A Lifetime of Prevention: Dr. Vivien Brown on women’s health, and why you should never be too busy for yourself

Dr. Vivien Brown has been a family physician in Toronto for more than 35 years, and is the Vice President for Medical Affairs of Medisys Corporate Health, a national network of medical clinics dedicated to preventative health care.

 

By Marie Moore

 


 

 

“No matter who I see, no matter what age group, when we’re talking about preventative health, women will say, ‘I know I’m supposed to do that, but I just don’t have the time.’”

It’s a paradigm that Dr. Vivien Brown has been dealing with throughout her long career. She’s been a family physician in Toronto for more than 35 years, and is the Vice President for Medical Affairs of Medisys Corporate Health, a national network of medical clinics dedicated to preventative health care. In her practice, she hears a variety of explanations from women regarding what makes them “too busy” ― from work demands to raising kids to taking care of elderly parents. Her response to each one is the same.

“I rephrase it for them. Everybody has 24 hours in a day. What you’re saying is that your health is not a priority. And if your health is never a priority, you and your family will pay the price.” She also doesn’t hesitate to point out just how high the stakes are, citing statistics on heart disease, the leading cause of death among Canadian women, as an example: “The first heart attack is fatal for 50% of women, and of those that survive, another 25% die within the next 12 months.”

Changing how women view their self care is just one of many goals Dr. Brown has focused on in a long career dedicated to preventative health. In addition to her practice, Dr. Brown is an award-winning educator in women’s health, and has lectured locally, nationally and internationally on preventative medicine. She serves on the Board of “Immunize Canada,” on McGill’s Medical School Advisory Board, as well as on the board of the Women’s Brain Health Initiative. And as the immediate Past President of the Federation of Medical Women of Canada, she’ll be speaking as the Canadian delegate to the UN’s Commission on the Status of Women in March of 2017.

With so many commitments, it’s amazing that Dr. Brown is able to maintain balance in her own life. Her secret is to ensure that whatever task she is focused on gets 100% of her attention. “I don’t want to carry the burden of one thing as I try to do another thing. So when I’m seeing patients, it’s 100% patient care. When I’m with my family, it’s 100% my family. I’m connected and giving quality time to whatever I’m doing, and then moving on.”

 

“When I’m seeing patients, it’s 100% patient care. When I’m with my family, it’s 100% my family. I’m connected and giving quality time to whatever I’m doing, and then moving on.”

 

Dr. Brown also makes time for her own preventative health care efforts, aiming for 10,000 steps a day, tracked by a FitBit. It’s a goal that works well for her, and she encourages individuals to figure out in their own schedule what exercise they can do on a daily basis, “because a pilates class once a week is not enough.” She also emphasizes the importance of not smoking ― even one to two cigarettes a day doubles your risk of heart disease ― and committing to your health care efforts fully, including following the advice of your doctor.

“When we do a preventative health assessment at Medisys, and we give people advice, you need to follow it. There’s no point being told you have high blood pressure, and then taking your pills most of the time rather than all of the time. When you have a risk factor that’s identified ― and 9 out of 10 Canadians have at least one risk factor for heart disease ― you want to really follow the instructions to get to the target.”

For those Canadians who are motivated to take charge of their own prevention efforts, Dr. Brown recommends preventive healthcare services like Medisys. While there’s no doubt that she’s a fantastic family doctor ― in 2012, the College of Family Physicians of Ontario named her “Physician of the Year for the Region of Toronto” ― she admits there are limitations in the public healthcare system that push her towards putting out fires rather than prevention.

“In my private practice, I see about 30 people in a day. That’s pressured, and not a lot of time with each individual. You can’t possibly give them the amount of attention that you want to. At Medisys, I see four patients in a day. I can go over all the details, rather than just focusing on the most important thing for the day. I like to think that the overview we give patients allows them to calibrate their health, from where they have been to where they are, and enables us to give recommendations on where they should be going.”

 

 

 

Dr. Brown is a noted family physician and international and national speaker on health prevention, wellness, continuing medical education and women’s health. She is a member of numerous advisory bodies for both the provincial and federal government, helping make decisions regarding healthcare of Canadians. In her role as Vice President for Medical Affairs of Medisys Corporate Health, she focuses on preventive health care. To learn more about Medisys preventive healthcare services watch this video.

