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The Current Transcript for January 25, 2024

Host: Matt Galloway

STORIES FROM THIS EPISODE

Prologue

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LISA LAPOINTE: I see the grief and I see the loss, and there's likely not a family in this province that hasn't been impacted or knows somebody who's died as a result of toxic drugs.

MATT GALLOWAY: The numbers are staggering. On average, seven people a day die in British Columbia alone from unregulated drugs. As she prepares to retire, BC's Chief Coroner is calling out the provincial government for what she calls a lackadaisical response to this crisis. In 30 minutes and exit interview with Lisa Lapointe about the spread of fentanyl, the ongoing controversy around safe supply, and what she would tell conservative leader Pierre Poilievre about the impact of toxic drugs. Also this morning, we worry a lot about our health and you can do all the right things exercise and eat well. But what if there is something lurking inside you that could pose a risk? Turns out there's a scan that might help. Full body MRIs are increasing in popularity. They aren't cheap, though, and at this point, it's not actually clear whether they're worth the cost.

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DR. ANIA KIELAR: If they do find something, incidentally, these people end up coming into our publicly funded health care system in Canada, and because we have such scarce resources, we don't have the capacity right now.

MG: In an hour, as part of our series on wellness, a doctor on what can go wrong when you search for a needle in the body's haystack, and what changed for him when he underwent his own full body MRI. But we begin with dramatic developments in the long running allegations of sexual assault surrounding members of Canada's gold medal winning world junior hockey team. Good morning. I'm Matt Galloway, and this is The Current.

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Five former world junior hockey players to face sexual assault charges

Guests: Robyn Doolittle

MG: Five former world junior hockey players are expected to face sex assault charges, according to The Globe and Mail. In 2018, a 20-year-old woman claimed that she was sexually assaulted in a London, Ontario hotel room by a group of hockey players, including members of Canada's world junior team. Those allegations didn't become public until four years later. The case led to a reckoning about hockey culture in Canada and eventually at Hockey Canada itself. And yesterday, according to the Globe's reporting, London police asked five of the former 2018 world junior players to turn themselves in. The CBC has not independently verified these reports. The Globe and Mail's investigative reporter Robyn Doolittle broke this story. And, a warning, the conversation we're about to have will reference details of sexual assault. Robyn, good morning.

ROBYN DOOLITTLE: Good morning.

MG: What did you learn from your sources about why London, Ontario police have asked these five players to turn themselves in now?

ROBYN DOOLITTLE: I mean, in some ways it's not a surprise because the police indicated well over a year ago that they believed that five members of the world junior team, that there were reasonable grounds to believe that these players committed sexual assault. They filed court documents in 2022 about this. What the surprise has been is why this has gone on so long. So, what the development is of this week is that they're acting on, kind of what they said publicly before. That they believe that these players were, that they had grounds to believe that they were, had committed sexual assault.

MG: What have you learned about when they will actually be charged?

ROBYN DOOLITTLE: So, what we know is that very recently they were told to surrender to London police headquarters to face charges. And it is an important distinction, they have not yet been charged. In these types of cases, it's very common for police to let people without violent records or criminal records to kind of take this on themselves and appear. It's not like they're going to go and put handcuffs on people at their home in this case. So, they all have a period of time. We understand it's later next week that they have to present themselves to London police headquarters. They'll get details of the charges that they're facing. They'll probably make some promises of various, you know, how they have to, or restrictions on their lives at that point. And then they will appear in court and at that point they will face charges. I have no idea when that court date will happen. But we do know that London police have scheduled a press conference for February 5th.

MG: We also know that a number of hockey players in the NHL in Europe have, in the past few days, taken indefinite personal leave from their teams. The CBC isn't naming those players, and officials from the teams have said they don't know why those players are leaving. But what have you heard from the lawyers who are representing those players?

ROBYN DOOLITTLE: You know, I think this is. It's a really tricky thing, right? The story is everywhere because it does touch on NHL players. Media from across the world has been covering it. I'm seeing it in my inbox right now. I think this is...

MG: And all across social media as well.

ROBYN DOOLITTLE: ...exactly. And I think this is just something that we absolutely have to be really cautious about, and we have to make sure we get it right. And this is something in journalism that we face all the time. And, you know, I think at this point The Globe and Mail is not drawing that aspect into the story at this moment. There is news out there that anyone on Twitter can look at. What we know for sure is that the London police have said, they had asked five members of that junior team to appear. We do know that among that group there are NHL players. We've reported that in the past. And other things that are happening right now are just not things that we feel comfortable drawing into this story at this moment.

MG: In 2022 the woman who is at the heart of this case, who was known in court documents as E.M., sued eight unnamed players, Hockey Canada and the Canadian Hockey League for $3.5 million. What does she say? This is difficult, but this is important in the context of this story. What does she say happened that night in 2018, in her statement of claim?

ROBYN DOOLITTLE: Yeah, there's two real windows into what happened. There's the statement of claim that she filed in 2022. And then there is that application that I mentioned earlier in this conversation where police filed court records. It's called an ITO. They're trying to get various investigative measures approved by a judge. And this is where we understand, of what the police case is and what E.M.'s allegations are. And basically, she says that on the night of June 18th, 2018, which is the same night as this big hockey fundraising gala in London, Ontario, E.M. went to a bar in downtown London, met some of the players. She was drinking heavily. They were, you know, hanging out, being young, partying. And she left the bar with one of the players. They returned to his hotel room at the Delta Armories and had consensual sex. And then she says that at some point she left and I believe she was in the bathroom. And when she came out, the room was full of players. And what we know from the ITO is that the player who was identified as player one, texted teammates to say to come to the room if anyone was interested in a sex act. And she says over the next several hours that she was sexually assaulted by those players, that she was humiliated, that, various other things happened. And that she had tried to leave, that she was crying, but that the players, "manipulated her," and pressured her to stay. And this is, it's really tricky because what we also know is that there were two videos shot in the room, and, E.M. says she wasn't aware the first one was shot, but she was aware the second one was shot. They're about six seconds and 12 seconds long. And in the first one she can be seen in the footage. A players is asking her, are you okay with this? And she says, I'm okay with this. And in the second video, she appears quite anxious, but sober, saying, "I'm totally fine with this, like, you're being so paranoid. It's fine. Like, I just can't right now." And she says that she felt that she had to say this because it was very intimidating having these giant hockey players in a small hotel room that she felt she had to go along with it. But like any sexual assault case, this is a really complicated situation where, you know, we are relying on different narratives. The players, through their lawyers in the past--and it's a really tricky situation with the lawyers where we know some of the lawyers involved, but we don't know which players they're attached to because they were initially kind of acting as a group--have said that they deny any wrongdoing.

MG: Lawyers for E.M. showed text messages to The Globe and Mail between one of the players and E.M. that were sent after that night. What did those text messages say?

ROBYN DOOLITTLE: Yeah. It's interesting. It was actually the player's lawyers who showed the text messages.

