Lou has published several opinion pieces, articles, referred papers, and chapters concerning his research on injury control. The following is a small sample of some of Lou's published works:
An Edmonton emergency physician gave a rapt Athabasca
audience a lot to think about last Wednesday when he spoke
candidly about Alberta’s culture of carelessness.
“When a man has a heart attack, he doesn’t say he had a
‘freak’ heart attack, or when a women has breast cancer, she
doesn’t say she had a ‘freak’ bout with cancer. Yet, when
someone gets killed on an ATV, or in a farming incident, or at
work, they always call it a ‘freak’ accident.’ And that type of
mindset, Dr. Louis Francescutti says, is what makes Alberta one
of the most dangerous places to live in Canada.
Francescutti, an internationally recognized injury prevention
expert, has been saving lives at the Royal Alexandra Hospital
since 1992. He says 1,500 people die from injuries each year in
this province, 99.9 per cent of which were clearly preventable.
“They die from suicide, homicide, motor vehicle collisions,
drownings, poisonings, burns, falls, occupational related
injuries,” says Francescutti. “I would say just about every last
one of them are preventable. Some of the suicide ones may be a
little more difficult, but definitely all the other injuries are
totally preventable and predictable.”
Speaking in front of an engaged group at the Nancy Appleby
Theatre, Francescutti said what has to change in Alberta is
people’s attitudes, particularly on the province’s roadways and
in the less-than-fertile minds of aggressive drivers.
“I usually call those people Neanderthals and these are
people that are difficult to change their behaviour,” the doctor
says. “Even taking away their license won’t work because they’ll
drive without a license. And so we’ve got to get pretty strict
in terms of what we’re going to do with these drivers and I
don’t think its beyond reason to take vehicles away and impound
vehicles for drivers who don’t follow the basic rules of the
road and don’t have any respect for other drivers.”
Francescutti said we, as a society, have a very high tipping
point before we will begin to take action.
“Remember that bus crashed coming down Highway 63 and six men
died? What did we do? Or do you remember how many people died
this past weekend? What have we done? All the kids that are
dying on ATVs. What have we done?
“We have this culture that we have a very high tolerance for
these events and I don’t know what it’s going to take to
mobilize us into action, other than to just keep hammering away
at it.”
Francescutti pulled no punches when talking about what he
perceives as a frightful lack of police officers or sheriffs
setting up shop on the highway, pulling speeders over.
“There is not enough traffic enforcement going on in the
province in spite of the recent addition of sheriffs on our
roadways. I can take you on just about any roadway in Alberta —
nobody is following the speed limits.”
Further to that, too many drivers, he adds, are continually
distracted by cell phone, Blackberry and text messaging use.
Among the audience was the entire Grade 12 class from Edwin
Parr Composite, about 30-strong. Francescutti regaled the
students with a story about a teenaged girl who racked up her
mother’s van one evening. The girl, while driving, had
text-messaged her boyfriend, telling him how much she loved him.
The punch line of the story: the boyfriend was among friends in
the back of the van.
It’s this type of mindlessness that keeps Francescutti and
other doctors busy.
“The basic rules of the road are not being adhered to, so it
comes as no surprise to me that people are killing themselves
left, right and centre,” he says. “And when you compare our
stats internationally, the figures speak for themselves. We’ve
got a long way to go.”
Francescutti gave some staggering if not totally bizarre
statistics, calling them “well-kept secrets” that the government
doesn’t want you to know about. For example: an average Albertan
can drive impaired 4,000 times before he or she will get caught.
One more thing: don’t get sick. One out of 13 people in Alberta,
when taken in to a hospital for whatever reason, will get sick
or injured as a result of a mistake, negligence or malpractice.
A professor at the U of A since 1995, Francescutti’s
appearance was a presentation of the Athabasca Rotary Club.
June 15, 2008 — Young people are the most accident-prone
employees on Canadian job sites and must be more closely
supervised if companies hope to reduce the disturbing number of
injuries they suffer at work.
And experts say governments must do more to enforce safety
laws and ensure that employers are properly training recruits if
young workers are to avoid becoming statistics.
More than 50,700 workers under the age of 24 lost time from
work after being injured on the job in 2006, according to the
Association of Workers' Compensation Boards of Canada. Another
51 died on the job.
The real injury numbers are higher because many mishaps
go unreported, says Dr. Louis Francescutti, a veteran
emergency room physician who teaches at the University of
Alberta.
"I can tell you there are hundreds of thousands of
injuries that are occurring across the country that don't
make the media simply because they aren't spectacular
enough," Francescutti says.
"Yet kids are losing arms and legs and being paralyzed
and severely burned as a result of workplace mishaps."
He adds that while this is not acceptable, it is
tolerated.
"If that many young people came down with meningitis in
one year, you could rest assured we would be doing something
about it. We have a crisis in this country when it comes to
injuries."
In Alberta, where the economy is booming, young people
make up 17 per cent of the work force. But they accounted
for almost one-quarter of disabled injury claims in 2006.
Workers in the province under the age 25 are 33 per cent
more likely to be injured on the job than older workers.
A recent incident involved Mitchell Tanner, a 16-year-old
part-time Rona employee who died near Edmonton after a
forklift he was riding on flipped over and crushed him.
Saskatchewan and other provinces with resource and
agricultural-based economies also have high injury rates for
young workers. British Columbia is in the middle of the
pack, according to figures compiled by the Institute for
Work and Health, while Ontario has the lowest numbers.
Why are so many young people being injured or killed at
work?
Experts point to a number of factors.
Newly hired young people don't have much previous job
experience, are often eager to please and are reluctant to ask
lots of questions of their employers about safety concerns, says
Francescutti.
They also think differently than older people. "They are not
thinking consequences," he says. "That's why young men make
great soldiers. They have no fear."
He advises that employers watch young workers carefully.
"When you ask them, 'What were you thinking when you were
riding on the side of that forklift' - they will probably
say to you - 'I don't know.' And the answer is pretty
honest. They weren't thinking."
The Institute for Work and Health found that only about
one in five employees in Canada receive safety training
during their first year with a new employer.
Those who did get training tended to be women in
medium-sized workplaces and men in large workplaces. Young
workers in jobs with higher physical demands and with a
greater risk of injury were not more likely to receive
safety training.
"The results suggest that provincial mandates to provide
safety training to new employees do not guarantee that this
training will happen, even in high-risk groups," researchers
reported last year in the journal Injury Prevention.
"A greater commitment is required from policy-makers,
workplaces and workers to ensure that all workers are
adequately informed and protected from workplace hazards."
Cameron Mustard, president of the work and health
institute, says injury rates are actually highest for new
employees regardless of age during their first month on the
job. But because young people tend to change jobs much more
frequently than older workers, they go through this danger
zone more often.
To lower the injury rates, experts recommend that
provinces enforce tougher workplace safety laws, heavily
fine employers who break the rules and ensure that young
workers are closely supervised.
British Columbia now requires that new workers receive
safety training before they begin performing their new jobs,
but that province is the exception.
"We are very concerned." says Mustard. "Very few
provinces actually in legislation make it clear that it is
the employers' responsibility to train workers before they
start work."
Some jurisdictions, such as Alberta, put part of the onus
for workplace safety on young people. Alberta Employment has
a website aimed at young workers that includes "Ten
questions you should ask your boss about workplace safety,"
including "What are the dangers of my job?"
Mustard says workplace safety courses should be taught in
high schools, with an emphasis on the rights of employees to
refuse dangerous work.
And while governments must do more to ensure that
employers are teaching young workers about job safety, he
adds that the buck really stops with employers.
"Standards are crucial," Mustard says.
Francescutti calls the injury rate appalling and says there's
no reason why governments and employers can't do more to deal
with something that is causing people so much pain while adding
to health-care costs.
"As a society, we are negligent in allowing young people to
die and be injured needlessly."
Jan 11, 2008 -
A leading workplace safety expert is calling for a $500-million
endowment fund to confront what he terms Alberta's terrible safety
culture.
