Staying #Up2Date 🚨

1: Staying in the Sun vs Seeking Shade: Prevalence and Associated Factors with Intentional Outdoor Tanning

A cross-sectional study of nearly 32K US adults found that 35.6% of women and 26.6% of men take part in frequent sun tanning. The highest prevalence of tanning was seen in women and men aged 18 to 29 years, as well as are physically active and report heavy alcohol use. Additionally, the prevalence of sunburn was significantly higher in those who tanned frequently (49.9%; 95% CI, 48.5-51.4%) compared to those who stayed in the shade (28.3%; 95% CI, 27.4-29.3%; P<.001). These findings can help inform future health-education strategies to inform targeted individuals about the risks associated with outdoor suntanning as it relates to skin cancer. 

Prescribing is Easy. Persistence is Hard.  

A cohort study of patients hospitalized for heart failure assessed if individuals are adherent to guideline-directed medical therapy (e.g. beta-blockers, RAS inhibitors, MRAs, and SGLT inhibitors) once they are discharged. After being discharged, prescriptions went unfilled for 51% of new prescriptions of beta-blockers, 48% for RAS inhibitors, 39% for MRAs, and 35% for SGLT2 inhibitors. This means that only half of new discharge prescriptions were initiated within 7 days of discharge. 6 months later, only 42% of patients were adherent to all HF medications used at discharge. Further research is needed to develop interventions to support patients’ medication use beyond their hospital admission. 

Puck Around and Find Out: Eye Injuries in Hockey 

A US-wide cross-sectional study looked at recent trends in hockey-related eye injuries over the last 20 years. In 215 cases, 79% of patients were male, 69% were pediatric (< 18 years), and 83% experienced equipment-related trauma. Of those injured, protective goggle use was reported in only 2% of cases. Injury incidence was similar in various modes of the sport, whether it be ice hockey, field hockey, or street ball. In total, 12% of patients experienced vision-threatening injuries. These results stress that hockey-related eye injuries are common, and most importantly, can be severe and vision threatening. More advocacy for protective eyewear in all forms of the sport should be prioritized to prevent vision-threatening hockey-related injuries.  

When did your practice become a corporate maze?

Sponsored by Wealthsimple

Remember when incorporating was just a simple way to protect your hard-earned cash from the highest personal tax brackets? Fast forward to mid-career, and suddenly you’re managing a mini-empire of retained earnings, salary-versus-dividend math, and talk of holding companies.

It’s a great problem to have, but let’s be honest: you went to med school, not business school.

If you’ve been sticking entirely to dividends because they require less paperwork, you might be accidentally shortchanging your future as dividends generate exactly zero RRSP contribution room. Skipping the payroll hassle means you’re leaving prime tax-sheltered compounding space empty.

Also, just letting that excess cash pile up inside your medical corp can trigger a tax trap. Holding too many passive assets can disqualify your corporate shares from massive tax breaks if you ever choose to sell or transition your practice down the road.

Corporate complexity doesn’t have to mean a Bay Street price tag. Wealthsimple Wealth Management pairs you with a dedicated advisor who understands the financial reality of running a medical practice — the retained earnings decisions, the compensation mix, the estate implications. Lower fees, full visibility into your portfolio, and none of the unnecessary complexity of traditional wealth management.

You built a successful practice. Now let’s make sure your corporate structure is working just as hard.

Splitting Hairs 💇 

Patients are losing more than just weight on GLP-1s

What happened: A large new BMJ study suggests people taking GLP-1 receptor agonists may be more likely to experience hair loss than those using other diabetes medications.

Why it matters: Researchers analyzed health data from more than 50,000 adults with type 2 diabetes taking GLP-1 receptor agonists and compared them with people using SGLT-2 or DPP-4 inhibitors. They found GLP-1 users had a 37% higher risk of alopecia than those taking SGLT-2 inhibitors and a 68% higher risk than those on DPP-4 inhibitors.

That doesn’t necessarily mean the drugs are causing hair loss directly. Instead, experts say the culprit is likely the rapid weight loss many patients experience. When the body is under stress, it shifts more hair follicles into a resting phase, leading to a temporary shedding condition known as telogen effluvium. The good news? The overall risk remained low, and the hair loss is usually temporary.

A Canadian dermatologist told Global News that it takes about 3 months of rapid weight loss for there to be shedding of hair. It lasts for around 6 months, and when the weight stabilizes, the hair grows back. GLP-1s have also been associated with gastrointestinal symptoms like nausea and vomiting, which can also cause nutritional deficiencies like hair loss. The FDA had previously stated that semaglutides and tirzepatides may impact hair loss.

But: Hair loss isn’t usually a reason to stop treatment. Experts say slower dose escalation, avoiding overly rapid weight loss when possible, and making sure patients get enough protein and key nutrients may help reduce the risk. If shedding is severe or persistent, it’s worth looking for other causes rather than assuming the medication is solely to blame.