MG: Right.

ROBYN DOOLITTLE: I mean, which was, you know, interesting. The conversation is between E.M. and player one and it's, you know, the same day that she went to police and the player says, did you go to police? You have to make this go away. Like, you said this was fine. And in those text messages--I wonder if I have this thing up in front of me. "You said you were having fun." She says, "I was really drunk. Didn't feel good about it at all after. But I'm not trying to get anyone in trouble." He says, "I was okay," or, she says, "I was okay with going home with you. It was everyone else afterwards that I wasn't expecting." It kind of continues from there. And it's interesting, you know, I've done... I'm not saying this shows anything, either way. What I can say is I've spent a lot of time reporting on sexual violence. And this idea that sexual assault complainants will try to normalize some of this stuff afterwards or have conversations with individuals who may be an accused in a case, is quite common.

MG: You spoke with E.M. in 2022. What did she tell you?

ROBYN DOOLITTLE: Yeah. I mean, I spoke a lot with her lawyer, and I had a very brief conversation with her. And we actually spoke after The Globe reported on the details of this video and these text messages exchanges, which are really obviously very intimate, raw moments. Right? And reported it and put it in the paper. And I spoke with her a little bit after that, and she said, you know, this is, it's been really frustrating, because she was quiet through all of this. It's been really frustrating seeing, kind of, bits and pieces of this story reported and kind of not being able to say anything, and that she never wanted this public. And I think that this is...but that she is interested in people facing accountability. And this is what's been really difficult, I'll say, from a journalistic perspective, reporting on this story is, as a consideration. This is not a case where a sexual assault complainant has come forward and said, I want attention on this. This was broken by outside media, by TSN reported on her lawsuit. And that's how this became this national firestorm story with so much attention and scrutiny. So that's been, you know, for her, from her perspective, is she did not do any steps there to have this broken. They didn't leak the settlement. This would have just went away.

MG: Have you spoken to her since this latest news broke?

ROBYN DOOLITTLE: I have not spoken to her since. And and partly because this is now a really active file and process. It's, again, from a reporting perspective, it's a tricky thing.

MG: We'll leave it there. Robyn, really glad to talk to you about this. And thank you very much.

MG: Thanks.

ROBYN DOOLITTLE: Robyn Doolittle is an investigative reporter with The Globe and Mail. Katie Strang is a senior investigative writer who's been covering the hockey scandal for The Athletic. She wrote an extensive piece on this in 2022, One Night in London. Katie, good morning to you.

KATIE STANG: Good morning to you. Thanks for having me.

MG: In the hockey community, such as it is, what has been the reaction, as you understand it, to The Globe's report?

KATIE STRANG: Well, you know, first of all, I just want to commend Robyn's terrific reporting throughout this process. She's been incredible and I think shed some light and provided some accountability in some really important places. And, you know, I think in the hockey community for so long, there has been this pervasive feeling of, you know, this process really dragging out and taking a long period of time. You know, people have been frustrated, they've been confused. They've been confounded by, you know, why we haven't really gotten any answers. And so I think to some degree, yesterday's developments, you know, were seen as, you know, kind of the first finite step toward, you know, understanding that this process will eventually have a resolution, in whatever capacity, however this plays out. So I think there was at least perhaps some, you know, relief, that, you know, that there was a significant development. I think there was a lot of speculation that the NHL would take, you know, steps or potentially assess some supplementary discipline, you know, even before the legal process had played out. That has not happened. So I think the fact, knowing that this legal process is playing out, and taking steps forward has been seen as sort of a, you know, a tangible step forward.

MG: I mentioned your piece in The Athletic in 2022, One Night in London, in which you report on the details of that night, but also what happened in the days and weeks subsequently. Hockey Canada settled this lawsuit in May of 2022. A few days later, the deal became public. There was huge outcry to that. What did you learn about Hockey Canada's response in the days after this alleged assault?

KATIE STRANG: Well, I think we learned a number of things, not just through, you know, that statement of claim. But I think when this news surfaced and that news was broke by TSN, you know, it ignited this national and, you know, international firestorm and was dominating headlines. And I think that prompted, you know, people from all corners, not just sports. This has really been a story that has transcended the sports world. You know, you saw Canadian parliament get involved. And so that has yielded some answers about how Hockey Canada handled these allegations. We know that, you know, when they first became aware, they had a number of internal discussions, both with people at the executive, and C-suite level, and then also with their insurers and legal counsel. And that they did eventually report to police. They did take measures to internally probe the matter. You know, I think the contours of that probe are probably something that have been heavily scrutinized. And both the London police investigation and the internal Hockey Canada investigation that resulted in the immediate aftermath, were subsequently closed. But the attention and the scrutiny on this case prompted both of those entities to reopen those investigations.

MG: And as you mentioned, I mean, Hockey Canada's leaders were hauled in front of a parliamentary committee in 2022. When you were on this program at that time, you describe the tone of Hockey Canada during those hearings as baffling.

KATIE STRANG: It was. I mean, you definitely got the sense that there was quite a bit, as there often is in cases like this of, you know, institutional protectionism. And, you know, I don't think that there was quite the acknowledgement of perhaps the gravity of the situation. You know, I think there was some--not a ton of introspection. And quite a bit of, sort of, institutional defensiveness when they were hauled in front of Canadian Parliament. And I think that the tenor of those hearings and, you know, the content of what they provided to Canadian lawmakers, I think, really struck a chord with everyone who was paying attention. And I think, you know, I think it sparked outrage, quite frankly.

MG: In part because E.M.'s case isn't the only one involving allegations of sexual assault. One of the things we learned during that testimony was that Hockey Canada deals with multiple sexual assault allegations every year, right?

KATIE STRANG: Absolutely. And The Globe and Mail did some incredible work in sort of discerning how Hockey Canada as an institution dealt with historical claims of sexual abuse. And when they made settlements where that money came from and how that was subsidized by participation fees and such. So, you know, I think it really peeled back a layer and provided people a peek behind the curtains of how these situations are handled at an organizational level from a national governing body that is tasked with oversight, and, you know, the protection and well-being of young athletes. So I think it did spark a larger and needed conversation about abuse and sexual misconduct in sports and perhaps how pervasive and rampant that is and how often it is mishandled.

MG: In the last few minutes that we have, let's talk about what is often referred to as hockey culture. I talked to Sheldon Kennedy a few weeks ago. Former NHL player, survivor of sexual abuse. He talked about toxic masculinity within hockey. People felt that this story in particular was going to lead to a reckoning when it came to issues of hockey culture. Has that happened, do you think, has that reckoning unfolded?