Dr. Louis Francescutti revealed plans for the endowment today,
after the province announced that fines for workplace deaths and
injuries exceeded $1.7 million in 2007, a record.
The provincial government said the record reflects "a growing
intolerance of unsafe workplace practices."
Francescutti differed, saying, "It's a continuation of the poor
safety culture that we have in the province, and a laissez faire
attitude that we really don't want to do anything about it."
He said fines would be higher still if there is more enforcement.
Francescutti, a University of Alberta injury researcher and Royal
Alexandra Hospital emergency physician, is known internationally for
his work on injury control.
He is also part of a group that he said is preparing a proposal
for the endowment, to be known as Injury Alberta, that would provide
$60 million a year to help create a safety culture. It hopes to
unveil the details in about a month.
"There's no reason why Alberta cannot put at least $500 million
towards this," he said from Montreal, after speaking to a group of
doctors in Ottawa on workplace safety.
"It would try to generate interest around all injury topics in
Alberta," he said. "It's starting at the grassroots and there's a
lot of support for it."
He said people interested in improving safety could tap into the
fund "and in a very rigorous, scientific fashion, using a
multidisciplinary approach, try to address the issues."
Only some of Alberta's largest companies, such as Syncrude,
Suncor and Husky Energy, are tackling the problem, he said.
"Alberta Incorporated, if it was a company, has got a terrible
safety culture," Francescutti said. "As a result of that we allow
companies to have terrible safety cultures, which then allows these
injuries to occur."
Alongside more than 100 workplace deaths a year there are
hundreds of thousands of injury claims to the Workers' Compensation
Board, he said.
There is carnage on roads and at work, Francescutti said.
The province issued a statement that the 2007's fines record for
workplace deaths "topples the 2006 tally" of more than $1.5 million
by $185,500.
In the statement Iris Evans, the safety minister, said she is
pleased "the courts continue to send strong, clear messages that
workplace health and safety must be taken seriously." She said
government, industry and labour "must also continue to send their
own clear messages."
The fines, under the Occupational Health and Safety Act, were
against 12 companies that had workplace deaths or injuries in 2003
and 2004, said Barrie Harrison, a spokesman for Evans' department.
He said the fatality rate on job sites has dropped steadily since
1991 because of efforts by employers, labour and government. "We
believe that our workplaces are becoming safer."
Even so, there were 124 deaths in 2006, the latest year for which
the numbers are available. That was down from 143 in 2005 but
matched 2004's total.
The average fine in 2007, on 12 cases involving death or injury,
was $143,333. A year earlier the average was higher, at $153,450 on
10 cases.
Harrison said 2006 was unusual because one court order was for
the $500,000 maximum, against Wetaskiwin's Reynolds Antique
Machinery Auto & Aircraft Museum in the death of a 14-year-old boy
working unsupervised and without a permit.
Nov 21, 2006 - A group of University of Alberta researchers and graduate students made a whirlwind tour of Alberta to mark the one-year anniversary of a program that convinces companies to keep employees cell-phone-free while driving.
On the first anniversary of the Coalition for Cellphone-Free Driving's launch, the group announced it is expanding. The coalition, previously a capital-region initiative, kicked off a provincial campaign today during a nine-stop tour of Alberta - hitting all of the province's health regions.
"We do want to put a little pressure on all the health regions in one day," said Dr. Louis Hugo Francescutti, a professor in the School of Public Health, during the group's stop in Edmonton. "Albertans have to understand that you can't talk on a cellphone - whether it's hand-held or hands-free - and drive a vehicle. You just can't do it. And if you try to do it, what ends up happening is you're more likely to be involved in rear-end collisions, you're more likely to be involved in left-hand turn collisions, you're four to six times more likely to be involved in collisions overall."
It doesn't matter if the cellphone is hand-held or hands-free, said Francescutti. "It's the conversation that's the distracter. This is an issue that doesn't need much talking. The science is irrefutable. Either we're stupid, and we don't believe the science, or we're stupid and we're just putting people's lives at risk."
The project, created and led by graduate students in the U of A School of Public Health, convinced several prominent Alberta companies to adopt policies that restrict their employees' use of cellphones while driving.
To date, six corporate sponsors officially signed on with a commitment to cellphone-free driving. It's a decision that made sense for engineering firm AMEC, said John Kageorge, the company's communications manager.
"Businesses that are loading their employees up with gadgets and gizmos, giving them huge task lists and putting them behind the wheel need to think twice and act responsibly," he said. "We have 20,000 employees around the globe - all cellphone free - and we encourage other businesses to do likewise. This model designed by Louis Francescutti is brilliant, but it's no more than what your mothers tell you to do - focus on the task at hand and work at getting home."
This year, the coalition has expanded its program to increase public awareness about the dangers of driving while using a cellphone, through a new partnership with some of Alberta's regional health authorities. Sterling Crane provided an aircraft to shuttle the team of students and supporters between nine locations to host kick-off events around the province.
"The safety of our employees is very important," said Russ Brown, Sterling Crane's director of safety and environmental affairs. "Whether an injury occurs on or off the job, it has an impact on our business, which extends well beyond economics and touches us very personally. We are confident that our cellphone policy will make a difference."
Drivers only need to watch the road to see how cellphones affect safety, he said. "You all see the activity on the road, you recognize the people who are driving while they're talking and you can see the bad behaviours of those people and the risk that we're at."
The policy developed by the students stipulates that employees must ensure that, while driving, calls are directed to voice mail. If an employee must make an emergency 911 call, the vehicle should be parked in a safe location before making the call. Finally, coalition members must ensure all employees are aware of the policy and are expected to comply with it.
"I am very proud of the great job our students and regional supporters did on this project," said Francescutti. "And to have the opportunity to celebrate our provincial expansion and meet our partners in person across Alberta is tremendous."
Injuries are the leading cause of death for people aged one to 44 years in Alberta; motor vehicle-related injuries account for the majority of these deaths. In Alberta, six people die every week in traffic collisions. Most motor vehicle collisions are the result of driver error.
"The School of Public Health is about this, it's about those things within our society that create injury, lead to chronic disease, lead to those sorts of things which our health system just can't manage," said Roger Palmer, dean of the School of Public Health. "If we have good basic public policy, if we start to change some of these habits that we all have, we would do a lot to improve the overall standard of care in the health system in this province."
 visit
www.cellphonefreedriving.com
U of A students expand Pan-Alberta Coalition for Cellphone-Free Driving to encourage people and companies to limit use of cellphones in vehicles
Nov 21, 2006 (EDMONTON) – On the first anniversary of the Coalition for Cellphone-Free Driving’s launch, the group announced a new expansion. The Coalition, previously a capital-region initiative, launched a province-wide campaign today during a whirlwind nine-stop tour of Alberta.
The project, created and led by graduate students in the University of Alberta’s School of Public Health, convinced several prominent Alberta companies to adopt policies that restrict their employees’ use of cellphones while driving.
To date, six corporate sponsors officially signed on with a commitment to cellphone-free driving. Members include Halliburton, Tucker Wireline Services Canada, Sterling Crane, Shippers Supply Inc., Schlumberger and Hole’s Greenhouses and Gardens Ltd.
“Our company has made a corporate commitment to employee safety by not permitting them to use a cellphone, either hand-held or hands-free, while operating a motor vehicle on company business or on company time,” says David Snyder, President of Sterling Crane. “We are proud to be partners in this coalition.”
“The safety of our employees is very important,” says Russ Brown, Sterling Crane’s Director of Safety and Environmental Affairs. “Whether an injury occurs on or off the job, it has an impact on our business which extends well beyond economics and touches us very personally. We are confident that our cellphone policy will make a difference.”
This year, the Coalition has expanded its program to increase public awareness about the dangers of driving while using a cellphone through a new partnership with some of Alberta’s regional health authorities. Sterling Crane provided an aircraft to shuttle the team of students and supporters between nine locations today to host kick-off events around the province.
“I am very proud of the great job our students and regional supporters did on this project,” says Dr. Louis Hugo Francescutti, Professor in the School of Public Health. “And to have the opportunity to celebrate our provincial expansion and meet our partners in person across Alberta is tremendous.”
