Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
@drotte.medsky.social
Palliative care/family doc in Nanaimo, BC. Clinical Associate Prof, UBC Medicine
Focus: the intersection of Palliative Care + sustainability. Was @lessismoremedicine.❤️quaternary prevention, preventing overdiagnosis, goal-concordant EBM, choosing wisely.
Focus: the intersection of Palliative Care + sustainability. Was @lessismoremedicine.❤️quaternary prevention, preventing overdiagnosis, goal-concordant EBM, choosing wisely.
“While you are on chemotherapy …” Myths:
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
“While you are on chemotherapy …”: common recommendations that lack evidence and may cause harm
Abstract. Patients on chemotherapy often use multiple resources to obtain information on wide-ranging issues, including prognosis, treatments, diet, exerci
academic.oup.com
November 18, 2025 at 5:17 AM
“While you are on chemotherapy …” Myths:
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
- Avoid large social gatherings
- Wash clothes w body fluids STAT
- Use a separate toilet
- Avoid all EtOH
- Avoid certain foods, coffee
--> lack evidence, cause harm academic.oup.com/jnci/article... great article from @csoncol.bsky.social #oncology
This is a huge challenge for patients. Proprietary parts for their means of mobility and very few vendors, lots of rules about who can fix them, etc and it means many simply can’t be mobile. That is not ok!
Imagine the driver's seat in your car needs to be fixed, and you're waiting for the dealer to get a new one.
It's going to be months.
Now imagine you have to stay in bed 24/7 until the new seat arrives.
This is life for many #wheelchair users in BC.
✅ READ: b.link/wheelchair
It's going to be months.
Now imagine you have to stay in bed 24/7 until the new seat arrives.
This is life for many #wheelchair users in BC.
✅ READ: b.link/wheelchair
November 13, 2025 at 11:03 PM
This is a huge challenge for patients. Proprietary parts for their means of mobility and very few vendors, lots of rules about who can fix them, etc and it means many simply can’t be mobile. That is not ok!
As it turns out, escitalopram is just a marketing parachute for citalopram.
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
🆕 UBC TI Therapeutics Letter 159 🆕
Escitalopram vs citalopram
www.ti.ubc.ca/letter159
✅ Citalopram best choice for most new prescriptions
✅ Citalopram costs less + works just as well
#BetterPrescribing #prescribing #MedEd #antidepressants
Escitalopram vs citalopram
www.ti.ubc.ca/letter159
✅ Citalopram best choice for most new prescriptions
✅ Citalopram costs less + works just as well
#BetterPrescribing #prescribing #MedEd #antidepressants
November 13, 2025 at 10:59 PM
As it turns out, escitalopram is just a marketing parachute for citalopram.
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
Oops!
/undoes escitalopram Rxs that could have just been cheaper and equalky safe/effectivr citalopram… 😬👀
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
🧵 TI Annual Course - REGISTER NOW!
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
October 28, 2025 at 5:11 PM
🧵 TI Annual Course - REGISTER NOW!
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
ti.ubc.ca/annual-cours...
1/ Featuring expert speakers including the TI's Dr. Jessica Otte @drotte.medsky.social
"Drugs and edema: A not so ‘swell’ effect"
#DrugEvidence25 #CME #MedEd #BetterPrescribing
this makes no sense. Clearly investing in exercise and social programs for vulnerable elders would be a much better use of resources.
“It does not stop people from getting worse, but the disease is slowed.”
(Lesions seem better without clinically significant effects)
Lencanemab aka Leqembi gets approved in Canada
www.ctvnews.ca/health/artic...
(Lesions seem better without clinically significant effects)
Lencanemab aka Leqembi gets approved in Canada
www.ctvnews.ca/health/artic...
‘An important milestone:’ Canada approves expensive new drug that can slow Alzheimer’s disease
Health Canada has approved an expensive new drug that can slow the progression of Alzheimer’s disease.
www.ctvnews.ca
October 27, 2025 at 11:30 PM
this makes no sense. Clearly investing in exercise and social programs for vulnerable elders would be a much better use of resources.