How one man and thousands of fish are helping improve women’s health worldwide

Gavin Armstrong in India

Solving one of the world’s most common women’s health problems may be as simple as dropping a fish in water. Gavin Armstrong, Founder, President and CEO of Lucky Iron Fish, tells us how.

By Teresa Harris


Iron deficiency is the world’s most common micro-nutrient issue, and has a disproportionate negative impact on women and children. Instances are increasing, as the traditional method of combating iron deficiency via pill supplements is expensive, inaccessible to many, and simply not very effective. In short, worldwide we’re spending more on a problem that’s just getting worse.

Introducing Lucky Iron Fish, a sustainable solution to iron deficiency in the form of a simple cooking tool. When added to a cooking pot and boiled for ten minutes, the small, fish-shaped piece of iron can fortify your food with enough iron to noticeably alleviate symptoms of extreme iron deficiency.

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The founder of Lucky Iron Fish is Gavin Armstrong, a University of Guelph graduate who has dedicated his career to the improving the health of individuals — primarily women and children — around the world.

Gavin realized an imminent need for a focus on micro-nutrient deficiency related health problems following a volunteer trip to a refugee camp in Northern Kenya, where he witnessed communities in dire need of proper nutrition.

“There is a ‘hidden hunger’ that often goes unrecognized, as the supplies food banks have to give usually don’t address micro-nutrient deficiencies. Thus we’re failing to address the questions of: What is the long term impact of a diet consisting solely on non-nutritious food, like beans and rice? And how does it affect these people’s development?”

Signs of iron deficiency range from dizziness to fatigue, and can even cause hemorrhaging and spells. Pregnant mothers are particularly vulnerable, as nearly every pregnant woman suffers from iron deficiency during and post pregnancy, and if untreated, their unborn child is at risk of its own associated health issues, including limited cognitive development.

“We’re failing to address the questions of: What is the long term impact of a diet consisting solely on non-nutritious food, like beans and rice? And how does it affect these people’s development?”

“When a mother is iron deficient, she can be so ill that she may miss work.” Gavin explains. Mothers in Cambodia lose approximately two weeks of work due to iron-deficiency related sickness. “When you consider their already meager income — about 70-80 cents per day — that’s a substantial loss.”

Upon returning to Canada, Gavin decided to set out on solving this issue.

Gavin Armstrong in IndiaWith an undergraduate degree in commerce, a masters in rural planning and development, and a PhD in biomedical science, Gavin is the first to admit that his academic path has been what many would call “non-traditional.” But he appreciates that this unique path brought him to exactly where he needed to be, allowing him to recognize that in order for his solution to micro-nutrient deficiency to be successful, it needed to be sustainable.

The primary recipients of donated fish are nonprofits and clinics and organizations that are focused on women’s health and nutrition. These include food banks, First Nations organizations here in Canada, as well as nonprofit organizations in Cambodia and India, which allows Lucky Iron Fish to distribute as many fish as possible to the pots of families in need.

Yet, Gavin admits he’s made his share of mistakes. “I won’t say I’m infallible,” he concedes, having learned through trial and error that cultural differences play a huge role in how readily accepted new innovations will be. “I think that abroad, dispelling taboos and myths was our biggest challenge. ‘Deficiency’ is not a term that’s understood, so instead we began to talk about the signs and symptoms and how using Lucky Iron Fish could help alleviate things like fatigue and headaches and make people stronger.” As they worked to educate women, dispelling false myths such as if you’re menstruating in Cambodia you’re not supposed to eat meat, Lucky Iron Fish was more readily adopted.

And in the parts of the world where iron deficiency is most common, it’s most important that women are on board.

“In traditional communities like Cambodia or India, the head of the household is typically the matriarch, and she prepares every meal. Gavin with woman in IndiaWhen she uses Lucky Iron Fish, she is empowered, knowing she is having a direct and positive impact on her family’s well-being.”