Injuries are the leading cause of death for people aged one to 44 years in Alberta; motor vehicle-related injuries account for the majority of these deaths. In Alberta, six people die every week in traffic collisions. Most motor vehicle collisions are the result of driver error.
"As an emergency physician in Edmonton, I have seen the catastrophic results of cellphone use by drivers again this month. But the car crash victims that I see in hospital are the lucky ones, because they still have a chance to survive. Those who die in these collisions never make it to me, and I don't ever see the devastating impact on their families,” says Dr. Darren Nichols, Director of the CFPC Emergency Medicine Program at the University of Alberta. “Just as there is no excuse for drunk driving, there is no excuse for this. Children, teenagers, adults are all at risk when cellphone using drivers are behind the wheel."
Several years ago, the Canadian Medical Association urged government to pass legislation banning cellphone use while driving. A Leger Marketing survey in 2001 found that 80 percent of Canadians favored a ban on cellular phone use while driving if not using the hands-free feature. And an academic paper by Donald Redelmeier, M.D. and Robert Tibshirani, Ph.D. in The New England Journal of Medicine in 1997 found that cellphone users are four times more likely to be in a collision than non-users. Some 36 jurisdictions have passed legislation governing cellphone use in vehicles.
The policy developed by the students stipulates that employees must ensure that, while driving, calls are directed to voicemail. If an employee must make an emergency 911 call, the vehicle should be parked in a safe location before making the call. Finally, Coalition members must ensure that all employees are made aware of the company policy and are expected to comply with it.
“Traffic injuries are a critical public health issue in this province,” says Robert Campbell, President of the Alberta Public Health Association. “We hope that these corporate policies will help educate employees and encourage cellphone-free driving both on and off the job.”
Mar, 2006 - To prevent the collapse of health care during an influenza pandemic, doctors shouldn't bother treating those seriously ill with the virus because they're going to die anyway, says a local physician.
"I don't think health care is ever going to be able to deliver the resources that are required ... in the middle of a crisis," says Dr. Louis Francescutti, associate professor at the University of Alberta's department of public health sciences.
"You can't build that much capacity in the system to deal with (an influenza pandemic)," he told me yesterday.
If 60% of those infected with influenza are expected to die, health-care officials should withhold treatment from those who aren't likely to survive, says Francescutti.
"Don't try and do anything heroic," he says. "Those people should be isolated and made comfortable but let them die because they're going to die."
Perhaps it sounds cold-hearted but Francescutti says he's just being realistic. "It's called triage. You've got limited resources. You'd better use them as efficiently as possible."
Francescutti spoke about pandemic preparedness at the Telus World of Science Tuesday night, along with deputy medical officer of health Dr. Marcia Johnson and Dr. Mark Joffe, medical director of infection prevention services at the Royal Alexandra Hospital.
It was a scary evening. Perhaps, as some maintain, we will be spared an influenza pandemic. But these three experts are convinced it's on the way and we'd better be prepared. Every 10 to 40 years, a brand new virus emerges and we're overdue for a whopper, Joffe pointed out.
The 1918 Spanish flu killed more than 20 million people around the world, most young, healthy adults. In 1957-58, another two million died of the Asian flu. And in 1968-69, one million people succumbed to the Hong Kong flu.
The current H5N1 bird flu, which has spread across Europe, Africa, parts of Asia and the Middle East, has had a 55% mortality rate, noted Joffe. Still, only about 100 people have died, after coming into contact with sick birds.
But if the strain mutates so that it spreads from person to person, we're in big trouble.
Health-care officials are planning for a moderate to severe pandemic and are assuming that up to 35% of the labour force will be off sick or caring for ailing relatives.
There will be shortages of hospital beds, drugs and ventilators. And, of course, there will be less hospital staff because some of them will also be ill.
Doctors will have to make difficult ethical decisions about who gets treatment when resources are limited, says Johnson.
"Is it going to be first-come, first-served or will it be ... that younger people would have more access?" she wonders.
"Balancing someone's need or want against another person's need or want is always a value-laden decision," she says.
Those kinds of troubling issues need to be discussed publicly before the pandemic hits, she says.
Another concern is that health-care workers will be too frightened to go to work during a pandemic.
People are going to be in for "a big surprise" if they think nurses, doctors and other hospital staff will show up as usual, says Francescutti.
Would he work through a deadly influenza outbreak? "I don't know," he says. "(If) there's absolutely no financial compensation to the family in the event that I would die, why would I?"
Whatever happens, Francescutti is ready. He's got a log cabin in his backyard as well as a stocked pantry, a trout pond and a brick oven. If transportation routes are disrupted, Edmonton would run out of fresh food within a week, he says. "Everybody has to look after themselves," he says. "Get in as good physical shape as you can because I think the fittest will survive this one."
Mar, 2006 - Alberta’s foremost expert in safety and injury prevention is coming to an APEGGA Annual Conference lunch — and he’ll be serving up a heaping meal of reality. “I am looking forward to coming and sharing some cold, hard truth with you and your members,” Dr. Louis Francescutti, MD, PhD, told The PEGG.
He speaks at the APEGGA Annual Conference lunch on Friday, April 21, in Edmonton. The day before, the lunch speaker is Scott Taylor, a Canadian war correspondent who was held hostage in Iraq.
Dr. Francescutti is a native Montrealer who came west, fell in love with the open space and clear blue skies of Alberta — and never left.
He has worked as an emergency medical technician in the Arctic and as a professional photographer with a studio in Old Montreal. Dr. Francescutti completed his MD and PhD at the University of Alberta and, while training as a resident in general surgery, became interested in the field of injury control.
He founded the Injury Prevention Centre at the University of Alberta Hospitals and developed the award-winning multimedia injury prevention program for teenagers called HEROES.
He has trained at the Johns Hopkins University School of Public Health in Baltimore where he completed his master’s degree in public health and a preventive medicine residency while pursuing further studies in injury control and public health.
He is an associate professor in the Department of Public Health Sciences in the Faculty of Medicine and Dentistry at the University of Alberta, and is currently developing an electronic injury surveillance system and community-based centres for injury control and research.
Dr. Francescutti works as an emergency physician at the Royal Alexandra Hospital in Edmonton, and he is the director of the Alberta Centre for Injury Control and Research.
A Q-and-A with Dr. Francescutti follows.
Q What message do you have for members of APEGGA that they haven’t heard before or perhaps aren’t ready to hear?
A Alberta is doing terribly when it comes to reducing injury. There seems to be very little will power to make a difference.
Q Protection of the public is paramount at APEGGA, because we regulate the engineering and geoscience professions. What can our members do to make the world a safer place?
A Take the injury problem far more seriously. Understand the issues and become advocates for change.
Q You are quite consistently referred to as a crusader. Is that what you are? Is it a description you’re comfortable with?
A I am better described as a visionary. Unfortunately, it is lonely at times seeing the problem so clearly and waiting for the world to catch up.
Q You’ve noted that accidents aren’t treated as a disease, and that research dollars tend to get funnelled by older men into the diseases they personally fear, such as cancer and heart disease. Do many of us have a misconception about risks and accidents? Why so?
A First of all they are not accidents, they are injuries. Injuries are a disease. Injuries kill more Albertans under the age of 44 than any other disease. Injuries are predictable and preventable. We have become habituated to injuries by the media. The media use the premise that if it bleeds then it leads. Every newscast and front page is always full of injury descriptions. We have become tolerant of them.
Q Are you being heard and are you optimistic that accident prevention will, more and more, be funded to the level it requires? Why is it that accidental injury and death have so much trouble grabbing the limelight? And is there some kind of misplaced machismo lurking behind all this (the kid without a helmet, the sour gas worker without a mask, the driver without a seatbelt)?
A We have a very primitive, redneck attitude in this province that has set our tipping point very high. I’ll bet a bus of workers coming home from Fort McMurray can crash and six men die and we still would do nothing. Wait a minute: that actually did happen and we did nothing.
Q Suicide is often mentioned in the same breath as accidental injury and death. Why is that?