Check it:
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
October 20, 2025 at 4:06 PM
Check it:
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
- low cost ($49 for students/etc, $99 for MDs by Oct 31st)
- virtual
- we dissect the evidence so you don't have to
- free of financial COIs (no industry funding),
- full of practice changing pearls and no BS
Please join us in your pyjamas from home Nov 28/29.
#cme #ebm #familymed
another TI @drug-evidence.bsky.social + collaborators publication:
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
October 7, 2025 at 12:07 AM
another TI @drug-evidence.bsky.social + collaborators publication:
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
It is possible to reduce the unnecessary over-use of TSH and related #thyroid tests!!! But it can be a challenge!
(DM me to ask how I know!)
qualitysafety.bmj.com/content/qhc/...
#choosingwisely #overtesting
One + of covid-era delays: learned Rx like rituximab for MS in lower/less frequent doses are still effective = lower cost & easier for patient!
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
October 3, 2025 at 10:57 PM
One + of covid-era delays: learned Rx like rituximab for MS in lower/less frequent doses are still effective = lower cost & easier for patient!
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
Opposite, nefarious: drug companies pushing higher doses of #cancer drugs than are needed, just for profit 🤮💰
#cancercapitalism #palliativecare #pallmed
@cfpjournal.bsky.social ah! you do have a Bluesky account! Couldn't find it the other day, sorry about that, would have @'d you otherwise :)
September 16, 2025 at 6:18 PM
@cfpjournal.bsky.social ah! you do have a Bluesky account! Couldn't find it the other day, sorry about that, would have @'d you otherwise :)
Our @drug-evidence.bsky.social team has worked so hard on Portraits www.ti.ubc.ca/portrait/ and we have RCT evidence that it improves prescribing patterns.
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
September 15, 2025 at 7:11 PM
Our @drug-evidence.bsky.social team has worked so hard on Portraits www.ti.ubc.ca/portrait/ and we have RCT evidence that it improves prescribing patterns.
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
How excited, grateful, & proud we feel to be recognized by @ubcmedicine.bsky.social for our innovation in #CME
www.med.ubc.ca/news/faculty...
Took a few years... but we got it done and in print thanks to @cfpc-cmfc.bsky.social's CFP.
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
Tramadol (with or without acetaminophen) efficacy and harm
Objective To evaluate the efficacy and safety of tramadol (with or without acetaminophen) in adult pain management compared with nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminoph...
www.cfp.ca
September 13, 2025 at 4:54 AM
Took a few years... but we got it done and in print thanks to @cfpc-cmfc.bsky.social's CFP.
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
Tramadol (with or without acetaminophen) efficacy and harm: Systematic review and meta-analysis.
www.cfp.ca/content/71/9...
#tramadol #pain #palliativecare #opioids
I also have questions!
Mid-Island MLAs were questioned regarding when the Nanaimo hospital will get a new patient tower and cardiac catheterization lab, promises made by Premier David Eby during last year's election campaign.
#Nanaimo
nanaimonewsnow.com/2025/08/22/p...
#Nanaimo
nanaimonewsnow.com/2025/08/22/p...
Promised new patient tower & cardiac care addressed by Nanaimo MLA’s
NANAIMO - Nearly a year after B.C.'s premier made significant healthcare promises for Nanaimo on the campaign ...
nanaimonewsnow.com
August 23, 2025 at 3:11 AM
I also have questions!
oh #academictwitter where you at?!
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
a man and two women are standing next to each other in a room .
ALT: a man and two women are standing next to each other in a room .
media.tenor.com
August 19, 2025 at 10:26 PM
oh #academictwitter where you at?!
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
When you get the abstract accepted but it says "you can do it as a poster"
x 2 in my case.
But... no..... I really need to TALK to youuuuuuuuu
#academic #conference #palliative #ohwell
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
Toronto-area MDs and pharmacists: Join us for Therapeutics Day 2025
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
August 13, 2025 at 12:05 AM
Toronto-area MDs and pharmacists: Join us for Therapeutics Day 2025
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
- Relevant topics
- Great speakers (but also me)
- You will be fed
- You will get CE credits
Register here: tinyurl.com/mr447y5n
🎆It's here!!!!! 🎆
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
July 31, 2025 at 2:13 AM
🎆It's here!!!!! 🎆
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
10+ TEN years in the making!!!