KATIE STRANG: I think that's really tough to say definitively, because I think a reckoning of that proportion is hard to--it's hard to affect in a matter of a year or two. I mean, I really think that, you know, there is probably, to some level, intergenerational trauma, as I'm sure Sheldon could attest to. That, you know, there have been elements of hockey culture that have been, you know, insidious for decades. And I think to expect that one case is going to act as, you know, a remedy or a cure-all or an anecdote, to decades worth of entrenched cultural values, I think, is perhaps a bit naive. You know, do I think that it has sparked needed attention and scrutiny in the right areas? Yes. Do I think it's an ongoing process that is far from over? Also, yes.

MG: I mean, there are questions about what the NHL has done around this issue, but also questions around Hockey Canada. Hockey Canada has new leadership. We've asked to speak with that new leadership. We've asked to speak on a number of occasions with the new CEO and president, Katherine Henderson. She says her goal is to rebuild trust with the Canadian public. How does she go about doing that, do you think, just briefly?

KATIE STRANG: You know, I think the biggest thing to rebuild trust is ultimately, transparency. And, you know, Hockey Canada is in some capacity still responsible for adjudicating this matter internally, as they're doing right now. And so how transparent they're willing to be in this process and with the public, I think, will go a long way to answering the question of how much change we're going to see with, even with new leadership and overhauled board.

MG: You spoke with the MP Peter Julian, who said there's a long way to go.

KATIE STRANG: Yeah. I think he felt like yesterday was, again, an important, tangible first step. And I think he was heartened to see that. But he also said that he was profoundly saddened by the fact that, you know, this has gone on for so long and that the young woman who has come forward has gone through such an exhaustive ordeal. And that, you know, so many people who have come forward with allegations of sexual abuse have felt neglected and abandoned by the federal government. And he just really stressed the need to put procedures and protections in place so that others do not endure that same experience.

MG: Katie, I'm really glad to talk to you again. Thank you very much for your work as well. KATIE STRANG: Thank you so much for having me.

MG: Katie Strang is a senior investigative writer with The Athletic. We did ask Hockey Canada for an interview or comment on this story, and we did not hear back. Your CBC news is up next. And then:

LISA LAPOINTE: I'm angry that almost 14,000 people have died, and that the response from our government has been very, I guess I would describe it as, lackadaisical.

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MG: British Columbia's chief coroner is worried that her province has no plan to reduce the record number of toxic drug deaths in BC. In her last month in the job, she talks to The Current about what it's been like to be in charge during this crisis and what she says needs to be done to help identify the people behind the numbers when we talk about the scale of this tragedy. She's here. Coming up in six minutes. I'm Matt Galloway, you're listening to The Current on CBC Radio and the CBC Listen app. Stay with us.

B.C. chief coroner angry at province’s ‘lackadaisical’ response to toxic drugs crisis

Guest: Lisa Lapointe

MG: Hello, I'm Matt Galloway and you're listening to The Current. The numbers are hard to wrap your head around. Two thousand, five hundred and eleven people in British Columbia died from unregulated drugs last year. That is an average of seven people every single day. It was the worst year on record, and that issue of unregulated drugs remains the leading cause of death in people between the ages of ten and 59 in that province. Lisa Lapointe is BC's chief coroner. Her latest report revealed the numbers yesterday. It's also her last report. She is leaving the job next month. She's in Victoria. Lisa Lapointe, good morning.

LISA LAPOINTE: Good morning, Matt. Thank you for having me.

MG: Thank you for being here. What do you think about when you release numbers like that? Record high death rates from toxic drugs.

LISA LAPOINTE: Well, I think about the people. I think about the families in particular. I don't have the opportunity to know the people who died, of course. But I hear from their families, and I see the grief and I see the loss. I hear about the people who died and how much they're missed and how much they're loved, and these reverberations that happen across our communities every time somebody dies and, you know, as you said, 2511 people, that's 2511 families times, you know, how many family members, how many friends, how many colleagues. And, you know, I don't think there's a--I think there's likely not a family in this province that hasn't been impacted or knows somebody who's died as a result of toxic drugs.

MG: Let's talk about some of the specifics. What is the report? And I've read through it. But from your perspective, what does the report show in terms of what drugs are killing people right now?

LISA LAPOINTE: Oh, this is a fentanyl crisis. This has been a fentanyl crisis in our province since 2012, in fact, well, it wasn't a crisis in 2012, but 2012 was when we first saw illicit fentanyl in post-mortem toxicology results. And since that time, the exponential growth of fentanyl in the drug stream, in the illicit drug market from 2016 till now--2016 was when this public health emergency was declared in BC. Fentanyl has been involved in 86 per cent of the deaths. And it's an opioid, highly unpredictable, very, not difficult to regulate if you're in a proper lab, with a, you know, very measured, controlled environment. But the way that illicit drugs are created, the regulation is very inexact, and that's causing people to die.

MG: What else have you learned about trends in drug use in your province?

LISA LAPOINTE: So, we have seen heroin basically disappear. Heroin was the opioid of choice for those who used opioids for many years. There's virtually no heroin in B.C. anymore. Fentanyl has taken that over. Fentanyl, as you know, Matt, because I've talked about this before, can be created in a home lab with precursors bought off the internet. So it is not a really difficult thing, sadly, to create. But we've also continued to see cocaine at significant, amounts about 40 per cent of the deaths involve cocaine. We see methamphetamine, amphetamines in the 40 per cent range as well, across the board. And then we've seen things like benzodiazepines show up more, sorry, benzodiazepines showing up more often. Benzodiazepines are also sedatives. So, when taken with fentanyl, you've got the synergistic effect. And, really hard to reverse an opioid overdose when somebody has also taking benzodiazepines. So, it's a mess. It's an illicit market. It's not controlled. It's not regulated. It's profit driven. And frankly, you know, the people in our province are at huge risk when they access that market.

MG: The numbers are a bit lower in this latest report, but your office has said unregulated drugs were the leading cause of death among youth in British Columbia from 2017 through 2022. How do you wrap your head around that?

LISA LAPOINTE: Well, you know, what we've seen is the number of, the percentage of youth dying in this crisis has remained, fortunately, fairly low comparatively. So one to one-and-a-half per cent of the deaths each year are youth under 19. But the fact that youth are dying, that this is one of the leading causes of death for youth in our province. Yeah. It's terrifying. You know, as parents and grandparents, what we faced as as young people potentially experimenting as young people do, we didn't risk losing our lives. And...

MG: And that's the reality now, as you see it? If young people are experimenting, and to your point, that's what young people do. They learn what the limits are. They try things. That they are at risk of losing their lives in that experimentation?

LISA LAPOINTE: Yes, absolutely. The illicit market is toxic, and it's unpredictable. It's frightening, you know. My kids are grown up. I have some, but I have small grandchildren. And it's terrifying to think that this potentially is out there for our children.

MG: I want to have you listen to Greg Sword. His 14-year-old daughter Kamilah died from an overdose in 2022:

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GREG SWORD: The only hope I get, and brightness is that my daughter didn't die in vain. That something actually comes out of this. I don't want to think that my daughter just was a number and died for no reason and no purpose, and that she didn't matter because she was from just a working-class family. But it's hard and every day it's a challenge.