A Suicide is an example of an intentional injury. More Albertans kill themselves than die in car crashes. We have a very serious problem when it comes to suicides in Alberta.
Q The advances in auto racing safety — softer walls, head-and-neck restraints, roof flaps — have been really significant in recent years. Does this technology trickle down to the rest of us, and why do we accept a car and highway that will kill us in a 60-m.p.h. impact — when auto racers routinely survive 180-m.p.h.-plus impacts?
A Simple. We think we are better drivers than the next driver. We have more knuckleheads on our roadways than I have seen in years and it looks like it will get worse not better.
Q What gets you up in the morning? Why do you do this, what do you gain personally?
A So much yet remains to be done and I have long ago accepted that it takes 25 to 30 years to change society’s views on an issue and I am only in year 20 of this mission. I must simultaneously pace myself and run the race as a marathoner while sprinting occasionally.
The only personal gain is knowing that I helped to identify a previously unidentified epidemic of a disease that is both predictable and preventable.
Mar 11, 2006 - Emergency room physician Louis Francescutti has eliminated the word "accident" from his vocabulary.
"All crashes are 100 per cent predictable," he said.
The founder of the Injury Prevention Centre at the University of Alberta Hospital argues that people need to think differently about injuries of all kinds, whether they are caused by car crashes, falling on ice or stairs, or by the violent use of guns or knives.
"Injury should be treated as a disease. The disease of injury takes up at least 25 per cent of all hospital beds," Francescutti said.
Francescutti will be the keynote speaker at the St. Albert Community Health Council Health Care Fair next Saturday, March 18, from 10 a.m. to 4 p.m. at the Alliance Church. The theme at the health care fair is Making St. Albert Roads Safer: What are you doing behind the wheel?
The health fair is an annual event, which is free to the public. The morning portion will feature Francescutti, speaking on Traffic Safety – There is no such thing as an accident. The afternoon session will feature a forum with representatives from the RCMP, City of St. Albert, Alberta Transportation Safety Services and the YMCA.
There will also be a child car seat safety inspection, interactive displays and door prizes.
"The idea to discuss traffic safety in St. Albert was supported by figures we’d seen from the Sturgeon Hospital and by a survey we did last summer at the farmers’ market, said Bob Gray of the St. Albert Community Health Council.
The Sturgeon Hospital statistics Gray referred to showed there were 1,258 emergency room visits as a result of traffic crashes during fiscal year 2004/05.
The second half of the forum will be open for discussion and Gray hopes that questions will be raised about road safety, traffic lights and safety for cyclists and pedestrians.
As an emergency room physician at the Royal Alexandra Hospital in Edmonton, Francescutti sees all manner of injuries, not just those caused in traffic collisions. He questions why as a society we raise enormous numbers of dollars for cancer research or heart disease but none for the disease of injury, which he says is preventable.
"I read obituaries of people, who have died of injuries. At the end of the obituary, where they ask for donations instead of flowers, I’ve never seen where people stipulate to give funds to injury prevention. No one has ever knocked on my door asking for funds for the disease of injury," he said .
"Only Mothers Against Drunk Driving focuses on injury disease, and they are very focused on one aspect of injury."
The disease of injury is especially hard on the young.
Injury Prevention Centre statistics prove that if you are younger than 44, you are more likely to die from injury than from any other disease. If you are younger than 34, motor vehicle crashes are the major cause of death.
"Injury disease is the leading cause of death for kids under age 19 and injury disease exceeds all other causes of death combined, including cancer," Francescutti said.
Save lives and dollars
The cost is huge not just in the numbers of lives affected, but also in dollars, but as long as the health care system is designed around treatment rather than prevention, nothing will change, the physician said.
Francescutti said the cause of injury disease is endemic within Alberta. The media focuses on spectacular crash scenes, but few stories deal with prevention. Municipalities do not make roads as safe as they could be and the judicial system does not lead to the prevention of more crash-related injuries.
"If we focused on this disease called injury and even if we just had a 25 per cent reduction in those injuries, we could improve the efficiency of health care in the province and emergency care. We wouldn’t need Ralph’s Third Way," Francescutti said.
The St. Albert Community Health Council and Sturgeon Community Hospital Foundation co-sponsor the health fair. Making St. Albert’s Roads Safer: What are you doing behind the wheel? takes place March 18 from 10 a.m. to 3:30 p.m. Dr. Louis Francescutti will speak from 10:30 to 11:30. The afternoon forum takes place from 1 to 3:30 p.m. The event is free and takes place at St. Albert Alliance Church on Villeneuve Road.
Law protects workers
Alberta Motor Association spokesman Randy Loyk cannot keep the anger from his voice when he talks about motorists who don’t slow down for emergency vehicles or tow trucks on the side of the road.
He knows some of those tow truck drivers who were injured or killed. He’s seen the photos of police cars and he has mourned the needless loss of life. He’s frustrated that so many motorists have the urge to go ever faster, to get some place even quicker, even though the law now requires slowing to 60 km/h.
"People should know by now that it’s the law," said a frustrated Loyk. "We ran weekly ads in every newspaper in Alberta, including the Gazette, on the radio and on television."
As of Oct. 31, 2005, Alberta legislation requires motorists to reduce their speed to 60 km/h, or slower if signs indicate, when passing emergency vehicles or tow trucks stopped with their lights flashing.
Fines for speeding around emergency vehicles have doubled and now range from $114 to $702 plus two to six demerit points, depending on the number of kilometres over the speed limit being driven.
The AMA, police, paramedics and fire department personnel lobbied for the change to the law after seeing so many accidents and deaths.
"It’s one of those things that no one tracked before but all of a sudden people started to notice," Loyk said. "Mostly it’s RCMP who are injured or killed and in the last two years there has been a member of the RCMP killed at roadside accidents at Wetaskiwin and Lake Louise."
This year there have already been two serious accidents on the Queen Elizabeth II Highway near Didsbury and Okotoks, because of motorists travelling too fast around recovery scenes.
"Motorists need to pay closer attention, to slow down and pass service vehicles cautiously. Speeding around an emergency vehicle assisting a stranded motorist is dangerous and it’s illegal," Loyk said.
Sept 20, 2005 - Three generations of Edmonton physicians -- grandfather, father and son -- have made the list of Alberta's 100 Physicians of the Century.
Doctors Andrew, Walter and William Anderson are included as one entry on the list, which was made public Monday by the College of Physicians and Surgeons of Alberta. The list is a centennial project of the college and the Alberta Medical Association.
Dr. Andrew Anderson arrived in Alberta in 1911 and set up his practice; his son and grandson followed him into medicine.
Most notably, all three men have served as AMA president. Dr. William Anderson headed the AMA in 1997-98.
Fifty-two Edmonton doctors made the list, many of them still practising physicians.
The youngest of the 100 is Dr. James Shapiro, just 43, the leader of the team that developed the Edmonton Protocol of transplanting islet cells into severe diabetics.
AMONG THE OTHER EDMONTONIANS ARE:
- Dr. Steven Aung, a pioneer in the integration of traditional Chinese medicine with western medicine.
- Dr. Ruth Collins-Nakai, a pediatric cardiologist who is current president of the Canadian Medical Association.
- Dr. Tony Fields, longtime Cross Cancer Institute executive.
- Dr. Louis Francescutti, a crusader for public safety.
- Dr. Larry Ohlhauser, former College of Physicians registrar.
- Dr. Lorne Tyrrell, noted researcher and former dean of medicine at the University of Alberta.
Among the earlier Edmontonians named are surgeon Dr. John Callaghan, who performed Canada's first successful open heart surgery; Dr. Charles Allard, a cardiologist who founded ITV television; and Dr. Amy Fong Wong, who, in 1950, became the first Chinese-Canadian woman physician in Alberta.
Thirteen women made the top 100 list, including St. Albert physician Dr. Marlene Lidkea, an expert in diagnosing and treating child victims of sexual assault.
Although a number of former provincial bureaucrats made the top 100 list, only two doctor-politicians are included.