Gavin is a deep believer that when you empower women, you’re empowering the future. “Women hold the key to the success of the future. Children are the next generation and they believe in and learn so much from their mothers. Especially in Cambodia and India, when the values of the household are situated around the mother, you see the power she has in influencing her children to make healthy choices as they grow.”

And it’s working. Quantitative clinical data revealed consistent use of Lucky Iron Fish resulted in healthier hemoglobin levels, and mothers reported less fainting, as well as associated physical and mental improvements in their children.

“Women hold the key to the success of the future. Children are the next generation and they believe in and learn so much from their mothers.”

But the work of dispelling taboos and myths associated with women’s health is not limited to developing nations. “Here in Canada, we shy away from talking directly about women’s health, which is a problem when the female body, especially during reproductive age, has an incredibly unique need for nutrients.” When it comes to women’s health, experience is needed to add depth to the conversation around innovation, and by taking women’s perspectives so closely into consideration, Lucky Iron Fish addresses a need in a way that may have otherwise gone overlooked.

“One of the best parts of Lucky Iron Fish is the buy one get one program, which draws a direct connection between the women in North America and the women in developing nations who are both benefiting from the exact same technology,” Gavin explains. Unlike programs that donate money after a Western consumer buys a product, creating a hierarchy of “saviour vs saved,” when you put this fish in your pot, someone around the world is doing the same, proving that in spite of the racial, geographical and cultural divides, iron is equally important to everyone. To date, 80,000 Lucky Iron Fish have been sold, and 80,000 fish have been given away for free.

In terms of career role models, Gavin has always looked up to leaders who’ve defied the odds or done things differently in the fields of business, society, and politics. “I believe in the outsider, and the idea that you don’t have to conform to be successful,” he says. “Look at Hillary Clinton. She is someone who persevered and turned that perseverance into something impactful.”

Gavin also wants to show how being financially successful and socially responsible are not mutually exclusive. “If I can prove through Lucky Iron Fish that social enterprises are profitable, sustainable, and effecting global change, I consider that a success.”

Learn more about the impact Lucky Iron Fish has had in developing communities, their awards and accolades, and how you can get your own.

A Case Study in Building a Brand with Leslie Beck

Leslie Beck is a Registered Dietitian with a private practice at Medisys in Toronto, and Globe and Mail columnist who has published 12 books since 2000.

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I entered my first year at UBC with the intention of becoming a lawyer. I took biology courses too because I had always loved the subject. I decided early on I wanted to be a corporate lawyer so, during my second year, I focused on courses that would lead to a commerce degree. But they just didn’t interest me like the sciences did. In fact, I nearly failed my economics class. At the end of the academic year I told my mother I was going to quit university and become a flight attendant. My mom was a pioneer really: she earned a MBA while working full-time and raising two kids on her own. She wasn’t happy about my desire to drop out of school (neither was I), so I researched degree programs in the human sciences. That’s when I learned about dietetics and I’ve been in the field ever since.

When I first started working as a dietitian in private practice, I was incredibly motivated to build my business. I was putting in long hours, and although I didn’t realize it at the time, I was developing a brand. And in the 20 years since, I feel I’ve learned a few things about branding yourself.

1. Be an early adopter
When I started out, desktop publishing was cutting edge. It’s a term we never hear or use anymore, but I jumped on it back then. I worked as a dietitian and ran a side business from home, publishing newsletters and communication materials for the Canadian Diabetes Association, for medical journals and other groups in the health field.
The brand impact: I learned how these organizations needed to market themselves to their audiences; how they could best present their messages and brand. And that helped me when it came to doing the same for myself and my business.

2. Create opportunity
I was asked to do a health segment for a local television station and when it was over, the producer said, “That was great. We should do it again sometime.” I went home and drafted a proposal for a weekly
lunchtime spot and faxed it to him the next day. He loved the idea, but said there wasn’t any money to pay me. So, I drafted another proposal and secured a sponsor. That first year it was the Ontario Milk Marketing Board—they paid me as well as station. After, Quest Vitamins sponsored the segment.
The brand impact: That tv spot lasted for six years and led to other tv appearances, including hosting a daily show on the Discovery Channel and 14 years as an on-air expert for CTV’s Canada AM. These platforms helped me expand my practice and become known as an expert in my field.