MG: When we spoke with Greg a few months ago, he had yet to receive the coroner's report. But he'd been told that cocaine, MDMA and hydromorphone were found in his daughter's system. What do you say? And this is, just kind of going back to what you were just talking about, how parents are terrified about this. What do you say to someone like Greg, who is seeing this crisis and the real toll of the crisis up close?

LISA LAPOINTE: Well, my heart goes out to Mr. Sword. You know, my sincerest sympathy to him and the pain that I hear in his voice is pain that I hear in the voices of parents across the province, whether their child is 14 or 15 or 19 or 30 or 40 or 50, for that matter. The pain is intense. And I've had people say to me, "I'm in the middle of a nightmare and I don't know where to go." And we do hear more and more from parents, "it's too late for my child." Or if it's a sibling or another relative, "it's too late for them. But what can we do for other people at risk?" And there's this real altruistic sense out there, and I hear from people every day, we need to prevent these deaths. They don't want what happened to their family to happen to another family. This public health emergency in British Columbia has been in place since 2016. We've lost almost 14,000 people. Drug toxicity is the leading cause of death for those aged 10 to 59. We have not seen a response commensurate with the scale of this crisis.

MG: Tell me more about that. You've been the chief coroner in British Columbia through the worst years of that crisis. How would you describe the response by governments to this?

LISA LAPOINTE: We hear... I want to be careful what I say, because I don't want to be discouraging. And there are many, many people working very, very hard every day to try to make a difference. But overall, I would say the response has been very disappointing. What we have not seen is a plan. What is the plan? And many of us have been asking for this for the last seven years. What are we trying to achieve and what are the steps that we need to take to get there? So, what we've seen are announcements here and announcements there. No evaluation. So, we have no follow-up to see if we announced 20 beds, what were the results of those 20 beds? What did we find a year later? Or two years later or three years later? So that real lack of evaluation, lack of systemic plan for what we're trying to achieve, and then, you know, a bit of a lack, or, an inability potentially to communicate well to the general public what is happening in British Columbia. What are the problems? What are some of the realistic solutions? And let's think rationally about evidenced-based measures that will actually make a difference.

MG: You paused before you answered the question. And checked yourself in terms of what you wanted to say. What were you trying not to say in terms of that response? What does, I mea, you're on your way out now, retiring. What is your honest assessment of how governments have handled this?

LISA LAPOINTE: I don't want to be--I'm not generally a negative person. And I don't want to be negative. But I have found myself becoming more angry over time, and more critical over time.

MG: What are you angry about?

LISA LAPOINTE: I'm angry that almost 14,000 people have died, and that the response from our government has been very, I guess I would describe it as lackadaisical. We don't have, well we, when Covid hit our province, for example, and our country, there were plans. We knew that a certain number of people needed to be quarantined for safety, and measures were taken to do that. And then when there were vaccines available, a very methodical plan. How are we going to vaccinate all these people all across the province, by age groups, etcetera? So, we haven't seen anything like that with this crisis. So we haven't seen any particular plan. We keep hearing that treatment and recovery are important. And certainly the panels that we've brought together acknowledge absolutely, treatment and recovery are critical. But what we still don't have in this province are any reporting requirements, despite the fact that we recommended that back in 2018. So there are services across the province purporting to provide treatment and recovery efforts for people's loved ones. Many of them are private, many of them are for-profit. Families are mortgaging their homes to pay for their loved ones to go to treatment. And sometimes the treatment is successful. Sometimes it takes three, four, five times, and sometimes people die. And it's not an uncommon story for us to hear that somebody has been in period of abstinence, following treatment or recovery. And of course, then they use, their tolerance is so reduced and they die. And we don't, but we don't have any rules around reporting. So we actually don't know what are the outcomes. And I mentioned beds. We hear about beds and the announcement seems to be, okay we made the announcements for beds. Problem solved. But what do those beds do? We have no idea. And certainly what we've seen is that the deaths are mounting and the risk is continuing. And if you talk to people on the front line, what they will tell you is that nothing has changed. They have not seen anything change.

MG: What's at the root of that? Just the last point on this. What do you think is at the root of that. Of, what did you call it? A lackadaisical approach.

LISA LAPOINTE: Well, I think there are a couple of things. I think, one, this is a complex issue. And I don't want to oversimplify, you know, our health care across the country is very, very challenging right now. There are not enough clinicians. There are not enough physicians. Long waiting lists. People don't have family doctors. This is a health care issue. And so like every other health care issue, there is a real dearth of services available. But more than that, I think we're in a transition. So for decades, people who use drugs are treated as criminals. And the force of the law in terms of policing, courts, probation officers, penitentiaries, correctional centres, were used to address the drug use. There is absolute clarity now amongst all levels and types of government and agencies, Canadian chiefs of police, you know, federal crown, federal government, provincial government. This is a health issue. So drug use is a health issue. Using that law enforcement punitive tool has been incredibly damaging and not helpful. So we're in a transition where we're recognizing this is a health issue, but we haven't created any of the infrastructure to respond in a meaningful way to this health issue. And we need to get on that, because across the country, 40,000 people have died as a result of drug toxicity. And more will die. You know, we can't stand and watch these people, our community members, die. And like Mr. Sword said, we need to do something. We need to learn from what's happened and move forward and prevent some of the future deaths.

MG: Let me ask you about one of the interventions. And that is what's known as safe supply. Hydromorphone is part of the safe supply program. There are doctors who have gone on the record raising the alarm about these sorts of drugs ending up in the hands of young people at parties and beyond because of a lack of oversight. You said that that is an urban myth. Are those doctor's wrong.

LISA LAPOINTE: So, we haven't seen a diagnosis of opioid use disorder in youth increase. And Dr. Henry keeps an eye on that. We certainly haven't seen any increase in deaths amongst youth related to hydromorphone. We see very little hydromorphone in post-mortem toxicology testing provincewide. About three per cent of tests we've seen hydromorphone. So, we don't have any empirical evidence that hydromorphone is making a difference. But we certainly hear those concerns. I guess for me, it comes down to this. If a child is going to be offered or is seeking, substances, I would far rather that they access a prescribed, regulated hydromorphone pill than some concoction that may be toxic from the illicit market. Now, that doesn't mean we want our youth using drugs, and I think we need to be clear about that. Safer supply is not encouraging people to use drugs. Safer supply recognizes that the people who are using drugs are at serious risk of harm and death. And this is an opportunity to say, okay, we're going to provide you safer supply. And then let's talk about some of the other issues that lead to your substitute substance use and where we can help people. Because, frankly, and this is, you know, it's blunt, but if you're dead, you don't have any opportunity to access treatment. You don't have any opportunity for recovery. So, you know, I hear these doctors and I completely understand their concerns.

MG: But you also called them an urban myth.