Dr. Wallace W. Cross was Alberta's health minister from 1935 to 1956, under premiers William Aberhart and Ernest Manning. Dr. J. Donovan Ross was an Edmonton MLA from 1952 until 1972, spending more than 10 years as minister of health.
The physician currently in the Alberta cabinet, Infrastructure Minister Lyle Oberg, did not make the top 100 list.
The list marks the centennial of the AMA and the College of Physicians, which were created after Alberta became a separate province in 1905. More than 400 names were submitted and the final list was selected by a panel of 14 physicians and members of the public.
Award ceremonies will be held Oct. 20 in Calgary and Oct. 25 in Edmonton.
For the complete list of Physicians of the Century, go to www.medicine100.ab.ca.
A shutterbug could be snapping pictures of licence plates on Highway 2 between Edmonton and Calgary before long. "Albertans have really got to get ready that the old days of driving like knuckleheads are over," said injury researcher and emergency room Dr. Louis Francescutti. "I think we're getting really serious about the problem." While an MLA committee on policing recommended the use of photo radar on provincial highways several years ago, the province decided to hold on to the idea until a traffic review was completed. That review didn't completely say if the province should implement photo radar on highways.
The Alberta Motor Association, however, backs photo radar on provincial highways, saying it would help reduce carnage on the roads.
"We're really trying to catch and deter those people who are habitually breaking the law and are becoming high risk in terms of their driving," said AMA spokesman Don Szarko.
But he said the province needs to sell the use of photo radar on highways to let people know what the technology is doing, why it's important and how it's deployed.
"People are always going to gripe and complain when they get a ticket," said Szarko.
Szarko said photo radar should be used in high-collision areas to create deterrence. "We're trying to change driver attitudes and behaviour," he said.
Francescutti agreed. "The trouble is if you only put one or two out there it doesn't slow anybody down and it just generates a lot of money," said Francescutti. He said photo radar operators should be spread out to catch speeders and slow them down.
He added if the province decides to use photo radar on highways, it should also attach demerit points to speeders.
March 21, 2005 - Injury prevention crusader says it's time to think of injuries the way we think of cancer and heart disease.
The leading killer of Albertans under the age of 44 could be eliminated this afternoon and 1,300 lives saved annually if people really wanted to, says Dr. Louis Francescutti. Only nobody cares about preventing injuries the way they care about finding a cure for cancer or raising research dollars for heart disease.
That's because the majority of people still think of injuries as accidents, acts of God, or things beyond their control, instead of seeing them as predictable and preventable, says the injury-prevention crusader.
"A police officer killed in the line of duty, someone getting hurt on the job, someone dying in a house fire, a kid getting hit by a car or mauled by a dog are all part of a disease I like to refer to as injury," says Francescutti, an emergency room physician and executive director of the Alberta Centre for Injury Control & Research. "They claim an enormous amount of lives every year and they maim hundreds of thousands of Albertans every year. It's literally costing our economy in the untold billions of dollars annually."
Francescutti has been speaking out about injury prevention for 15 years and is practically evangelical on the subject, prompting some critics to tune him out as a loon.
But Dr. David Rayner, associate dean responsible for undergraduate medical education at the University of Alberta says any doctor "worth his or her salt can tell you that spending one dollar on prevention is going to save $10 to $20 down the road in terms of treating established diseases."
Doctors are still trained, and a lot of traditional medical models are still based, on treating disease, Rayner says, "but there's been a big shift towards emphasizing prevention over the last few years which I'm sure is going to continue.
"We know that prevention is the way to go," he says.
Prevention doesn't mean you have to start living a safe and boring life, "just be fully cognizant of the fact that depending on your age and sex there are different leading causes of death," Francescutti says.
For example, the leading cause of death for people under age 33 is motor vehicle related. Knowing that, make sure you are 100 per cent focused on driving: that means not yakking on a cellphone and driving, which is distracting, not going over the speed limit, not running amber and red lights.
People usually learn the lesson of prevention after it's too late.
Shawn McCloskey, 23, is in a wheelchair, heavily dependent on others to help him carry out routine activities, since a mountain-bike trail ride during a family vacation when he was 14.
"I was wearing a helmet, but I broke my neck trying to jump my bike on purpose over a log," he says. "I'd done a lot of stupid things before. I thought of the consequence only I didn't go far enough. The most I thought could happen is I could break a leg or an arm. I never thought if I jump over this, I could break my neck.
"If I wasn't wearing a helmet, we wouldn't be having this conversation," McCloskey says.
His message to kids is not to stay off trails, but not to take any unnecessary risks that could leave them fatally or permanently hurt.
Linda Rybak's son Craig Hlady never got the chance to learn from his mistake. The 18-year-old died of massive head trauma after he lost control of a company truck he was driving to a job site near Lesser Slave Lake. The vehicle rolled and Hlady and two co-workers, who suffered minor injuries, were thrown out.
The loss of her son has left Rybak with a lot of "if onlys": if only Craig had been wearing a seatbelt; if only his employer had been aware that he only had a learner's driving permit; if only he hadn't been allowed to drive the company truck; if only he hadn't been sent to Lesser Slave Lake; if only he had been supervised. "I push a pencil all day and I have a supervisor," she says. If only she'd paid for him to take a driver's training course, maybe he wouldn't have had a rollover or would have known better how to handle it.
"Everything that happened that day was preventable," Rybak says.
The average Albertan may read this and wonder why should he or she care. They think it doesn't affect them, but it does, Francescutti says.
"If you're a 65-year-old woman waiting to have a hip replaced electively, chances are good Monday morning, there won't be a bed for you to have it replaced because that bed is filled with someone who was in a car crash on the weekend," he explains.
Parents bellyache that their kids' school classes are too big. "Well they're too big because there's no money to hire more teachers or build more schools and the reason there is no money to do that is because of the money spent on health care. The health-care system is the biggest addict we have in this province," Francescutti says. "It's addicted to disease and injury and the more disease and injury there is, the more it can ask for more resources to build up this empire."
He points out one spinal cord injury (someone in a car crash breaks his neck and is in hospital for a year) costs close to a million in health-care costs alone and there are 110 spinal cord injuries in Alberta each year.
The economic burden of unintentional injuries costs Albertans $1.8 billion or $662 for every person every year. That doesn't include the heartache and human suffering experienced by families and friends of those who experience fatal or life-changing injuries, Francescutti says.
He used to be like the majority of physicians who are Dr. Fix-Its until he went away to Johns Hopkins University School of Medicine. "Medical school brainwashes you into thinking that treatment, treatment, treatment is everything, so I had to go to John Hopkins for two years to get de-brainwashed and come to understand that it's far more important to prevent disease and injury than it is to treat it."
If Francescutti had one wish, he says it would be that public awareness of injury would be raised: Every time the premier or a provincial minister open his or her mouth to say anything they would preface their remarks by acknowledging that injuries are the number one cause of death for Albertans under age 44 adding that this is unacceptable and something has to be done. Every time an Albertan finished a visit with a health care provider, he or she would be reminded to wear a seat belt.
The last thing most people who are injured think of is that something was going to happen to them that day, Francescutti says. "Unlike other diseases there's no incubation period, no time to prepare for the event. One minute you're perfectly well and the next you're perfectly dead or perfectly disabled.
"There's no shortage of outpouring of grief or support when a police officer is shot on duty or when a high school student dies in a car crash. Bottom line is we care when it's too late."
January 6, 2005 - An emergency-room physician wants the Alberta government to make injuries the next provincial "debt" to eliminate, after the province revealed job-related fatality figures yesterday. "It's an unsafe province and we've got to do a hell of a lot more than what we're doing now," said Dr. Louis Francescutti, head of the Alberta Centre for Injury Control and Research.
"The only way I would be happy is if I woke up tomorrow and the premier of the province said very clearly, 'Listen folks, we've eliminated the financial debt of the province and the next debt that I'm going to eliminate is the injury debt.
