#1 Assiduité (92.1%), #1 Lowest % ER visits (1.7%) in CIUSSS Centre-Ouest de L'île-de-Montreal (2023-2024)

Bill 20


Bill 20 – will adversely affect Cote Saint Luc’s only GMF Clinic


Dear Mr. Birnbaum,

As the Medical Director of Cote Saint Luc’s only GMF clinic, I must express my concerns regarding the proposed Bill 20.

GMF Sante Kildare serves almost 20 000 registered patients in our community.  We are a group of 25 family physicians – offering medical services 365 days per year, including evenings, weekends and holidays.

We have an open, daily walk-in clinic for any patient (even “orphaned persons”).  We provide services to local Foster Homes, collaborate with McGill, coordinate with CSSS Cavendish, conduct research studies – all in an effort to provide the best, comprehensive and timely care to all persons.

We started with two physicians in October 2011 – and now pride ourselves on exceptional growth with a stellar and superb team of 25 committed doctors, nurses, and other health care professionals.

Of the 17 family doctors based at my location, 14 are female.  In fact, most are young doctors who recently completed their Family Medicine Residencies.  They were attracted to Sante Kildare for many reasons: our inclusive philosophy, teamwork, supportive network, flexibility and GMF status.

And this is my point – GMF works.  The incentives offered by previous Ministers of Health were working.  We actively remove orphaned patients from the CLSC Guichet list.  We keep doctors in our territory.  We offer extended hours.  We keep patients out of the ERs.  We cover young female doctors during maternity leaves.  We cover patient practices when doctors are away fulfilling their AMPs.

Group GMF coverage is the only solution.  80% of Family Medicine graduates are female!  While I personally work 70 hours each week, most doctors don’t.  It is ridiculous, unrealistic and unreasonable to demand young, female doctors to work 36+ hours/week.  They have made sacrifices to continue schooling to serve and heal others.  They should not be penalized for striving to balance home and work.

But this Bill punishes everyone.  Why should I be fined (or docked pay) if my patient sees another physician – even if I am open and available?  If you live in Quebec City and your family doctor works in Cote Saint Luc, should he/she be penalized if you seek urgent or semi-urgent attention locally?  What if someone lives in Dollard and works downtown?  What about chest pain at 3 am?  In all scenerios, it’s the family doctor who pays.

I care about quality.  I book 30 minutes per physical.  The RAMQ agrees that a check-up requires more time.  Am I to work 15 hours each day to meet the Minister’s quota of 30 patients?
Should I tell patients to book multiple appointments to “get through their list of problems?”

We need a system that rewards productivity – not a plan that punishes.  We need a Bill that recognizes the reality of our workforce – not an outdated, punitive vision that frowns upon families.  We need an open dialogue – not a demagogue.  Quality and commitment should be recognized and embraced – not attacked.  The family physician is the backbone of the health care system – the quarterback – the human face.  We only succeed by developing and nurturing the doctor-patient relationship – not timing it.

Family Medicine is not radiology.  We see patients – not their films.  We talk to patients – teach, advise, advocate, heal.

Please, please, please.  I urge you to visit our clinic and see how this Bill will devastate us.

Leadership should not be achieved through bullying.  We desperately need collaboration, discussion, vision.

Thank you.

Dr. Michael Kalin




& FluMist

Sans rendez-vous.

new bug

Disponible à partir du: dimanche 2 novembre

Dimanche 8 h – 12 h

lundi au vendredi: 8 h – 12 h et de 15 h – 19 h

Le Vaccin est gratuit pour tout ceux qui répondent aux critères

Is stress really bad for you?

I’m sure we have all heard that stress is bad for you. As a nurse, I have been warning people that chronic stress is bad for your health and can cause cardiovascular disease and cognitive deficits.

But what if we weren’t seeing the whole picture? What if the way we think about stress is what is affecting our health?

That’s the message in the TED talk by Kelly McGonigal, a health psychologist. According to her TED talk individuals who reported high levels of stress in the past year were more likely to die ONLY IF they also perceived stress as bad for you! That means that just changing the way you think about stress can save your life. Rather than view stress as a bad thing think about stress, think of it as a way of your body preparing you to rise to a challenge.

Dr. McGonigal also discussed research that shows the hormone oxytocin (known as the cuddle hormone) is released when we are stressed. This hormone causes us to seek out social support when we are stress and also helps repair the heart muscle from stress related injury. This means that reaching out to people you care about when you are stressed can help protect you against the negative effect of stress.

This TED talk really made me re-think how I think about stress. Check it out! It could change your mind too and save a life!


Pop Quiz

What medical treatment can do all of the following?

  • Decrease knee pain and disability due to arthritis
  • Help control sugar in diabetes
  • Decrease hip fractures in post menopausal women
  • Control high blood pressure
  • Reduce anxiety and depression
  • And improve overall quality of life


If you guys exercise, you are right!

Check out this great video by Dr. Mike Evans called 23 1/2 Hours about the benefits of 30 minutes of daily activity:


The current Canadian Activity Guidelines suggest adults get 150 minutes/week of moderate to vigorous activity and children should get 60 minutes of physical activity a day.  For the full guidelines see the link below:




Sante Kildare Green Thumb

715b1ce1a4bf0ff01966952d374ec726Seems simple enough.  We have lots of talented, educated, successful professionals at Sante Kildare.  Surely, one of the doctors or nurses can nurture and sustain an office plant – after all, we treat acute and chronic illnesses all day.
Our challenge – to maintain an office plant for a month (or beyond)
The subject – The African Violet
According to Canadian Gardening, “the African violet may just be the perfect houseplant.  It blooms readily and has no specific flowering season, so it can be in bloom year-round. And it’s easy to multiply and share with others. As a result, it’s found worldwide, from the Far North to the Antarctic, anywhere there’s a cozy windowsill for it to grow on.”