3. Upgrade constantly
Things in my industry change quickly as scientists uncover new findings about diet and health. In order to do educate my clients and readers on how the latest nutrition findings—and foods—apply to their lives, I have to stay on top of it all. I spend weeks at a time attending conferences and taking courses in the United States and Canada. Researching and writing books and my weekly Globe and Mail column also keeps me current.
The brand impact: I’m able to present my clients and readers with the most up-to-date information and advice, which increases their odds of succeeding with their goals. And it solidifies me as an expert.

4. Choose partners carefully
If a public relations firm asks me to do a media campaign for their client, I have to be extremely confident in that brand to even consider the proposal. I am very careful about how my brand is positioned.
The brand impact: Integrity matters. Be known for having it.

5. Maintain the brand
In the early days especially, I sat on committees that interested me. I was definitely one of those people who said “yes” to volunteer opportunities in my field (until I learned you have to start saying no). I probably didn’t realize I was doing it at the time, but I was networking.
The brand impact: I was meeting other people who could help me at a later point in my career; it was great exposure for me and for my future brand.


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Lesie was a 2014 Women of Influence Health Panelist – beginning in Toronto and travelling to Calgary, Vancouver, Ottawa and Montreal – helping women battle stress and encouraging them to put their health FIRST. You can also watch the video of the Toronto event here!

Intern of Influence: Adding Confidence to your Toolbox

I am always inspired by the Women of Influence keynote speakers and magazine contributors. They give practical advice that truly resonates with me. If I could manage to somehow translate my enthusiasm into actually TELLING these women how much they influence me…that would be fantastic.

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How healthy are you?

Dr. Brown is a noted family physician and international and national speaker on health prevention, wellness, continuing medical education and women’s health. She is a member of numerous advisory bodies for both the provincial and federal government, helping make decisions regarding healthcare of Canadians. She was awarded, Family Physician of the Year, 2012 by the Ontario College of Family Physicians.

Profile: www.linkedin.com/in/drvivienbrown


The Benefits of having a Personal Health Risk Assessment

Don’t we all want to know how we’re doing from a health point of view and if we’re on the right track? That was a question posed centuries ago by the learned Hippocrates-the father of modern medicine who focused on diet and exercise to forecast the health of his patients.  Fast forward a few centuries later and we now have a more formal process, called the Personal Health Risk Assessment.

The process refined over the years is a four-part questionnaire used to evaluate the health risks and quality of life of patients.

The questions are based on lifestyle including what level and form of exercise is practiced, demographics such as age, sex, personal and family medical history, and physiological data such as your weight, height, blood pressure and cholesterol. Another important part of the process is your level of willingness to change your behaviour in order to improve your health.

A personal health risk assessment can have enormous benefits, whether the assessment is for an individual or used as part of an employee health and wellness program.

It provides a snapshot of your current health. Enables individuals to monitor their health status overtime. Having concrete information helps prepare you for a change in your lifestyle.  The information is there, before you, and makes it clear in black and white what needs to change.

If your company is engaged in a health prevention program –it can help determine on an aggregate basis how healthy and productive the company work population is AND what health related programs they might include such as lunch and learns, flu shot clinics, reviewing the company cafeteria menu to ensure healthy food choices are available, and introducing a health management program.

Hippocrates was imprisoned for 20 years for believing and arguing that disease was not a punishment inflicted by the gods, but rather the product of environmental factors, diet, and living habits.

The same holds true today.
You can make changes to your health—a Personal health risk assessment is one of those ways.

The more information you have—both the good and the challenges—the better able you are to make informed decisions about what you can do keep or improve your well-being.

 

Dr. Vivien Brown, MDCM, CCFP, FCFP, NCMP
Vice-President, Medical Affairs, Medisys Health Group

Women & Health Panel – Toronto, March 6, 2014

Women of Influence

From our Health Panel: For the ambitious professional woman, work is never-ending, never mind the constant care taking of families, friends and social responsibilities; as a result the unfortunate by-product is that women’s personal health now occupies the lowest priority on the to do list. A recent poll of our members revealed that only 10% of professional women make personal health their number one priority – outside of work and life – but a staggering 68% of members wished they spent more time doing so.