LISA LAPOINTE: Well, the urban myth that every child out there who's accessing drugs is accessing hydromorphone and that if it weren't for hydromorphone, they wouldn't be using drugs. That, to me, is the myth. That somehow hydromorphone is luring children into drug use. We just, we don't have any data that supports that. We don't have any statistics that support that. I completely believe that some child's been offered that. Somebody's children have been offered that as a party. I heard a doctor say that. I don't doubt that. But is that having the, sort of, the critical negative effect that those doctors are espousing? We haven't seen that anywhere.

MG: Pierre Poilievre, the leader of the Conservative Party, who, if you believe the polls could well be the next Prime Minister of Canada, said this. These are his words. "The theory of safe supply is destroying lives. Stop taxpayer funded hard drugs, fund treatment and recovery." What would you say if you were able to talk to Pierre Poilievre? What would you say to him?

LISA LAPOINTE: I would say to Mr. Poilievre, the discussion is not about safer supply versus treatment and recovery. The discussion is about, how do we keep people alive? How do we support people to wellness? So, treatment and recovery is critical. Treatment and recovery across our country is, I was going to say sadly lagging--critically lagging. There are no standards right now for treatment and recovery. There's thousands of different, you know, approaches, these sort of ad hoc approaches, that not-for-profit, for-profit, community funded services take note. Most of them, I'm going to say, are extremely well intentioned. But we have no data. We don't know what works. We don't know what's effective. We don't know if something's more effective than others. So, I would say, yes, we need treatment and recovery. But more than that, we need to look at what do we mean by treatment and recovery? We need to have some regulations for all of these services to be reporting. We need to start evaluating. So yes, but we also need harm reduction measures.

MG: He says that the BC and the federal government's approach to the overdose crisis is, his words, is an "abject failure." I mean, we've seen deaths at the highest they've ever been. And, just wondering, is he wrong in saying that the approach thus far has been a failure?

LISA LAPOINTE: No. So, if you look at, for example, British Columbia and Alberta, we both have significant challenges with opioid toxicity in our provinces. Different approaches. British Columbia has taken a more focussed harm reduction approach. A safer supply in principle is available. In actuality only about 5000 people in our province, out of a possible 225,000 people using drugs, have access to safer supply. So it's very, very limited. It certainly isn't driving this crisis. Fentanyl is driving this crisis. We know that without a doubt. Alberta is the same. Fentanyl is driving Alberta's crisis. And when we look at their data, they have taken a much more treatment and recovery focussed approach, less focus on harm reduction. No safer supply. Their deaths are rising. The rate of death in their province more than doubled what our rate of death increased by last year. So the data comes out from the federal government twice a year. You have to almost be in the middle of this crisis to understand all of the data. But if you look at it, Alberta's approach is not working any better than British Columbia's approach. And I think that is a really good argument for a national approach that brings together subject matter experts, that looks at this rationally, hopefully. That leave the ideology aside, look at the evidence and say, what will actually make a difference? What will save lives? You know, I heard Mr. Poilievre in the House of Commons and I was very saddened to hear the hatred in his voice when he talked about...

MG: Hatred?

LISA LAPOINTE: Hatred. When he talked about "addicts." Giving free drugs to "addicts." That is dehumanizing. That is polarizing language that is trying to vilify a group of people as if they don't matter. As if they are criminals, as if they are not worth our time. And I can tell you, like Mr. Sword and the thousands of other families that I speak to, have spoken to, over the last ten years or, you know, or the 13 years that I've been in this role. Any loss of life is heartbreaking, and we are losing valuable members of our community. These people matter. So, if safer supply will keep people alive, then families would like their loved ones to be able to access safer supply and ground them and get them to a place where they are now ready and able to access treatment and recovery services with success.

MG: Let me just ask you, we're out of time, but let me ask you two final very quick questions. One is, do you see hope for the crisis to be turned around?

LISA LAPOINTE: I see so many people in communities working so hard to turn this around at a grassroots level. Social services, community groups, who recognize that the people who are using drugs are people. They are their loved ones; they are their friends. And trying to bring a human perspective to this. We are talking about, you know, if we talk about a patient focused service, a human focused response, what do people need? Let's ask people who are using drugs. What would help you? And so I do think there's hope. We certainly know across the board, including from law enforcement, this is a health issue. So that's a huge shift. It's shifted from a crime issue to a health issue. But all of the infrastructure for that needs to be built. It isn't ready. And so that's where we need to go. And I--so I do see hope. But it's going to take time.

MG: And just finally, thousands of those people have died during your tenure as chief coroner. We talk a lot about the moral injury of some of this work. How are you holding up through this?

LISA LAPOINTE: Oh, it's been hard. It's been hard. The longer this goes on and the more families I hear from and the more despair and grief. You wear it. I wear it. I'll be at home and I'll be staring into the, you know, to the distance. And my husband will say, what are you thinking about? And I'll say, the toxic drug crisis. I think about this 24/7. And I feel badly that I'm leaving now when there is so much to be done. But honestly, Matt, I'm tired. I'm not sure I have it in me to continue to do this work at this pace. And there will be people who will come in and take up this role and this work. And I will be there behind them. I will not--I do not intend to walk away from this issue. It's too important. But I think there will be, I know there will be other people who will take the reins and continue to lead in a really positive way.

MG: I'm glad to talk to you again, Lisa Lapointe. Thank you very much.

LISA LAPOINTE: Thank you so much, Matt. Take care.

MG: Lisa Lapointe is British Columbia's chief coroner. She is leaving that post in February. Well, coming up after your regional update.

SOUNDCLIP

SPEAKER: The scans are currently not covered by insurance, and the reason for that is that there's no real evidence that they're going to help you. And so, insurers, government payers, they're not going to cover these things. And currently many of the scans can cost as much as $2,500.

MG: These scans are full body MRI's. They're not MRI's that are ordered by your doctor. They're scans to look for things that might be lurking inside your body. Tumours, cancer, other things. They're becoming increasingly more popular. Doctors say they may not actually help you despite the celebrity endorsements that they're getting. And in fact, they could harm our health care system. We'll talk about these scans as part of our new series, Well Founded: looking at issues of wellness and some of the pitches being made to how to be a better you. That's coming up in 90 seconds. I'm Matt Galloway. This is The Current on CBC Radio. Stick around.

[Music: Instrumental fades up]

Whether full-body MRIs are worth the money

Guests: Dr. Dhruv Khullar and Dr. Ania Kielar

MG: Hello again. I'm Matt Galloway and you're listening to The Current.

[Music: Well Founded Theme]

MG: The global wellness industry is worth trillions of dollars. Every day people are telling you what you need to do right now to be healthy. We're going to help you figure that out. What works, what doesn't, what's worth your time and money. And today we are talking about full body MRIs.

[Music fades up: Well Founded theme]

MG: After a bout of prostate cancer, Don Garnier wanted to take control of his health.

SOUNDCLIP

DON GARNIER: Getting cancer diagnosis, it kind of made me think that I want to be more on top of my health, and I wanted to take a proactive approach.