To help us succeed, we have selected a plant that “can also cope with less light than most other flowering plants.”  Apparently, we should look for a spot that gets bright light most of the day with little full sun in the afternoon.
Here comes to tricky part: According to the Canadian Gardening website, we need to “ let the plant tell [us] what it needs: long, stretching petioles and leaves that bend toward the sun, or lack of bloom

indicate insufficient light, while dense, compact, hard growth with bleached-out leaves tells you the plant is getting too much light.”  Yikes – medicine already seems simpler.
We should “keep the growing mix (peat-based houseplant mix is fine) slightly moist; wait until it feels dry, then water abundantly, drenching it. Wet leaves can result in leaf spot, so it’s best to water from below by pouring tepid water into the plant’s saucer and letting it soak up what it needs. After 20 to 30 minutes, drain any surplus.”
Finally, we should “fertilize” the young plant with a foliage-plant fertilizer rich in nitrogen.”
I wonder if pharmaceuticals will help!  Maybe a little Cialis or testosterone?


Is Sugar Addictive?

Lately you hear a lot about how sugar is addictive just like some drugs.  But is there any scientific evidence to prove this?


It turns out that there may be some truth to this.  Studies have shown that sugar and other highly palatable foods can induce rewards and cravings the way some drugs do.  And, although more research is needed in humans, there is clear evidence in non humans that sugar and sweet foods can be even more rewarding than addictive drugs!

I have to say that from my personal experience I can see how sugary foods are addictive!  Staying away takes a lot of willpower.  So what can you do to get over your sugar addiction?

  • Try cutting down your sugar intake slowly, your taste buds will adjust to lower levels of sugar over time and you will crave it less
  • Choose healthy sweet treats.  Try eating fruit instead of the cookie, put some fruit puree on your oatmeal instead of sugar.  Although fruit has sugar it also has fiber that helps slow the digestion so your sugar level doesn’t rise too quickly
  • Try adding protein to each meal.  Healthy protein like lean chicken, nuts, eggs, low fat yogourt, and beans are great.  they help you feel full longer so you won’t be hungry and crave carbs


WebMD has a great slide show with information and tips on sugar addiction.  Check it out:



Reference: Ahmed, S.H., Guillem, K., & Vandaele, Y. (2013). Sugar addiction: pushing the drug-sugar analogy to the limit. Current Opinion in Clinical Nutrition and Metabolic Care, 16 (4), 434–439.

Mon defi sucré WHO

Comme vous aviez peut-être lu récemment sur notre  page Facebook,  l’Organisation Mondiale de la Santé (WHO) recommande maintenant de diminuer la quantité de sucre qu’on consomme.  Nous consommons environ 26 cuillerées a thé de sucre par jour!! Les nouvelles recommandations suggères que nous diminuons notre sucre a 5% de notre apport nutritionnel, c’est 25g/jour. Cela équivaut a 6-7 cuillers a thé par jour.

La consommation excessive de sucre a été liée a plusieurs problèmes de santé tel que le diabète, les maladies cardiovasculaires, les caries et même certains  cancers.


En sachant cela, j’ai décidé d’essayer de relever le défi de ces nouvelles recommendations.

A partir d’aujourd’hui je vais limiter ma consommation de sucre a 25g/jour. Je vous tiens au courant!


Update: My WHO Sugar Challenge

So I have been on my WHO sugar challenge for a few weeks. I have had good days and bad days. The good news is I am not a big soda drinker. The bad news is I have a big sweet tooth. The hardest part so far has been avoiding all of the treats like muffins, cookies, and chocolates that are brought by the clinic to thank us. The second hardest thing is going to celebration and functions that are full of treats. I have been working slowly on treating myself to small things occasionally.

The Heart and Stroke Foundation published a good article on sugar. They have some good Tips for reducing sugar in your diet like:

-Know where sugar hides by reading Nutrition Facts tables on food packages. Choose foods that are lower in sugar. Swap your sugary pasta sauce for homemade sauce and try the sugar-free salad dressings.

-Switch from pop to sparkling water, or try our unsweetened Minted green iced tea.

-Add less sugar to coffee or tea. Instead, add flavour with cinnamon, vanilla, cocoa or ginger.

For more good tips go to:



Have you ever heard the saying “It takes 17 muscles to smile and 42 to frown”? Turns out it’s actually a myth, it actually takes about the same amount of muscles to do both! I read an interesting paper recently that discussed the health benefits of smiling and I wanted to share it with you. Smiling can help lower your blood pressure, improve digestion as well as decrease anxiety. One more reason to smile!


Abel, MH, Hester, R. (2002)


What a coincidence!

So I am 1 week into my WHO sugar challenge when I came across this article in Maclean’s magazine!

What a coincidence!

It is an interesting article about the health risks of having too much added sugar in our diet. 

Author Kate Lunau writes:

“Of course, as a source of calories, eating lots of sugar leads to extra pounds. But it’s more complicated than that. While sugar isn’t the direct cause of diabetes, for example, it seems to spark a cascade of effects that wreak havoc in the body.”