.

Register

Dr. Terry Wuerz inspires solutions in the realm of healthcare. Serving as an Adult Infectious Disease and Internal Medicine physician at the University of Manitoba and the Winnipeg Regional Health Authority, his focus centers on enhancing the utilization of antibiotics within the broader health system.

In addressing the crucial issue of antibiotic usage, Dr. Wuerz highlights the important question: How can we employ antibiotics judiciously to benefit not only individual patients but the entire healthcare system? Citing international data suggesting that 30-50% of antibiotic prescriptions may be unnecessary, he underscores the gravity of the situation.

The concept of ‘unnecessary’ antibiotics can be divided into two key domains—prolonged regimens and application in non-bacterial infections such as viral or other organisms. Prolonged regimens, often characterized by doctors erring on the side of caution, contribute to a concerning trend. Meanwhile, the use of antibiotics for non-bacterial infections like viral bronchitis or influenza proves ineffectual and potentially harmful.

Contrary to the perception that excess medications pose no harm, Dr. Wuerz points out a startling reality. In 2019, an estimated 5 million deaths were attributed to antimicrobial-resistant (AMR) infections, with a quarter directly resulting from antibiotic-resistant strains. Alarming predictions by a UN report suggest that by 2050, 10 million deaths could be directly linked to AMR infections, paralleling the anticipated toll of cancer.

Addressing the misconception that AMR is predominantly a foreign concern, Dr. Wuerz sheds light on the 5,400 deaths associated with AMR in Canada in 2018. He emphasizes that AMR is not a distant future threat but a current menace affecting patients within our healthcare facilities.

While acknowledging the vital role antibiotics play in treating life-threatening infections, Dr. Wuerz underscores the double-edged nature of antibiotics. Their misuse, especially in non-bacterial infections, can lead to adverse effects, including the development of antimicrobial-resistant strains.

The repercussions of AMR infections are severe—prolonged hospital stays, costlier and harder-to-obtain medications, and an elevated mortality rate. The work of the Manitoba AMR Alliance aims to increases awareness, information and strategic studies.

This call for awareness extends beyond physicians to patients, urging them to be empowered advocates in their healthcare journey. Dr. Wuerz encourages patients to pose critical questions to their providers, including the necessity of antibiotics and the likelihood of a viral infection. The Manitoba AMR Alliance, through ongoing initiatives and the opportunity to pledge antibiotic stewardship, seeks to cultivate a collective consciousness surrounding this critical issue.

Antimicrobial Awareness Week, spanning from November 18-24th, is accentuated by the Go Blue campaign illuminating landmarks across Canada on November 24th. For more information, visit the Manitoba AMR Alliance website: https://manitobaamr.ca/ #GoBlueforAMR

Pictures of the Esplanade Riel lit up blue from November 24, 2023

Dr. Sokoro Awarded at National Conference

4 Questions To Ask Your Doctor

Choosing Wisely Talks | Bronchiolitis: Why Less is Best

Join Choosing Wisely Talks on January 31 at 12 p.m. ET for a discussion on why less is best when it comes to bronchiolitis. Speakers will share practical guidance in managing bronchiolitis, sharing tools and resources from the recently released Choosing Wisely Canada toolkit.

Antimicrobial Awareness Week 2023 with Dr. Terry Wuerz