CLINICAL DAY IN OCCUPATIONAL MEDICINE AND

WORK DISABILITY PREVENTION

CONFERENCE

PROGRAM

OCTOBER 26, 2017

General Event Information

Event Check-In Event Check-In begins at 7:30 a.m. on Thursday, October 26th, 2017 at the Delta Prince Edward Hotel. Delegates will receive their lanyards, which includes a copy of their selected workshop sessions as well as a floor layout of the venue.

Trade Show Exhibitors will be set up in the Pope Room from 7:30 a.m.- 3:00 p.m. Feel free to visit the Trade Show during the morning and afternoon breaks and over lunch to check out the trade show and meet the exhibitors.

Wi-Fi Complimentary wireless internet is available in the conference space.

Continuing Education Accreditation This Group Learning program has been certified by the College of Family Physicians of Canada and the Prince Edward Island Chapter for up to 5.75 Mainpro+ credits. The event has also been approved for 5.75 CE Credits for Chiropractors of Prince Edward Island. Each delegate should claim only those credits he/she spent in the activity. Certificates of attendance will be provided to each delegate at the end of the conference.

Evaluation To assist in the planning of future conferences, please take the time to complete the evaluation form which is included in your event check-in package. The completed form can be left on your table at the end of the last session.

Faculty Disclosure Statements

Dr. Paul Farnan - nothing to disclose Dr. Edvin Koshi - nothing to disclose Caroline LeBlanc - nothing to disclose

Matthew Letson - nothing to disclose Jason Parker - nothing to disclose

Dr. Scott Wotherspoon - nothing to disclose

Welcome

7:30 am - 8:15 am Registration/Coffee & Tea

8:30 am - 9:30 am Reducing the Human, Social and Economic Costs of Work and Disability Jason Parker

9:30 am - 9:45 am Question and Answer with Jason Parker

Description With the estimated cost of work disability costing the Canadian economy 60 billion dollars per year and the indirect costs adding as much as 2 to 3 times that, Work Disability Prevention has become a focus of researchers and stakeholders. Understanding why we need to make a shift from managing disability to preventing work disability is an important step in reducing the human, social and economic costs associated with work disability. In this session you will learn what a work disability prevention model looks like and the modifiable determinants that we can intervene on. Learning Objectives: 1. Gain an understanding of why we should focus on work disability prevention. 2. Determine what a work disability prevention model looks like. 3. Learn the 3 types of work disability. 4. Apply the 3 factors that determine ability.

8:15 am - 8:30 am Opening Remarks, WCB Chair Stuart Affleck

9:45 am - 10:30 am Clinical Use of Marijuana and its Potential Impact at the Workplace Dr. Paul Farnan and Mathew Letson

Description As the legal framework surrounding marijuana changes in Canada, marijuana in the workplace is a hot topic. Managing marijuana as a treatment option for injury or disease is an emerging area and requires specialized knowledge of medical research, workplace policy, and case law. A facilitated discussion featuring panelists from each of these fields will provide delegates with a well-rounded discussion on the challenges of marijuana in the workplace. Learning Objectives: 1. Learn more about how the legal framework around marijuana has changed 2. Describe managing marijuana as a treatment option 3. Discuss challenges of marijuana in the workplace

Concussion: Historical Perspective and Review of Literature on Prognosis and Rehabilitation Dr. Edvin Koshi

11:15 am - 12:15 pm Breakout Sessions (choice of three sessions)

Description Concussion diagnoses have risen with the emergence of “concussion specialist”. Rehabilitation of concussion (mild traumatic brain injury) is a straightforward process, if the practitioners treat their patients based on sound literature that represent mainstream Rehabilitation Medicine. Learn more about the diagnosis, treatment and prognosis for concussion injuries.

Learning Objectives: 1. Understand history of controversial diagnosis in Medicine. 2. Identify how the diagnosis of concussion is made. 3. Understand what findings are the important clinical features in making the diagnosis. 4. Learn about the causes of post-concussion syndrome. 5. Learn about the process of returning to normal life and work for individuals diagnosed with concussion.

10:45 am - 11:15 am Nutrition Break

10:30 am - 10:45 am Question and Answer with Dr. Farnan & Matthew Letson

Post-Traumatic Stress Disorder Caroline LeBlanc

Description Post-traumatic stress disorder (PTSD) and its treatment have received a great deal of media attention lately, particularly from military deployment and in first responders. Workers with major workplace physical injuries, and others who witness intense traumatic events, may also experience psychological injury. This workshop will review the diagnostic criteria for PTSD, tips on early recognition and early interventions to help prevent disability.

Learning Objectives: 1. Review the criteria for diagnosing PTSD and an Assessment of PTSD. 2. Outline tips on early recognition of PTSD. 3. Discuss early intervention strategies to help prevent and treat PTSD.