Choosing Wisely BC!
We are the LAST but not LEAST province/territory.
healthqualitybc.ca/choosing-wis...
I'm so so so happy!
@healthqualitybc.ca @choosingwiselyca.bsky.social #lessismore #quaternaryprevention #choosingwisely
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
Just wait. The comments after the post will confirm this post's truth.
July 22, 2025 at 12:03 PM
Just wait. The comments after the post will confirm this post's truth.
a reasonably accessible explanation of overdiagnosis and why it matters in cancer screening:
iai.tv/articles/50-...
iai.tv/articles/50-...
We are overcounting cancer cases by vast amounts | H. Gilbert Welch
iai.tv
July 19, 2025 at 2:40 AM
a reasonably accessible explanation of overdiagnosis and why it matters in cancer screening:
iai.tv/articles/50-...
iai.tv/articles/50-...
If it’s on purpose, that’s just good legacy planning 😉
realizing that if you knew you were dying you could use the “send later” option on messages to haunt someone from beyond the grave
July 15, 2025 at 4:58 AM
If it’s on purpose, that’s just good legacy planning 😉
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
This is how to have difficult conversations with vaccine sceptics
July 2, 2025 at 3:07 PM
This is how to have difficult conversations with vaccine sceptics
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
The sheer volume of harmful & exploitive BS?
Study finds 81% of cancer cures touted by TikTok videos are fake medicalxpress.com/news/2024-11...
From study: "...draw on a conspiratorial worldview to present various miracle cures..."
"...the app provides accessible avenues for monetization..."
Study finds 81% of cancer cures touted by TikTok videos are fake medicalxpress.com/news/2024-11...
From study: "...draw on a conspiratorial worldview to present various miracle cures..."
"...the app provides accessible avenues for monetization..."
Study finds 81% of cancer cures touted by TikTok videos are fake
As many as 81% of cancer cures touted by content creators on TikTok are fake, according to new research from City St George's, University of London.
medicalxpress.com
June 30, 2025 at 2:19 PM
The sheer volume of harmful & exploitive BS?
Study finds 81% of cancer cures touted by TikTok videos are fake medicalxpress.com/news/2024-11...
From study: "...draw on a conspiratorial worldview to present various miracle cures..."
"...the app provides accessible avenues for monetization..."
Study finds 81% of cancer cures touted by TikTok videos are fake medicalxpress.com/news/2024-11...
From study: "...draw on a conspiratorial worldview to present various miracle cures..."
"...the app provides accessible avenues for monetization..."
Don't eat THIS.
Opened up the mozzarella and it was the same shade of violet as PUBS (purple urine bag syndrome). Had to wonder: "What in the fresh !$%#^* got in there?!"
No it isn't a UTI. It's pseudomonas fluorescens!
www.pagepressjournals.org/ijfs/article...
#medsky #purpleurine #purplecheese
Opened up the mozzarella and it was the same shade of violet as PUBS (purple urine bag syndrome). Had to wonder: "What in the fresh !$%#^* got in there?!"
No it isn't a UTI. It's pseudomonas fluorescens!
www.pagepressjournals.org/ijfs/article...
#medsky #purpleurine #purplecheese
June 28, 2025 at 7:52 PM
Don't eat THIS.
Opened up the mozzarella and it was the same shade of violet as PUBS (purple urine bag syndrome). Had to wonder: "What in the fresh !$%#^* got in there?!"
No it isn't a UTI. It's pseudomonas fluorescens!
www.pagepressjournals.org/ijfs/article...
#medsky #purpleurine #purplecheese
Opened up the mozzarella and it was the same shade of violet as PUBS (purple urine bag syndrome). Had to wonder: "What in the fresh !$%#^* got in there?!"
