*The interview had to be translated from French into English.

1. Can you please state your profession?

Family doctor

2. In your eyes, what are the greatest medical achievements known to man?

The biggest accomplishments in medicine are the knowledge and control of infectious diseases. This is probably the means by which the biggest number of lives have been saved. The discovery of the vaccines, antibiotics, the advances of microbiology and our knowledge of the means of propagation of infectious diseases, all contributed to reduce considerably the amount of mortality to the infectious diseases in the world.

3. Do you feel that all the new medical technologies are for the best? Why?
The new medical technologies are most often fascinating and allow to better diagnose the diseases, to visualize the human body in a better way (medical imagery), to operate surgically in a better way (usage of cameras in surgeries by laparoscopy), to better treat the heart (pacemakers), or cancer (radiotherapy, targeted chemotherapy) etc. Nevertheless the usage of the above mentioned technologies, of the general practitioners (the doctors that use these technologies) is problematic. A great number of medical imagery examinations (magnetic Resonance, tomodensitométrie i.e. CT scan, Rx) are done uselessly. Of the other technologies some of them are not very precise like the ostéodensitométrie which has a very imprecise measure of bone density and leads to an over-diagnosis of the osteoporosis disease and to an over-prescription of medicine against osteoporosis without discernment. The pharmaceutical companies that make these medicines are often the only ones to profit from it... There is equally often a therapeutic after effect. For example we use very sophisticated technology to treat cancers while we know very well that this will only have for effect to extend life a for a little while longer while the patient falsely believes that this will save him. Technology is so perfected that patients falsely believe that doctors can do everything and heal anything which is not the reality of things.

4. How has your job changed over the years?

My work has changed a lot since 1980 where I began my practice in medicine. First of all, the average age of our sick patients increased by at least 10 to 15 years. The quality of pills that we give has at least doubled or tripled. Everywhere in rich countries, at least 3 different medicines are given to treat diabetes, three others for heart diseases, two or three medicines for hypertension. Elderly people take great quantities of medicine. Pharmacology is complex and we can say without a doubt that a lot of medicine is uselessly given to people. In general people prefer taking pills than to follow a light diet or exercise. However, diet and exercise play a very important role in diagnosis and treatments of principal North American diseases such as hypertension, the coronarienne cardiac disease and diabetes. We can say that we prevent less than before. In addition, medical imagery techniques such as magnetic resonance (IRM) and CT scans, and the laboratory examinations have unfortunately replaced examinations by doctors because doctors simply trust results of examinations.

5. What medical devices do you use that have greatly changed your work?

CT scans, Magnetic Resonance (Magnetic Resonance Imaging i.e. MRI), Palm Pilot (pocket agendas equipped with medical and medicine books), the Internet (subscriptions to specialized medical sites such as Mdconsult.com and www.epocrates.com), color Doppler Echo graphs for the study of the blood circulation, abdominal Echo graphs, and cardiac three-dimensional; Mammography, Stereotaxy in radiology Laboratories of cardiac homodynamic where we proceed to take angiograms and fix coronation guardians (stents); our patients are then sent in ambulances to Quebec City öL'Hotel Dieu Hospital. Computerized laboratories then send an electronic message to the hospital which comes directly to our offices. Larascopy surgery here at the hospital. Recuperation for an appendisectomy or for a vesicular biliaire surgery is a lot quicker for the incisions to the abdomen are slight. Usage of optic fibre for colonoscopies, bronchoscopies, gastroscopies, laparoscopies and cystoscopies.

6. What medical developments have most affected life expectancy?

7. Have new medical technologies affected our life expectancy?

(Answers to questions 6 & 7)
We now proceed to cardiac surgeries with patients who are sometimes 80 years old. The anesthetiques techniques have become so advance that we can put to sleep and awaken patients at will without great risk. We now treat elderly people with multiple health problems and thus extend their lives. The question is not only to know how lere is only the life length that is lengthened and if the life quality also is lengthened... All the mentioned ones here high techniques contribute to lengthen life expectancy. The technology certainly contributed to lengthen our life expectancy in my opinion.

8. What has the biggest influence in the life expectancy of a woman? Of a man?

Certainly their daily lives. For lengthening our lives these are probably more important factors than the medical technologies: nutrition, exercise, avoiding tobacco, excess salt, fast-food, avoiding fatty acids etc. Nevertheless pharmaceutical companies have no interest in financing studies that would prove that exercising is more important to prevent heart diseases than pills used to fight cholesterol...

9. Do you think that the new medical equipment that is used commonly today still has room to improve? In what ways?

This question is too technical for me to reply. The plans for devices and medical technologies of the next 20 years are already in preparation. I do not doubt that they will constantly improve all medical technologies to better target cancers for chemotherapy.

10. Were the doctors who treated you in your youth different from today's doctors? In what away?

We practically never went to the doctor except in severe cases. Today everything is a motive for consultation; maybe because it is free.

11. Was stay in the hospital during your youth different from hospital stay today? In what way?

Today, as much as possible we try to shorten our hospital stay which is very expensive. We proceed therefore, to a lot of examinations in a very short amount of time and we do the most things possible on an external basis which means without being hospitalized.

12. Do you think that all the new medical technologies improve our daily lives? Why? Can you give some examples?

The new medical technologies serve to facilitate our lives and to improve our lifeâs length. As for our daily lives that is another thing. A majority of people use the entire medical technology available to their use without questioning their sedentary daily lives with deficient food habits. For example, patients undergo complex cardiac surgeries (coronary bypass) and continue to smoke after the operation. Diabetics take medicine to lower their blood sugar level and use human biosynthetic insulin with artificial system injections (pens), measure their sugar level with a small technological wonder that they can handle themselves (glucometre) but at the same time they continue to abuse on foods, to drink gaseous sweetened drinks etc. ·. In all, it is like if they said to themselves that the medicine they receive is so good, that light diets are no longer necessary; this is obviously false. I currently treat a lady that measures 4 foot 10 inches and weighs 285 pounds and suffers from diabetes caused by her excess of weight. To add more, she is so heavy that at night when she sleeps, she has difficulty breathing because she is crushed by her own weight. She needs oxygen (so we installed at her place an oxygen concentrator) for the night. She drinks 5 to 6 litres of seven-up a day, is depressed, receives medicine for anxiety and is totally inactive. You might say this is an extreme case but it shows how the technology can sometimes allow someone to live longer without changing their daily habits·

13. Are there medical procedures of which you disapprove?

I do not disapprove the medical treatments, but the usage that one does. For example I agree with cardiac intensive care but I think that in an old folkâs home, if a person is attained with advanced Alzheimer disease, and has a cardiac arrest, we should let this person die with dignity. I disapprove of a new medicine that American authorities have accepted that is the somatotropine. It is a growth hormone that one gives to children that we think are genetically too small in size. So the child will have to receive one injection every day during years, to grow taller until he is an adult. I totally disapprove human clonage. I usually consider that the pharmaceutical companies are omnipuissantes by their advertising campaigns of the conduit of the doctors and that lack of vigilance of the population. It is necessary to be extremely attentive to withstand the wave of consumer that invades all the spheres of the human activity including the pharmacopée. This medicine of high technology made everyone forget that life and death are natural phenomena. This race to immortality is unhealthy.

It has pleased me to fill this questionnaire that gave me the occasion that one rarely has, to reflect on what people do in this world in which we live in.