MG: And so, he decided to pay $2,500 for a full body MRI scan at a private clinic in Vancouver called Prenuvo.

SOUNDCLIP

DON GARNIER: When I received my results, actually, they came in pretty quick. It was actually five days. The nurse clinician or the techs, they went through the results with me. I was able to do it sort of on my own terms, and when it was sort of comfortable, and I can do it in the comfort of my own home. You have this amazing information, and you can review it any time.

MG: Don says the scan results were unremarkable. That's good news. That's what you want to hear. But it was worth the money for his peace of mind.

SOUNDCLIP

DON GARNIER: I've had a few health concerns in my life, and early detection is the key for anything. And we live in a world now where getting medical care can be a bit of a challenge. So, the more you are on top of your health, the better.

MG: If you have the means, you can now pay to get a full body MRI in many places in Canada. And with celebrities like Kim Kardashian endorsing this procedure, demand has shot up. Dhruv Khullar is a physician and assistant professor at Weill Cornell Medical College. He wrote about full body MRIs and a fascinating piece for The New Yorker magazine. Dr. Khullar, good morning.

DR. DHRUV KHULLAR: Good morning. Thanks for having me.

MG: Thanks for being here. As you understand it, why are these scans, these full body MRIs so popular now?

DR. DHRUV KHULLAR: I think there's a number of reasons. I mean, I think the first is that things like direct consumer health care are becoming much more popular. People want to be active consumers of health care. They appreciate the convenience of being able to kind of bypass the traditional medical system, which often is not the most convenient thing in the world. And these scans kind of promise a sense of control. They promise a sense that you're in charge of your health care. You can catch things early, can be proactive, and maybe you get some peace of mind even if you don't find anything problematic. I think that narrative is only partially true. I think, you know, the other side of the story is that these scans can sometimes unleash all sorts of problems as well. I mean, there's the obvious issue of costs, but, people may experience anxiety. They may receive false positive test results. They may be diagnosed with conditions that might never end up hurting them. They get unnecessary downstream tests. And so when we think about this issue, it's actually a much more complicated issue than some people try to make it out to be.

MG: What's the sales pitch that the companies that are offering the scans are making?

DR. DHRUV KHULLAR: And the main things that they're saying are things around, you know, "take control of your health," "be proactive instead of waiting for things to emerge," and "get a peace of mind for yourself and for your family members."

MG: And so, who's getting--I mean, we know that celebrities are getting this, and this is a huge thing. I mean, the influencers are telling people, we got a scan, I got a scan, and this is good for my health. But who else is getting the scans?

DR. DHRUV KHULLAR: That's exactly right. I mean, you know, these companies are in part, doing a good job marketing by giving free scans to influencers and then encouraging them to share with, you know, millions of followers on social media. But the scans are currently not covered by insurance. And the reason for that is that there's no real evidence that they're going to help you. And so insurers, government payers, they're not going to cover these things. And currently many of the scans can cost as much as $2,500. And so it's really a select group of people that can afford a scan like that. And then not just for the scan, but for kind of the downstream cost that might occur after such a scan.

MG: You spoke with one of those clients for your piece in The New Yorker. His name is Ryan Crownholm. Tell us a little bit about his experience.

DR. DHRUV KHULLAR: Sure. I mean, you know, he had a very positive experience. And, you know, one thing I should just say, before we start is that, you know, while there will be positive success stories, there are also many people who receive kind of, no results or, results that aren't going to change the way that they see their health care. Or potentially, you know, results that encourage them to get follow up tests that don't end up helping them. But Ryan ended up having a good result, you know. He was feeling well. He was totally fine and got a full body MRI. Ended up finding that there was a tumor in his kidney and had his kidney removed to prevent that tumor from spreading. And he was one of the lucky people. You know, the question is, how many people, how many scans need to be done for one such case to occur? And we don't really know the answer to that question, but we can suspect based on, you know, the available evidence that it's many, many people would need to get scanned for every one person who has an outcome like that.

MG: Now, that's the promise, right? That there's something that's lurking in your body that you have no idea is there. It might kill you. And so, you have the scan. The scan picks it up and it goes and you're better off.

DR. DHRUV KHULLAR: That's the promise. You know, whether or not that's actually true, I think, is an empirical question that we need to sort out. And, you know, based on our experience with other screening tests, it's important for screening tests to be targeted. You know, we think about colonoscopies, we think about mammograms. These tests are advised for certain groups of people at certain ages, at certain points in life, because the likelihood of finding something that you can actually intervene on and change the trajectory of someone's life in a positive way, is relatively high. When you take a broad-based screening test that looks for everything in the body or tries to, in a general population, that's a recipe for having a tremendous number of false positives and potentially overdiagnosis. And so, you know, while I'm sympathetic to the view that we want to be proactive about our health--I can understand why people might want to know some information about their health at earlier stages--we need to be really thoughtful about how do we do that in a targeted way, to give people information that they can actually use and benefit from?

MG: Tell me more about that and how doctors see these scans? In your piece you quote from an episode of the sitcom Scrubs, where a doctor says, "I think showing perfectly healthy people every harmless imperfection in their body just to scare them into taking invasive and also often pointless tests is an unholy sin." Is that what doctors think?

DR. DHRUV KHULLAR: Yeah. I mean, you know, that's a bit of an exaggeration. It was from the sitcom, Scrubs, as you mentioned. But the general idea is that, you know, when you order a test, you should have reason to order that test, and you should know what you might do with the results of that test. We don't want to, you know, go looking for a needle in a haystack. And as one, you know, one doctor put it to me. You know, the haystack can cause harm. You know, if you just broadly look for things in people's bodies without an understanding of what you're looking for, what you would do with that information, what's the likelihood that information might actually help someone, you can end up in problematic places. And so, I think the general view of the medical establishment is that, you know, these things don't have a lot of evidence and we should be very cautious before we advise people to get something like this. And, you know, currently at least, no medical professional society, you know, recommends these things as a preventive screening tool.

MG: I mean, the other thing is, it sounds strange, but not every needle in the haystack is going to kill you, right? You have this analogy that you referred to in the piece. The barnyard analogy when it comes to cancer. Can you just briefly explain this? I found this fascinating.

DR. DHRUV KHULLAR: That's exactly right. And so, you know, a way to think about cancer is it's not just one disease. I mean, there are many different types of cancers. And, you know, doctors sometimes talk about a barnyard. And so some tumors can be turtles, some are birds and some are rabbits. Turtles are cancers that basically, and you talk about screening and treatment as a way to keep those from escaping the barn. And so you put the fence up and the turtles move so slowly. You know, a lot of prostate cancers might fall into this category. Some thyroid cancers, there's a number of cancers that move so slowly that they're never going to make it out of the barn. So the screening doesn't really help you. In fact, you find it and you may end up with unnecessary biopsies or other tests. And so there's the turtles. And then there's the birds. That birds or things that just fly out. There's no real way, even with a fence, you're going to keep them in. And so, you know, very aggressive cancers that you may pick up at some stage, but it's not like we currently have any treatments or interventions that are going to help you. And then there's the rabbits. And these are the things that can actually be fenced in. You know, this is the reason that we do screening. You might think about some breast cancers, you might think about colon cancers. You do the screening, you find the problem and you can intervene on it in a way that would be helpful. And so, thinking about tumors in terms of turtles, birds and rabbits illustrates why screening tests may not be helpful in every type of cancer and why we need to be judicious about their use.