No it isn't a UTI. It's pseudomonas fluorescens!
www.pagepressjournals.org/ijfs/article...
#medsky #purpleurine #purplecheese
Reposted by Dr Jessica Otte, 🇨🇦 MD, CCFP, FCFP 🩺🌍🌱
#Disability tax credits are critical for some Canadians. But applying for them can cost thousands. Experts raise alarm that DTC companies are bilking applicants, by @thatemfagan.bsky.social www.cbc.ca/news/canada/... via @cbcnews.ca
Disability tax credits are critical for some Canadians. But applying for them can cost thousands | CBC News
As Canada launches its new disability benefit payments in July, medical and disability experts are raising alarms over barriers to obtaining the main eligibility requirement, the disability tax credit...
www.cbc.ca
June 26, 2025 at 2:50 PM
#Disability tax credits are critical for some Canadians. But applying for them can cost thousands. Experts raise alarm that DTC companies are bilking applicants, by @thatemfagan.bsky.social www.cbc.ca/news/canada/... via @cbcnews.ca
Well, it happened folks:
I received a “mild update.” ‼️
And they also request that I submit my manuscript, even if it’s by accident.
How should I proceed?!
PS is this low rent AI or a maltreated ESL laborer generating these emails?!
#scamjournals #academia #medacademia #predatorypublishing
I received a “mild update.” ‼️
And they also request that I submit my manuscript, even if it’s by accident.
How should I proceed?!
PS is this low rent AI or a maltreated ESL laborer generating these emails?!
#scamjournals #academia #medacademia #predatorypublishing
June 26, 2025 at 2:16 PM
Well, it happened folks:
I received a “mild update.” ‼️
And they also request that I submit my manuscript, even if it’s by accident.
How should I proceed?!
PS is this low rent AI or a maltreated ESL laborer generating these emails?!
#scamjournals #academia #medacademia #predatorypublishing
I received a “mild update.” ‼️
And they also request that I submit my manuscript, even if it’s by accident.
How should I proceed?!
PS is this low rent AI or a maltreated ESL laborer generating these emails?!
#scamjournals #academia #medacademia #predatorypublishing
Autism remains both under and over diagnosed
RFKJ remains one of a handful of current leaders who will no doubt make the health status worse for all autistic people and probably all Americans.
RFKJ remains one of a handful of current leaders who will no doubt make the health status worse for all autistic people and probably all Americans.
This people, THIS!!!
We've heard RFKJ spew on about increasing rates of childhood autism and how the cause MUST BE vaccines or toxins. But he failed to acknowledge or investigate the simplest answer: we expanded the definition of autism, leading to more diagnoses.
www.nytimes.com/2025/06/23/o...
We've heard RFKJ spew on about increasing rates of childhood autism and how the cause MUST BE vaccines or toxins. But he failed to acknowledge or investigate the simplest answer: we expanded the definition of autism, leading to more diagnoses.
www.nytimes.com/2025/06/23/o...
Opinion | Autism Rates Have Increased 60-Fold. I Played a Role in That.
www.nytimes.com
June 24, 2025 at 4:24 AM
Autism remains both under and over diagnosed
RFKJ remains one of a handful of current leaders who will no doubt make the health status worse for all autistic people and probably all Americans.
RFKJ remains one of a handful of current leaders who will no doubt make the health status worse for all autistic people and probably all Americans.
Palliative care seeks neither to shorten or lengthen life but in a study of lung cancer patients on chemo, those randomized to palliative care lived 2.7 months longer on average, had better quality of life, and had fewer invasive/costly treatments near end of life
pubmed.ncbi.nlm.nih.gov/20818875/
pubmed.ncbi.nlm.nih.gov/20818875/
June 17, 2025 at 1:41 PM
Palliative care seeks neither to shorten or lengthen life but in a study of lung cancer patients on chemo, those randomized to palliative care lived 2.7 months longer on average, had better quality of life, and had fewer invasive/costly treatments near end of life
pubmed.ncbi.nlm.nih.gov/20818875/
pubmed.ncbi.nlm.nih.gov/20818875/