12:15 pm - 12:30 pm Question and Answer with breakout presenters

12:30 pm - 1:30 pm Lunch & Networking

1:30 pm - 2:30 pm Breakout Sessions (choice of three sessions)

Lumbar Radiculopathy: Can it be Managed in a GP's Office? Dr. Edvin Koshi

Description Back injuries represent a significant portion of work related injuries. The diagnosis of radiculopathy is made at an increasing rate, although the pathology remains the same. In this session, you will learn how to easily distinguish clinically between lumbar radiculopathy and other conditions presenting with leg pain. Dr. Koshi will examine the value of imaging studies and discuss whether there are better tests to determine the presence of lumbar radiculopathy. During the session Dr. Koshi will discuss the new treatment options and prognosis for lumbar radiculopathy. Learning Objectives: 1. Distinguish clinically (and with high diagnostic confidence) between lumbar radiculopathy and other conditions presenting with leg pain. 2. Identify testing options to determine the presence of lumbar radiculopathy. 3. Discuss the successful treatment of radiculopathy by family physicians, without the need for a specialist referral. 4. Discuss prognosis (what happens if left untreated).

Common Injuries and Disorders of the Shoulder Dr. Scott Wotherspoon

Description This session will focus on the common injuries and disorders of the shoulder. Join Dr. Wotherspoon as he presents on diagnosis, acute management, and the natural history of shoulder disorders and definitive treatments. Learning Objectives: 1.To understand common shoulder injuries and disorders. 2. Being able to differentiate these injuries and disorders with key history and exam findings, and confidently initiate acute treatments.

Coming Full Circle with Opioids in Chronic Non-Cancer Pain Dr. Tom Evans

Description Dr. Evans has been treating injured workers from both PEI and NB for many years and will use his own research data to guide primary care clinicians in the sensible use of opioids for chronic post injury pain. He will provide the historical perspective of prescribing patterns from very judicious use to excessive use from the 90’s onward, and now to the newly released Canadian Guidelines.

Learning Objectives: 1. Discuss the appropriate use of opioids for chronic post injury pain. 2. Understand the historical perspective of prescribing patterns of opioids. 3. Understand the work disability risks of long-term opioid use and dependence.

Opioid Trial – Entrance and Exit Strategies Dr. Tom Evans

Description In this workshop Dr. Evans will provide very practical prescribing advice for primary care clinicians on when and how to use an opioid trial post injury, as well as how to end it if the desired outcome of improved function and return to work is not achieved. Learning Objectives: 1. Outline when and how to use an opioid trial post injury. 2. Recognize when the opioid trial is ineffective. 3. Learn how to apply the newly released Canadian Opioid Prescribing Guidelines in the treatment of injured workers.

2:30 pm - 2:45 pm Question and Answer with Breakout Presenters

2:45 pm - 3:00 pm Nutrition Break

3:00 pm - 3:45 pm Engaging Your Patients in Their Recovery and Return to Work Jason Parker

3:45 pm - 4:00 pm Question and Answer with Jason Parker

Description Evidence suggests that patients who have the willingness and ability to take independent actions toward their recovery do substantially better, recover sooner, and have reduced costs associated with their health care. Engaged and activated patients behave differently towards their recovery and return to work. In this session you will learn why engagement matters and how to apply a 3 step process to helping patients become activated towards their recovery and return to work. Learning Objectives: 1. Discover what triggers the return to work process 2. Understand what the 2 primary predictors of work disability are 3. Apply a 3 step process to help patients with their recovery and return to work planning

4:00 pm - 4:15 pm Closing Remarks & Draw For Ipad Mini, WCB Medical Advisor Dr. Hendrik Visser

Speaker Bios

Dr. Paul Farnan, MD, FCFPC, dipl ABAM

Dr. Farnan has worked in the field of occupational medicine and addiction medicine for more than twenty-five years. As well as being a member of the Occupational and Environmental Medical Association of Canada, he is Board certified in Addiction Medicine and Family Practice. He is a Clinical Associate Professor,

Department of Family Practice at the University of British Columbia. Dr. Farnan’s consulting with employers and unions has involved developing and delivering programs to assist employees whose work is impacted by addiction and other substance use problems. He has provided independent assessment and provided treatment recommendations for thousands of individuals with addictive disorders, especially those involved in safety sensitive work. He has a particular interest in the interface between workplace safety and impairment at work as a result of prescribed medications and other drugs such as cannabis.

Dr. Tom Evans

Dr. Evans obtained his undergraduate degree in Psychology, Medical Degree, and specialty training in Anesthesiology from Dalhousie University and is a fellow of the Royal College of Physicians of Canada. After training in Anesthesiology, Dr.