Moderator: Dr. Marla Shapiro; Panelists: Dr. Vivien Brown, MDCM, CCFP, FCFP, NCMP, Vice-President, Medical Affairs, Medisys Health Group, Lynn Posluns, President, Women’s Brain Health Initiative and nutritionist Leslie Beck, RD.

Genetic Testing & Drugs

Pharmacogenomics: Determining the most effective drug for your genetic makeup.

Each person is unique and so is his or her response to certain medications.  Since the mapping of the Human Genome Project was completed in 2003, a new area of study and research has opened up called, Pharmacogenomics, the technology that analyses how genetic makeup affects an individual’s response to drugs—will a drug be helpful for a specific treatment or will it be toxic? Will it help or hinder? Will you be at increased risk for certain side affects or will genetic testing help to avoid a serious adverse drug reaction.

Such approaches promise the advent of personalized medicine in which drugs and drug combinations are optimized for each individual’s unique genetic makeup.

There are two areas  pharmacogenomics is being applied.  One is in the area of cancer treatment and the other is using genetic testing to determine response to certain medications.

In the area of cancer treatment, oncologists may order certain tests that will look at the genetic features of a tumor to assess how the cancer will respond to certain types of treatment and what form of therapy would be best for a particular patient.  This is the only area today that may be covered by health insurance in Ontario.

The other use for genetic testing is in the area determining the effectiveness of certain drugs for treatments related to heart disease such Plavix or Warfarin.

We have learned that the uniqueness of our genetic makeup means that not all drugs work in the same way for all individuals or it may be hard to get the dose right.   It is not yet common practice in Canada or covered under OHIP, but genetic testing in this area can be carried out privately if your doctor determines it is warranted.  Ideally, Medisys genetic counselor, Katherine Hodson, suggests the test be carried out before a drug such as Warfarin or Plavix is prescribed to avoid adverse reactions and ensure the right dosage.

Genetic testing may also be used to determine whether certain pain relievers such as codeine will work well for a given patient.  An individual suffering from chronic pain may not respond to codeine as genetically, that person may metabolize the drug too quickly.  In this case, the patient would need a different medication and of course, given concerns about narcotics and drug seeking, how reassuring it is to have a clear medical answer about different or higher dosing requirements.

We are on the cusp of understanding more about genetics, medications, reactions, both good and bad, and that will make prescribing drugs much more personalized, with predictable and better outcomes.

Dr. Vivien Brown, MDCM, CCFP, FCFP, NCMP,
Vice-President, Medical Affairs, Medisys Health Group

Staying Strong

Among all of the incredibly inspiring stories I hear of women’s rise to the top, there are also always a few shared from women who’ve hit the wall. From one brilliant woman who described nearly breaking her neck from hitting the glass ceiling, to real life disease and depression that has stopped leaders, role models and executives in their tracks.

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Webinar: Healthy Aging with Dr. Vivien Brown

Dr. Brown is a noted family physician and international and national speaker on health prevention, wellness, continuing medical education and women’s health. She is a member of numerous advisory bodies for both the provincial and federal government, helping make decisions regarding healthcare of Canadians. She was awarded, Family Physician of the Year, 2012 by the Ontario College of Family Physicians.

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Dr. Eve Tsai, Neurosurgeon The Ottawa Hospital and Scientist

Named one of 2011’s Top 25 Women of Influence for her determination to succeed, Dr. Eve Tsai was also voted through an online poll to grace the cover of Women of Influence Magazine’s Winter issue. Her dedication and perseverance is inspiring; her breakthroughs revolutionary. Each day that she goes to work, whether as a neurosurgeon at The Ottawa Hospital, a scientist at Ottawa Hospital Research Institute, or as a mentor to students at the University of Ottawa, she is one step closer to finding a cure for spinal cord injuries. Throughout her career, Dr. Tsai has also been breaking barriers as a member of over 30 boards, including being the current president-elect of Women in Neurosurgery (WINS). Join us on March 29, 2012 to be inspired to achieve your own career breakthrough.

To read more about the Top 25 Women of Influence click here >