MG: And so, you did this yourself. You had a full body MRI. What was that experience like?

DR. DHRUV KHULLAR: I did, and you know, my experience kind of speaks to some of the challenges with these types of things. And so, I ended up getting a full body MRI for the piece itself. And most everything looked okay, but there was one spot on my prostate. And it was about a one-centimetre lesion in my prostate. And these things are usually graded on a scale from one to five. One being probably not cancer and five being almost certainly cancer. And mine, of course, was exactly in the middle. Smack dab in the middle. It was a three. And so, it's not really clear what to do with this. These are sometimes called incidentalomas. These are kind of asymptomatic abnormalities that are found incidentally, and they generate more questions than answers. In my case, you know, I needed a blood test to follow up. I'm still going to have to get a follow up, dedicated prostate MRI to really figure out what's going on there. My sense is that it probably won't hurt me. I'm still a relatively young person. This is still a relatively small lesion. I may or may not have been better off not knowing about it at all. But now that I know about it, I've kind of had to change my identity a bit from someone who was healthy to someone who is a patient. And it's something that I need to watch and will continue to watch.

MG: And that happened, that change essentially happened when you went into the tube, right? Like, you go in healthy, you come out as a patient, even rationally knowing that this thing probably is fine, but you can't unsee it.

DR. DHRUV KHULLAR: Exactly. I mean, you go in, and you feel a certain way. And now, you know, kind of flip the default on its head. Now instead of assuming that I'm healthy and going of my life, I assume that I know that there's something inside me and I need continued tests to kind of prove to myself and to my loved ones that I am, in fact, healthy. And this is not going to hurt me. And so, you're right. It's kind of, you go in as a healthy person, you come out as someone with a problem. You know, in some cases that might be a good thing. You know, people might say, look, I want to know about these things that could harm me. But for many people, they may not want to know about these things, particularly if in the vast majority of cases, they're not going to actually harm the person. And so that's kind of the challenge here.

MG: You talked to Andrew Lacey who's the co-founder of Prenuvo, and you asked him about, I mean it is a psychological toll. Of these weird, what do you call it, the incidentaloma. This ambiguous finding, this thing that may or may not be anything. What did he say about that?

DR. DHRUV KHULLAR: Yeah. You know, his point is that, you know, from the company's perspective, that, you know, they're giving people information early. And knowing about things early actually is not anxiety inducing. It's something that's empowering. That's kind of the kind of way that they think about it. And in fact, you know, they have told me that they've done surveys of the patients that they have cared for and most people, the vast majority of people, are happy that they got the scan, and they don't have a lot of anxiety. And so, again, these are things that we should be testing kind of empirically. We should be asking people in a rigorous and representative way, you know, what is the impact on your psychology after you get a scan like this? Are you happy? Are you not happy? And you know, I'm open to the idea that maybe not everyone feels anxious about these findings. Some people do, in fact, feel empowered by them. And so, again, this is an issue that we need to understand better through research if these types of tests continue to spread.

MG: Are you surprised at the popularity of this? I mean, there are--all of these interventions. One of the reasons why we're doing this series on wellness is because there are all of these interventions that are proposed in terms of ways that you can take control of your health. Some of them may be proven. Some of them might just be woo, do you know what I mean? Are you surprised in that context that something like this, which costs a lot of money and can have negative side effects, is still really popular? Or growing in popularity?

DR. DHRUV KHULLAR: You know, I'm not surprised. And part of that is that the intuitive appeal of this, the kind of common-sense understanding, is very obvious. I mean, you know, people probably think, you know why--this makes a lot of sense. Why can't you just do this kind of broad screening test and pick up things? And then we can catch them early and we can head off, you know, the downstream consequences of late cancer diagnosis. And that makes a lot of sense. And, you know, that's backed by, you know, one in a million, one in, you know, who knows what the number is. We don't actually know. But stories of individuals who caught things at exactly the right stage and are better off for it. You know, the other side of the ledger is much more complicated. It's a hard story to tell. And it's often, you know, kind of tucked away in academic journals. And this idea that there are all these other consequences of these types of tests, the number needed to treat, may be very high to have one saved life. There are all these hidden costs, both to the system and to the psychology of people and potentially in the form of infections and bleeding from unnecessary biopsies. That's a much messier story to tell and doesn't have the dramatic impact of, you know, a singular story that someone received a diagnosis at the right time. And so, I'm not surprised that these things are spreading. My goal in writing the story is to help people understand and have their eyes open. You know, if this is something that they are considering, I want them to be aware of all the types of things that can happen if they end up choosing to get one. And my general view is that, you know, if you're worried about a medical problem, if you have a family history of a particular type of cancer, there are often better, more targeted ways to get at the information than you want than a generalized screening test like this.

MG: It's a really fascinating piece. I'm glad to talk to you. I wish you the very best with your own health as well. But thank you very much.

DR. DHRUV KHULLAR: Thanks so much for having me.

MG: Dr. Dhruv Khullar is a physician and assistant professor at the Weill Cornell Medical College and a contributing writer to The New Yorker. Doctor Ania Kielar is president of the Canadian Association of Radiologists and has been listening in. Doctor Kieler, good morning to you.

DR. ANIA KIELAR: Hi. Thanks for having me.

MG: Thanks for being here. Let's just do a little definition off the top. What's the difference between these full body MRI scans that we've been talking about and an MRI that, you know, the kind that I think people are familiar with. That targets one area that's offered in the public health care system in this country.

DR. ANIA KIELAR: So most targeted MRI is requested by a physician or a health care provider for a particular problem or a particular set of symptoms that patients are having. And these MRIs have very specific parameters. So, we have special coils for different body parts. We have different protocols including use of intravenous contrast. So, they are very specific to answer a specific question. Full body screening, generally you are put in a tube as was discussed by Dr. Khullar and a non-contrast MRI is performed, and you get what you get.

MG: Is there any evidence, you get what you get, is there any evidence that this is an effective tool?

DR. ANIA KIELAR: There are currently no medical associations in North America that recommend full body screening, for a variety of reasons. But most of them is because we don't have the evidence that it actually has a positive impact on the population at large.

MG: Is there any risk to getting one of these? I mean, again, Dhruv talked a little bit about the psychological toll, finding something that may or may not be anything, but it lurks in your mind. You can't unsee it. And now, it just, you carry this thing around with you. But beyond that, are there risks in getting a scan like this?