Evans pursued sub-specialty training in the Functional Restoration approach to Chronic Pain with Dr. Jim Rainville at the Harvard University Hospitals and Dr. Robert Gatchell and Dr. Tom Mayer at The University of Texas. Dr. Evans is also certified by the International Spine Intervention Society (ISIS) in the interventional diagnosis and management of Cervical, Thoracic and Lumbosacral spine pain and he is a past member of the ISIS Standards Committee. He is a contributing author to the ISIS "Practice Guidelines for Spinal Diagnostic and Treatment Procedures,” Second Edition. In 1993, Dr. Evans founded the Atlantic Pain Clinic, in Moncton. The Clinic receives patients from across New Brunswick, Nova Scotia and PEI and specializes in evidence based, functional restoration oriented chronic pain management and research. With co-researcher Dr. Douglas French, Dr. Evans has published and presented extensively on the subject of Chronic Pain over the past 20 years.

Dr. Edvin Koshi, MD, FRCPC, FIPP, FAADEP, CEDIR, CIME, CFE

Dr. Koshi is an Assistant Professor in Physiatry (Physical Medicine and Rehabilitation) at Dalhousie University. He is a Fellow in Pain Medicine from Dalhousie University as well as a Fellow in Interventional Pain Practice from the World Institute of

Pain. Dr. Koshi teaches on back/neck pain and on spinal procedures, certifying physicians all over the world in performing pain procedures as an instructor for the International Spine Interventional Society. He also teaches a Canadian Interventional Pain Course, is as an examiner for the World Institute of Pain and course director of many international cadaveric courses He was given the “Top Instructor Award” by the International Spine Interventional Society. Dr. Koshi is a member of the following associations/Societies:

International Education Task Force of International Spine Intervention Society.

Education Division and Continuous Medical Education Planning Committee of the International Spine Intervention Society.

Education Committee, World Institute of Pain. Dr. Koshi is certified in Evidence Based Medicine (Assessing Studies on Treatments) by the International Spine Intervention Society. His main area of expertise is the diagnosis and treatment of neck and back pain, spinal procedures, TBI, and Disability Medicine/Vocational Rehabilitation.

Caroline LeBlanc, Registered Psychologist

Caroline graduated from the Masters program in Clinical Psychology from Universite de Moncton in 1991. Her work background includes Correctional Services of Canada, Provincial government Corrections and EAP program, Veterans Affairs Office of Conflict Resolution and Director of

Holland College’s Assessment Services for Adults. Since 2002, she has been in full time private practice. Her areas of interest are trauma, PTSD, first responders, anger management, couple therapy, anxiety and depression. She has also been involved in the community by being an active member of the PEI Critical Incident Stress Debriefing Network since 1996, the Psychologists Association of PEI, the francophone community of PEI , was involved in the Swissair

Matthew Letson

Matthew Letson was admitted to the New Brunswick Bar in June 2003. Working for Lawson Creamer, he is a guru in all matters appellate and administrative law. He has extensive experience at all levels of Court in New Brunswick, as well as involvement in matters before the

Supreme Court of Canada. He is a tireless litigator with expertise in civil litigation, employment, labour and administrative law and has a special interest in the areas of workers’ compensation and human rights. Matt has taught Bar Admissions sessions, has been a guest lecturer in Employment and Labour Law courses and is a member of the Employment, Labour and Administrative Law Sections of the Canadian Bar Association and of the Atlantic Provinces Trial Lawyers Association. Matt has presented on a variety of topics at various Continuing Legal Education conferences including the “Legalities of Drug and Alcohol Policies in Workplace.” In addition, Matt was Chair of the Administrative Law Committee for the CBA-NB in 2010/2011, and, most recently, was appointed to sit alongside members of the judiciary, civil service and fellow members of the Bar on the Law Society of New Brunswick’s Strategic Development Committee of the Rules of Court.

Jason Parker, B.HK

President and Senior Work Disability Consultant of Centrix Disability Management Services, Jason Parker is the creator of the Return to Work Toolkit— a strategic behavioural work disability prevention tool. Over the years, he has developed an evidence based method for Return

to Work Planning and Work Disability Prevention to engage injured workers. In addition to leading Centrix, Jason continues to provide direct consulting to organizations while maintaining his hand in case management. Jason holds a Bachelor of Human Kinetics from the University of British Columbia.

recovery in Peggy’s Cove and subsequently was part of Health Canada’s Psychosocial Emergency Response Team for several years. Caroline has recently completed training in EMDR and has been certified in Equine Assisted Psychotherapy. She now spends some of her clinical time in a horse arena, introducing the psychological benefits of horses to first responders, veterans and their families.

Dr. Scott Wotherspoon

Dr. Wotherspoon was born and raised in Toronto, Ontario. He completed his undergraduate degree at McGill University and his medical degree at Dalhousie University in 2004. He completed his Orthopedic residency training at University of Western Ontario in 2009. Following that, he received

his fellowship training in Knee surgery and Sports surgery in Melbourne, Australia and Auckland, New Zealand. He started practicing in Charlottetown in 2010.

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