" 'And I'm instructing all my ministers to take this injury problem seriously, and our target is within the next five years to reduce all injuries in Alberta - occupational, recreational, in transportation - by 60%.' "
Alberta Occupational Health and Safety spokesman Chris Chodan said overall workplace injuries and fatalities are going down, but admitted the statistics still need to drop.
"It looks like they got better in 2004, but it's not time to go to sleep," said Chodan, adding the workforce jumped from 1 million in 1991 to 1.8 million for 2004.
"We have more people working but less people getting killed or injured."
For 2004, the province had 124 job-related fatalities versus 127 in 2003, 101 in 2002, and 118 in both 2001 and 2000.
Injury figures weren't available yet for 2004, but in 2003 Alberta had 39,100 injuries that caused workers to miss at least one day of work.
The number of injuries in 2002 was 40,100, while 2001 had 40,200 and 2000 had 40,600.
Chodan pointed out that 38.6% of the deaths in 2003 were from occupational diseases that were probably contracted years earlier, while 35.4% were from motor vehicle crashes and 26% were the result of actual injuries.
November 3, 2004 - There's not enough photo radar and every police officer, including the chief and top brass, should be writing more tickets, says an expert in injury and collision prevention.
Dr. Louis Francescutti told members of the Lethbridge regional police commission Tuesday Alberta highways are among the most dangerous in the country and the road to safety must be paved with increased traffic enforcement measures.
"Traffic safety is a core function of policing," he said. "Police, more than any other group, have the greatest ability to make a significant deterrent effect on the actions of road users. I don't care how much brass you have on your shoulder, traffic enforcement is a responsibility of every sworn member."
Francescutti is an emergency room doctor at the Royal Alexandria Hospital in Edmonton, a professor at the University of Alberta and the director of the Alberta Centre for Injury Control and Research.
"It really doesn't matter where you go in this province," he said. "As long as you've got people driving cars in your community, you've got problems."
Driver error is to blame in 85 per cent of collisions with speed, not wearing a seatbelt and impaired driving, major causes of fatalities.
But Francescutti says increasing traffic enforcement initiatives will lead to changes in individual driver behaviour and in turn generate a shift in culture.
He recommends police increase their ticket quotas from one per 12-hour shift to five, install red-light cameras and take advantage of other technology such as photo radar to help drive home the point.
"There's not enough (photo radar)," he said. "You have to have lots of it out there. The perception that it's a cash cow. . . it isn't. There's nothing wrong with it."
He added the only people who seem to complain about photo radar are those who are caught speeding.
Police issued about 4,500 more photo radar tickets between January and May this year than 2003. By the end of May, 11,398 photo radar tickets had been issued. A total of 20,565 were issued in all of 2003. Those figures raised concerns at an earlier police commission meeting about the tool's usefulness and what kind of a deterrent effect it actually has.
Sgt. Tom Ascroft, head of the traffic response unit, says the addition of a second photo radar unit, strategic placement along problematic roadways such as Whoop-Up Drive and the fact receiving a ticket only slows people down temporarily, explains why so many tickets are being mailed.
"Studies tell us (the deterrent effect) lasts for about three months," he said. "If you get a speeding ticket you will drive like a good (person) for about three months and then you'll forget and you'll slowly creep back up to the way you used to be."
Ascroft says Lethbridge cops have increased the number of officers in the traffic unit and a combination of education and working with the city from an engineering perspective has helped identify problem areas and solutions.
For the first six months of 2004, collisions in the city were down 14 per cent compared to last year.
Between January and June 30 there were 1,137 crashes, down from 1,328 for the same period in 2003. Injury collisions also dropped to 154 from 209 in 2003.
Francescutti said increasing traffic enforcement and in turn police presence, also contributes to decreases in property and other violent crimes and it isn't uncommon for police to crack a major case through a routine traffic stop.
He said serial killers John Wayne Gacy and David Berkowitz -- Son of Sam -- along with Oklahoma City bomber Timothy McVeigh, were all exposed for their more heinous crimes in part because of tickets.
October 9, 2004 - All you guys who'd rather sleep in instead of being forced to work bleary-eyed early in the morning have an unlikely champion: Dr. Louis Francescutti.
"Most young guys will sleep till noon," says the head of the Alberta Centre for Injury Control and Research. "Does it make sense to make them get up at 6 a.m. to work?"
Guys in early adulthood are hardwired differently from everyone else, says Francescutti. They simply don't function well in the morning.
"We're making people work when they should actually be sleeping," he says.
And those 12-hour shifts for days on end that are so common in the oilpatch? Maybe that's not such a great idea, he adds. People can only concentrate for so long before accidents happen, he says.
Fatigue is a major cause of road accidents, along with speed, drugs and booze, he notes.
I can't help thinking about Christian Alexis, the 21-year-old oilpatch worker who died last week when his vehicle crossed the centre line on Highway 43 and crashed head-on into a pickup truck about 7:40 a.m.
He had just finished a 12-hour shift. Did he fall asleep? We may never know. But his death underscores a troubling reality.
Alberta workplaces may have had their best safety performance in a decade last year. The annual injury rate in 2003 was the lowest since 1991.
Safety training standards have dramatically improved in the oilpatch over the past two decades and that's great news. But workers are still dying - on the road.
Oil rigs used to be called "killing fields," says Murray Sunstrum, executive director of the Canadian Petroleum Safety Council.
In the past, injuries and fatalities to workers typically involved things like crushing accidents, spinning chains or explosions, he says.
"The industry has stepped up to the plate on this issue," he adds, noting the heightened concern with safety in recent years.
"Now something as seemingly mundane as driving has supplanted everything else as the No. 1 cause of death (in the petroleum industry)."
Fatigue, speed and inattention are the new killers of oilpatch workers, says Sunstrum.
"If our outcome is peak performance and safety, we have to ask ourselves are we doing the best we can?"
He agrees with Francescutti that it may be time to look at whether making employees work such long shifts - and such early hours - is doing more harm than good.
On the other hand, winter is "gravy season" for oilpatch workers and long hours go with the job, Sunstrum says.
Also, many people like working longer shifts, he adds. (Under Alberta labour standards, oilpatch employees and other industrial workers can work 28 12-hour shifts in a row before getting four days off.)
Part of the problem is that there has been no comprehensive analysis of our traffic collisions, says Sunstrum. Different agencies compile various statistics but no one can see the forest for the trees, he says.
"We're doing an abysmal job of putting together information that we can (base) research trends on."
That's the daunting task facing various groups scheduled to meet Tuesday in Edmonton to begin mapping out a provincial road safety plan, says Sunstrum.
That meeting stems from a recent government-commissioned report that recommended the province spearhead a wide-ranging plan to improve traffic safety.
Oilpatch companies are "at their wits' end" as to how to get workers to drive safely, says Roger Soucy, president of the Petroleum Services Association of Canada.
"Trying to change human nature is a very difficult thing to do," he says.
"You give them training and scare them to death with movies of accident victims and there's a percentage of people that just don't get the message."
September 3, 2004 – As far as I am concerned, there is no doubt that a global epidemic exists which has been neglected for far too long. This epidemic continues to kill an estimated 1.2 million people a year and injures and disables another 50 million. This epidemic started at the turn of the century and all predictions are that it is going to get worse before it gets better unless we smarten up. The disease I speak of is traffic injuries.
The World Health Organization and the World Bank boldly released their 'World Report on Road Traffic Injury Prevention' in April, calling on the globe to take this problem more seriously. Their call to action included four key points: firstly, the identification of a lead agency to guide national road traffic safety efforts; secondly, that there is an assessment of the problem, policies, institutional settings and capacity relating to road traffic injury; thirdly, those countries prepare a national road safety strategy and a plan of action; and finally, that financial and human resources are allocated to address the problem.
Closer to home, we have all been reading about the recent unbelievable carnage on our own roadways. A woman who was an employee of the University of Alberta, killed while out for a peaceful evening walk; motorcyclists smashing themselves to death; teenagers dying without seatbelts; a pedestrian hit by an alleged impaired driver; and the insanity continues.
