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Sam Solomon – Associate Editor, National Review of Medicine

By Admin | June 2, 2008

Sam Solomon is Associate Editor of the influential Canadian medical journal National Review of Medicine. We recently had a chance to get this thoughts on the Canadian healthcare system and publishing a medical journal.

Where did you go to college and what was your academic major?

I studied English and a bit of music at Bishop’s University, in Sherbrooke, Quebec.

What was your career path from college to your current position.

I ran the student newspaper at Bishop’s and then freelanced for some Quebec newspapers and magazines after I graduated.

I started a graduate program in journalism a few months after my graduation but left after one semester to take this job.

What properties do you publish?

Often in the National Review of Medicine, we tend to cover the more serious and practical questions about practising medicine in Canada and how to manage one’s practice.

The blog, on the other hand, is where we publish lighter stories — ones that will keep fast-browsing web readers coming back.

For instance, we’ve done pieces for the blog on odd news stories on Canadian healthcare, like when the deputy premier of Ontario recently said he was thinking of trying out one of those elderly incontinence diapers himself, or a story about what really killed Jane Austen.

Those are things that we probably wouldn’t have much space to devote to in NRM, but the web gives us the freedom to expand on our NRM stories and to cover all kinds of things that we otherwise might not have covered.

What is the focus of each of your publications?

NRM is geared towards doctors exclusively, although all the content is available free online to anyone who’s interested.

We cover everything from clinical news and health policy to practice management and financial and legal advice. The blog is slightly different; the target audience is physicians as well as the general public.

What has been your biggest news scoop?

I covered the quickly rising popularity of the doctor ratings website RateMDs back in 2006 before it became the internet phenomenon that it is now. We featured the site’s founder, John Swapceinski, in a front-page Q&A.

I’m not sure how much credit we can claim for the site’s subsequent popularity in Canada, but it’s undeniably become a very divisive issue, with many doctors firmly set against RateMDs and plenty of patients plus some doctors strongly in favour.

We even got a follow-up story later about an Ontario doctor who attempted to sabotage the website, and then another one later on for our blog about a suicide threat posted to RateMDs that Mr Swapceinski alerted police to.

Who is your dream interview?

I’ve been lucky in this job to have the chance to speak with some really amazing people.

I recently met two people I respect very much: Stephen Lewis, who used to be the United Nations special envoy on AIDS in Africa, and Dr James Orbinski, who was the president of Doctors Without Borders when the organization was awarded the Nobel Peace Prize in 1999.

But a dream interview? Personally, my choice would be John Brown. He was the American extremist who assembled a group of abolitionist activists in New England, New York and Canada and launched a small-scale invasion of the South in 1859, in Virginia.

He was captured by federal troops and executed for treason — all this just two years before the incident at Fort Sumter started the war that he had been trying to fight.

He was sort of a religious extremist, which I can’t say I sympathize with, but he’s nevertheless always been a hero of mine.

How do you come up with ideas for interviews and stories?

Besides talking to doctors, we read. A lot. And then we read some more. We read medical journals, newspapers, magazines, websites, online forums, medical organization newsletters, hospital notices, blogs — whatever we can get our hands on.

The key to deciding what’s important to cover, whether it’s a new drug that’s been released or a certain aspect of a new government budget, is to get a good grasp on the context of the story.

The question is always really the same one that all journalists ask themselves about every article they write – does this matter to my readers?

Are your publications profit or nonprofit?


Why do you think some Canadians travel to the United States for medical care?

The Canadian medical system’s technology use still lags far behind that of the US system’s, mostly because of funding. For exmaple, the US has something on the order of five times as many MRI machines than Canada.

Granted, Canada seems to use its MRI machines more effectively than most other countries, but still — five times fewer is a lot. And doctors here tend to be very sceptical of electronic medical records.

Of course, we know that MRI machines and electronic medical records are fast becoming necessary elements of successful medical care.

But, the way the Canadian system is funded and delievered — “from each according to his ability, to each according to his need,” essentially, if you’ll excuse my use of Marx’s decidedly unfeminist construction — means that basic healthcare is better here but advanced, high-end, high-tech care is sometimes inferior to what can be found in the US.

What aspects of the Canadian healthcare system most need to be fixed?

From a policy wonk perspective, there are a whole slew of cross-jurisdictional headaches here. Medical licensing isn’t always standardized from province to province — especially for the huge number of foreign-trained doctors who are trying to get licensed to work in Canada.

And each province has a different medicare plan, so a certain type of procedure might be 100% covered by the public system in Ontario but only 50% or even 0% covered just across the river in Quebec.

What are the best features of the Canadian healthcare system?

That vaunted socialist ideal — “from each according to his ability, to each according to his need” — is great in theory, like much of Marx’s work.

As I mentioned earlier, it’s led to a far more equitable medical system here than exists south of the border. But medicine has undergone transformative changes since Canada adopted a single-payer model in 1966.

Now that so much of medical practice is predicated on technology-heavy, expensive procedures, it must be said that the restrictions placed on Canada’s patients and its doctors, in 1966 and during later reforms in 1984, seem to be the root cause of the biggest difficulties Canada’s system is now facing.

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