Bottom line: Hair loss may not be the side effect patients expect when starting a GLP-1, but it’s one worth mentioning. Setting expectations early can reassure patients that, in most cases, the shedding is temporary, and may help keep them from abandoning an otherwise effective treatment.

Hot Off The Press 🔥

1: 🚑 5 years, 1 pandemic, and a whole lot of burnout later, here’s where Canada’s emergency physicians landed. Researchers tracked a national cohort of ER docs from April 2020 through a January 2025 follow-up survey, and the toll adds up: 1 in 10 have left the specialty entirely, nearly half have cut their clinical hours, and 1 in 5 have taken time off, according to new CMAJ research. Lead author Dr. Kerstin de Wit, didn’t mince words, writing that “the prevailing theme was that the health care system is broken.” Women and younger physicians reported the highest burnout rates, and the accompanying editorial warns Canada risks squandering 50 years of investment in emergency medicine training if the trend continues.

2: 🦟 West Nile season has officially arrived in Ontario. Positive mosquito pools have turned up in Toronto, Windsor-Essex, Belleville, York Region, and Halton Region over the past couple of weeks, alongside 14 infected dead birds across Ontario and Manitoba. No human cases have been confirmed yet this year, but health units are urging the usual precautions: DEET or icaridin, clearing standing water, and keeping an eye out for a fever, headache, and body aches in patients aged 50-plus or immunocompromised, who face the highest risk of severe illness.

3: 🦠 South of the border, measles just hit a milestone nobody wanted. The US has logged 2,318 confirmed cases so far in 2026, already surpassing all of 2025’s record-breaking total, making this the worst year for measles since 1991. 93% of cases are in people who are unvaccinated or have unknown MMR status, and 1 in 10 kids under 5 have been hospitalized. With outbreaks still active in South Carolina, Utah, and Arizona, it’s a good week for a routine vaccination status check with your American-adjacent patients, or really, anyone due for their MMR booster.

4: ✈️ Planning a flight on WestJet this long weekend? You’ll want a backup plan. The airline is now letting passengers booked between July 30 and Aug. 4 change or cancel their flights for free, as 4,400 flight attendants represented by CUPE Local 8125 could legally walk off the job as early as Aug. 2, after voting 99.4% in favour of a strike. A walkout would ground Canada’s second-largest airline right in the middle of the August long weekend, one of the busiest travel stretches of the summer. WestJet says it’s “actively engaged” in negotiations and optimistic a deal can still be reached.

Notable Numbers 🔢

330,000: the number of people who have now fled wildfires tearing through southern France and Spain, with authorities in France’s Gironde region ordering fresh evacuations ahead of a heat wave forecast to hit this week. Around a dozen countries have sent planes, helicopters, and crews to help battle the blazes, but with temperatures set to climb further, officials warn the worst may still be ahead.

10: the age of Austin Byers when he completed the Toronto Supertri, 4 years after a lawnmower accident nearly cost him both feet. After multiple surgeries at SickKids and years of rehabilitation, he crossed the finish line alongside Canadian Olympian Tyler Mislawchuk and members of the medical team who helped save his legs.

9 hours: the maximum daily eating window linked to slower cognitive decline in a small Rutgers University study of older women classified as overweight or obese. Participants who ate within a 9-hour window for 6 months showed greater improvements in memory, problem-solving and spatial planning than those who spread meals over about 12 hours, despite both groups losing a similar amount of weight.

Postcall Picks ✅

🍅 Make: this burst tomato burrata pasta. Sweet cherry tomatoes are slowly cooked until jammy, then tossed with garlic, fresh basil, Parmesan, and silky burrata for a tasty dinner that comes together with just a handful of summer ingredients.

🐔 Try: raising backyard chickens. With egg prices still keeping shoppers on their toes, this beginner-friendly guide walks through everything from choosing a coop and protecting your flock from predators to the daily care chickens need before you bring home your first hens.

💰 Save: on the Apple AirPods Pro 3, currently 21% off at $259.99 (regularly $329). The latest model adds heart rate sensing and live translation while keeping features like active noise cancellation, spatial audio, and USB-C charging.

🏛️ Visit: the ancient city of Troy. If Christopher Nolan’s The Odyssey has you dreaming of Greek myths and epic journeys, this guide explains how to explore the legendary archaeological site in modern-day Türkiye, from its famous ruins to a replica of the iconic Trojan Horse.

📺 Watch: Can You Solve the Virus Riddle? from TED-Ed. This 5-minute animated puzzle challenges you to stop a prehistoric virus from escaping the lab, using nothing but logic and quick thinking.

Relax 🧩

First clue: Early heartbeat with a distinct p wave on EKG, for short

Give it a go ➤

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your physician friends to beat your time.

Meme of the Week 😂

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Want to reach thousands of Canadian physicians every week? Email denis.bricov@mdbriefcase.com to learn more.

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