The problem is simple. We as a society have become desensitized, habituated and complacent when it comes to traffic injuries. We expect our front pages to bring us the latest crashes; we are not surprised by our evening newscasts starting by showing the spectacular mishaps on our roadways. We are not outraged, when we should be. Traffic injuries are the leading cause of death for Albertans under the age of 34, and for our children. Everyone knows someone who has died in a car crash.
Trauma due to traffic crashes is extremely costly and disruptive to the health care system. One of the reasons grandmas cannot get in to have their hips or knees electively replaced is that those beds are filled with victims of car, pedestrian and truck crashes.
In Edmonton alone, if the deaths on our roadways continue at the current rate, we are set to eclipse last year's dismal tally which was already almost twice what it was the year before. The solution is actually quite simple, but requires an enormous amount of political will and steely determination.
Albertans need a good dose of traffic enforcement and it needs to start today. Our current levels of issuance of violations are anemic. We could use an immediate 500 per cent increase in ticketing, no warnings please. The judicial system has to make sure that any driver is dealt with appropriately--no plea bargaining, no backroom deals.
Any education campaign considered must be of the same quality and have the same amount of financial backing as the brewing, liquor and vehicle industries. They have been allowed to portray a culture of speed, recklessness and risk-taking, as evidenced by the current crop of ads we are seeing. One brewing outfit even has the audacity of labelling their recent campaign the 'Trauma Tour'. Go figure!
Unless Albertans speak up and ask that something be done, Alberta's real debt--our injury debtload--will continue to extract an unbelievable toll on all of us.
March 21, 2004 - The potential exists that you young men and women here today may be destined to become our leaders of the future. By choosing to show up this weekend you have taken the bold, first step in that direction. Some say that leaders are born leaders; others say that leaders can be created. Neither is really correct. In spite of all the books on leadership and all the recent media hype are we any better off? I do not think so. A leader can only exist with followers. A leader can be cruel or can be kind. A leader can be a winner or a loser. Leaders are a rare commodity these days. Our political leaders are sadly lacking the integrity required to gain our trust. A lot of our families are leaderless.
Never ever mistake managers for leaders. There is a world of difference between the two. A leader is someone who you unquestionably follow over the hill when the bullets are flying overhead. A manger is someone able to take direction from a leader and make things happen.
Leaders have visions, are usually charismatic, can make decisions and can see the big picture. Not everyone is cut out to be a leader. A leader that is on a power trip is not a leader. They are control freaks. A great leader has an even greater sense of humor. A leader is secure and confident in their ability to lead. Leaders make mistakes. The difference is that leaders rarely make the same mistake twice. Leaders take chances, lots of them.
Inspirational leaders consistently treat individuals with respect and dignity. Confident leaders surround themselves with others who are always better than they are. Leaders cry. Wise leaders know when it is time to move on.
Why would anyone want to become a leader?
Simply because our world functions with leaders. The head of a family is a leader, a principal of a school is a leader, a Chief of police is a leader, a soccer coach is a leader and the captain of an airplane or ship is a leader. Our society would collapse without leadership.
More than ever we are in need of men and women willing to sacrifice and become leaders. Leaders are easily identifiable targets for assassins. Leaders are easy to criticize; everyone always knows how to do it better. Society by and large is made up of a few leaders, but mostly by followers and a small minority of whiners and complainers.
Paul Belserene taught me years ago that the twelve most important traits of great leadership are actually quite simple:
1. They are good listeners.
2. They do their homework.
3. They keep their word.
4. They let others take the credit.
5. They tell the truth.
6. They know themselves.
7. They stay loyal to the goal.
8. They keep their promises.
9. They are resourceful.
10. They know their abilities.
11. They know their needs.
12. They care.
I encourage you today to find out how you can become a better leader and a better follower. To find out how you can start to make this world a better place for yourselves, for your family and for your friends. When you see a need, fill it. When you see an injustice, write a letter or speak out. When you seeing someone cry, comfort him or her. When you see a dish that needs washing, wash it. If you see something that needs to get done, do it.
Does the world need you to be become more engaged? Absolutely, now go out and make a difference today; for tomorrow is not guaranteed to anyone, including leaders.
January 9, 2004 – Britain recently joined some 40 countries in announcing legislation banning the use of hand-held cellphones while driving. On April 1, 2003, Newfoundland became the first and only province in Canada to do so. More than 95 per cent of the population had supported such a ban prior to its implementation.
Several different well-designed and executed studies over the past seven years have convinced me that you cannot drive safely and use a cellphone, whether it is hand-held or hands-free. It is the conversation that is the distraction, and the more heated the conversation, the greater the distraction. Breaking up with a lover, getting fired, missing a deadline, being late for an important meeting, finding out where to pick up the kids, closing a deal, or just idle teenage chatter distracts us from the task at hand. Driving safely.
It will be ethically impossible to get that final definitive study that conclusively links cellphone use to driver distraction to crashes. But we have enough convincing evidence today that is begging for some immediate action.
Alberta is a dangerous place to drive, make no mistake about it. Every year more than 420 of our neighbours die on our roadways and in hospitals. But the deaths are just the tip of the iceberg; thousands of others are needlessly injured and permanently disabled. Not all from cellphone use, but mostly by driver distraction and inattention.
What concerns me more than the current cellphone debate is the emerging trend towards the increasing use and marketing of telematics within the vehicle. DVD players, fax machines, printers, satellite navigation systems, ON STAR, computers and countless other gadgets that are designed to make us more comfortable and productive in the vehicle are distractions.
The technology being introduced into our vehicles is running way ahead of the legislation required to ensure that driving is simply that. A driver’s attention now has to compete with a whole new array of fun things to do while behind the wheel.
Recently in Australia, a woman walked free after having killed a cyclist while text-messaging on her phone. How many legislators and policy makers even know what text-messaging on a cellphone is?
Japan Vodaphone KK now has a cellphone capable of receiving television signals. Great. Why not watch TV while travelling down some dirt road or through a school zone? It is fairly safe to say that in Alberta we are unlikely to see such a ban on cellphone use for a variety of reasons. We always seem to be the last to use common sense when it comes to road safety. The lobbying pressure from the wireless telecommunications industry is enormous and will continue to intensify. The growth of cellphone users is beyond anyone’s wildest expectation. Idle cellphones do not generate profits.
There are benefits to having a cellphone in the vehicle in the case of an emergency. But it should be turned off and available only if need be. Even suggesting that drivers pull over to the side of the road if they get a call is insane. Do we know that pulling over and then trying to get back into traffic is not as dangerous?
The solution then, is simple. Follow the lead of industry. Halliburton has a company policy banning the use of any cellphone in a moving company vehicle.
Do not use a cellphone yourself in your private vehicle, no matter how great a driver you think you are (and we all do).
You ain’t seen nothing yet, my friends. I predict that driving will actually become more dangerous as a result of this new wave and movement towards in vehicle telematics, and cellphones are just the beginning.
In many people’s minds, injury is inextricably connected to accidents. This perception implies that we are helpless to change the prevalence and severity of injury. In fact, most injury is preventable.
It is easy to see that intentional injuries (the result of suicide attempts, family violence, fights, rape, etc.) are preventable. What is less apparent is that we can also prevent unintentional injury, injury that results, for example, from motor vehicle collisions, fires, or falls. We know this to be true. Why else have campaigns against drunk driving? We know that if we can prevent an intoxicated person from driving, we can avoid the consequences of an "accident."
Injury is a disease with widespread consequences. It results in greater annual economic costs to society than cancer does. Because it disproportionately strikes the young, injury also costs us more in potential years of life lost than any other disease. In 1997, of the 1350 Albertans who died from injuries, 452 were between the ages of 15 and 34. In that same age group, 49 died of cancer.
Despite its tremendous cost to society, few resources are devoted to preventing injury. Our response to the cancer problem is far more sophisticated and much better resourced.
A similar situation is apparent when one examines the magnitude of the suffering associated with the disease of chemical dependency versus the amount of resources dedicated to treatment, prevention and research. This incongruity is baffling to me.