DR. ANIA KIELAR: Well, I think the way he put it was excellent. I mean, there are definitely some risks associated when we find something, an incidentaloma, as he mentioned. Often this ends up having additional testing that is specific. At that time you may require intravenous contrast. You may be allergic to it and not know about it. There can be associated biopsies. Biopsies are done as safely as possible, but they're not without risks. The other thing to consider is that at this time in Canada, we have a huge shortage at crisis level of human health resources. Specifically for technologists in CT and MRI. So, we also have a shortage of modern equipment in our country, which is resulting in really long wait times for people who actually need imaging in an evidence-based way. And radiology is a keyhole. Like we can't, you can't usually get chemotherapy or surgery or management if you don't know what your diagnosis is. And a lot of times radiology is what provides that diagnosis. So, it's a keyhole. And there are a lot of people in our publicly funded health care system that are waiting in line to get their imaging that they actually need. The issue with full body screening for a healthy population is that, you know, these for-profit companies are making money off of you, and if they do find something, incidentally, the majority of times these people who are healthy people and are now patients, end up coming into our publicly funded health care system in Canada. And because we have such scarce resources, we don't have the capacity right now to take on a bolus of people who have non clinically significant incidental findings, but kind of need them worked out because they've now been found. So you know, from the Canadian Association of Radiology perspective, our primary focus right now should be rectifying these challenges of human health resources and to expand our equipment for publicly funded health care. And then maybe we can look at these technologies in the future. But right now, you know, these are our areas of concern.

MG: How would you describe, I mean, tell me more about the shortage. How acute is that shortage of technicians and radiologists within the health care system right now?

DR. ANIA KIELAR: So right now, in terms of technologists, we are, you know, thinking in the thousands. We are very short.

MG: There are thousands of positions that are not being filled.

DR. ANIA KIELAR: Correct. And in the next several years, because technologists are retiring, we are not able to backfill those positions. Before COVID, many technologists, when they retired in quotation marks, would still come back casually to do some work. But now there seems to be a trend because of burnout in general in the health care sector, that they're just not coming back. So, we're having a hard time filling these positions.

MG: What does that mean for wait times? If you need a scan because the suspicion from your doctor is something needs to be looked at before, as you said, more targeted treatment. What do you, how long are you waiting? And I'm sure that this, that there's...

DR. ANIA KIELAR: The data's definitely out there.

MG: ...variation across the country. But what's your sense?

DR. ANIA KIELAR: So, it is variable across the country. But on average in Canada people are waiting up to 100 days for an MRI, whereas most of the guidelines say that a non-urgent MRI should be less than 28 days. So, we're waiting three times longer than we should. The same number is just a little bit lower for CT. But this is really too long, and we don't want people to have to wait for something, especially when it's medically indicated.

MG: Is there an argument to be made--and I just mention this, in part, because of the story that Dr. Khullar told about somebody who got an MRI scan. They found a tumor, they wouldn't otherwise have known about this tumor. They had the surgery; the tumor was removed. That this is a good reason to pay for this procedure that you're paying $2,500, could be a lot of money. But in spending that money, you found out something that you wouldn't have known otherwise. And perhaps you're healthier because of that.

DR. ANIA KIELAR: And again, as he mentioned, that number needed to treat. So, we may have to scan thousands of people before we are able to find one patient that we actually help. And think about all the other patients who have something that's found that's actually completely benign, but then requires follow-up. And then they have that anxiety, then they may have to get contrast, and it turns out they're allergic, or maybe they have a biopsy, and they end up with a complication.

MG: Or they get into the queue for other treatments and other scans and what have you.

DR. ANIA KIELAR: Absolutely. But let's say they get a complication from one of these, you know, follow up imaging that does require something more invasive. You know, think about all those people who may negatively suffer from this same test. And then, you know, if we even look at it a little bit more at a meta large scale, if we only have, in Canada, a certain number of spots and a certain number of machines, certain number of technologists, what happens to health equity among people? For those who suddenly join the line, that probably would not have ever needed to be in that line in the first place and actually don't have anything medically significant, but we still have to work it out. How is that fair for everybody else?

MG: Do you worry if people, if you don't have enough technicians in the first place, that some of those technicians could end up going and working for the companies that are offering the private scans?

DR. ANIA KIELAR: I would love to know where those people come from, because you can't just pick somebody off the street to run an MRI machine. If this is a for-profit company and they're charging people, presumably they can pay their employees well. Possibly better than what we can pay in the publicly funded health care system.

MG: With less stress than the publicly funded health care system.

DR. ANIA KIELAR: Sure. If you can have somebody popping on and off the machine by themselves, as opposed to somebody who's attached to numerous lines and tubes, maybe have communicable diseases, you're at risk. You know, you can strain your back. That's a tough job. And we really appreciate our technologists. But, you know, if you're that person who has the opportunity for two different jobs, which one would you pick?

MG: These clinics are charging upwards of $2,500 to get the full body scan. People are paying that amount. But what do you make of the price tag?

DR. ANIA KIELAR: Well, you know what? There's tens of thousands of health related products that you can buy out there, and it's up to each person how much they want to spend on whatever they're choosing. More hair, thinner, less wrinkles. MRI.

MG: Dr. Kielar, we'll leave it there. I'm really glad to talk to you about this. Thank you very much.

DR. ANIA KIELAR: Thanks so much for having us.

MG: Dr. Ania Kielar is the president of the Canadian Association of Radiologists. We did contact Prenuvo for their response, and they sent us a statement from their CEO, Andrew Lacey, reading: "In part, we rely on 14 years of clinical practice performing these examinations and making many early, potentially lifesaving cancer and disease diagnoses to stand by the efficacy of this exam." He also wrote, "we believe that our health care system is burnt out because treating cancer and disease late is horribly inefficient and leads to much worse patient outcomes. We hope the approach that Prenuvo is championing will one day be part of standard of care in a transformed health system based around preventative precision medicine." That is The Current for this Thursday. Q is up next on CBC Radio One. As you might have heard, the nominations for the Academy Awards were revealed earlier this week. Lots of big names in those nominations, but it's a couple of people who weren't nominated who are getting a lot of attention. Margot Robbie, who played Barbie in that blockbuster film, did not make the list for best actress. The movie's director, Greta Gerwig, also not nominated, despite the fact that she directed the highest grossing film by a female director in history. And there is debate growing over whether these two were snubbed. Even Hillary Clinton has chimed in, calling the two more than Kenough because, of course, Ryan Gosling, who played Ken, did get nominated. He wrote a big, long piece saying that he thought it was outrageous that his co-star and his director were not nominated. Billie Eilish was also nominated for her song What Was I Made For? And that's part of that film. We'll leave you with that today. I'm Matt Galloway, thanks for listening to The Current. We'll talk to you tomorrow.

[Music: "What Was I Made For" by Billie Eilish]

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Thursday January 25, 2024 Full Transcript

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