From my experience as a clinician, and a researcher and advocate for injury control, what is readily apparent is the extraordinary prevalence of chemical dependency and alcoholism in injury patients, particularly in those with major trauma. When we look for it, we find that a great number of individuals who are injured are under the influence of alcohol or other drugs. Alcohol is involved in over 65% of snowmobile related deaths. Close to half of all drowning cases involve alcohol. The relationship between those injured as a result of violence and substance abuse is even higher.
To compare, as many as 69% of trauma patients meet diagnostic criteria for substance abuse or dependence. When screened, over 40% of trauma patients test positive for chronic alcohol abuse. This proportion greatly exceeds the reported rates of alcoholism on medicine (25%), neurology (19%), obstetrics-gynecology (12%), and even inpatient psychiatry service (30%). What is even more apparent to those who treat trauma patients is the high rate of reinjury among those with substance abuse problems.
To those of us who work in emergency rooms, the link between substance abuse and injury is obvious. We see it on a daily basis. What I also see, however, is a great reluctance in our current acute medical system to identify people with chemical dependency and intervene to help them. Despite the fact that for years the Trauma Association of Canada has recommended that admission blood alcohol levels be determined for every major trauma patient aged 12 and older, in Alberta’s trauma centres less than 20% of patients are screened.
Several studies suggest reasons why medical professionals are not looking for substance abuse in those injured: they feel they are not qualified to identify it, they don’t have the time and they feel they wouldn’t know what to do when they found it.
As acute care professionals, we have a choice. We can simply go on treating those under the influence and injured with the standard sew them up, sober them up and send them back out for more attitude that is our current modus operandi. Or, we can admit that we don’t have a clue what we are doing when it comes to identifying and treating people struggling with substance abuse, and seek the help of addictions specialists.
The real answer is going to be when we find out why people need to be under the influence of intoxicants in the first place. People who have deep and often hidden wounds (physical, spiritual, emotional) medicate their pain and often, as a tragic consequence, suffer more trauma.
I am convinced that it is axiomatic that trauma, if left untreated, begets addiction, which, if left untreated, begets more trauma. Whether emotional or physical, trauma begets trauma. As long as people have the need to abuse substances, they will continue to get injured and injure others. People who cannot or will not heal their own pain will hurt themselves and others. We should seize the opportunity, when they self-select and present to our emergency department, wounded and asking for help, to help them. Any medical care system can patch them up temporarily but a truly caring system would try to find out why they put themselves at risk and intervene then and there.
Even if we were able and willing to offer treatment and rehabilitation for everyone who needs it, however, our system, in its present format, is simply not capable of supporting the flood of people who would be identified and offered help. Also, in many cases, not even a major trauma can break through the denial that often accompanies chemical dependency.
I only wish I could wave my magic wand and conjure up more resources (money, courage, compassion, insight, understanding) for the system. Maybe then we could have addictions specialists available to work side by side with trauma and injury professionals in the trenches in acute care in order to help us better understand what we should be doing.
Until then, I remain, like everyone else, struggling to do my best to help the addicted and the injured.
January 30, 2002 - Can you believe all this nonsense about health care these days?
We really don't have a health care system at all; we have a “sick care system”. And it's terribly addicted to treatment. Across Canada, we are wasting billions of dollars annually on sick care without getting the least bit healthier.
Truth be known, the health care system has little to do with making anyone healthy. You're far more likely to be healthy if you go to college or university, have adequate housing, a supportive social structure, a job, inherit the right genetics and have the ability to love and be loved. All of these things have nothing to do with the health care system.
So what do we need to do to get Canadians healthy again? Actually it's quite simple. Almost embarrassingly simple. We need to go after the biggest killers and causes of disability in society today: injuries, smoking, obesity and inactivity.
It will take hundreds of millions of dollars but that could easily be raised by introducing “health surcharges fees” on products known to contribute to ill health: tobacco, fast foods, alcohol, soft drinks and junk food. We'd have enough money for a dedicated and sustained wellness fund that could only be used for innovative and proven health promotion initiatives.
We would get our greatest immediate returns by first concentrating on the epidemic of injuries. Injuries are the leading killer of Canadians under the age of 45. Injuries are not “accidents”; they are both predictable and preventable. Injuries can and should be viewed as a disease. Our new Federal Minister of Health Anne McLellan would be wise not to ignore this killer epidemic as all of her predecessors both federal and provincial have done. To date not one Provincial or Territorial government has adequately funded injury prevention.
Smoking is an obvious no-brainer – tax the hell out of cigarette products, ban advertising outright or counter it with more creative ads, and pay for smoking cessation programs proven to work.
And whatever happened to Participaction? We need to resuscitate it, modernize it and get Canadians off their butts again. Get into the schools and reintroduce kids to phys ed. Our kids are overweight and inactive. An extra penny per liter of gasoline would go a long way towards raising the money for increased activity programs. We need to set a target of Canadians collectively losing several thousand tons of fat over the coming years.
Doctors and nurses and other health professionals should go to work each day thinking of ways to put themselves out of business. Their current addiction to “sick care” has to end – it is the greatest barrier we face in getting Canadians truly healthy.
For Commentary, I'm Louis Hugo Francescutti in Edmonton
December 5, 1997 - Amidst the flurry of discussion following the car crash that killed Diana, Princess of Wales, something vitally important was missing, says Dr. Louis Francescutti. People talked endlessly about the intrusiveness of the media, the need for spiritual community, and the future of the English monarchy.
But according to the outspoken injury prevention advocate, one crucial question never got asked, a question that, for him, sticks out like a sore thumb: why weren't Diana and her companion wearing seat belts?
"The only guy that survived the crash was wearing a seat belt," said Francescutti last Friday at a seminar on current issues in public health sponsored by the Department of Public Health Sciences. "The car they were in was a tank-if they were all wearing their seat belts, they would have survived. Yet nobody talked about putting funds towards trying to prevent these things from occurring, so at an opportune time like that, where progress could have been made, the issue was totally ignored."
While the thrust of Francescutti's talk may not have been altogether new, it is one the professor of health sciences takes great pains to repeat whenever he gets the chance-in a weekly segment on CBC radio, in newspaper editorials, and at academic conferences. And he makes no bones about it: injury should be treated as a disease, one meriting the same attention, and the same funding, as cancer and heart disease. The only reason injury is not taken as seriously as it deserves, he says, despite the fact that it's the leading cause of death for those under 44, is a matter of politics.
"Injuries affect primarily younger people who don't have too much say in the political process. Who decides where research dollars go? Usually men in their 50s and 60s, and what do they die from? Cancer and heart disease."
Some of the brass in health care, however, are beginning to listen to Francescutti's message. Last October, Alberta Health appointed him chair of a 10-member advisory board on injury and also provided $300,000 for the new Alberta Centre for Injury Control and Research, set to open next April. The centre will assume responsibility for injuries in much the same way the Alberta Cancer Board does for cancer cases.
Albertans in particular have good reason to sound the alarm, says Francescutti. Our province has the highest death rate due to injury outside of the territories. The leading cause of injury-related death in Alberta is suicide, accounting for more victims than even automobile collisions.
Perhaps surprisingly, the region with the best injury record is the Northern Lights Regional Health Authority in the northern part of the province. Francescutti attributes this success to the big petroleum companies located there, such as Syncrude and Suncor, which have been stressing safety among their employees for 25 years. Now the entire community is starting to benefit from company policy.
"The reason (corporations) do it is that it affects their bottom line-God bless free enterprise! If we could have some of that gung-ho spirit spill over into the other regional health authorities, we might be able to beat Sweden (the leader in injury prevention), so that five years from now people around the world will be able to use Alberta as the bench mark." Francescutti added that the health-care system should be willing to take the kinds of spending risks that are taken for granted in the corporate world.
The place to begin changing attitudes about injury, however, is with younger generations, he says. Towards that end, he plans to recruit "gangs" in high schools to promote safety as cool among smaller children.
"Wouldn't it be great to have the Syncrude Prevention Dudes, and all these dudes and dudettes do is drive around in the summer looking for small kids doing stupid things. I think teenagers are ready to take up a cause, and my job is to train future leaders."
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