The next speaker and last speaker before the business meeting of the Chapter and the lunch break was Dr. Hal Koch, speaking on "Diving and Hyperbaric Medicine: a Growth Industry?"

He opened his presentation with a discussion of some of the historical events in both diving medicine and hyperbaric medicine. He then reviewed the current status of diving medicine in Canada and recent events that have taken place. The federal government has rewritten the offshore diving regulations and omitted any recognition of physicians trained in diving medicine. This means that physicians will no longer have reciprocity with the Health Services Executive in the UK and will not be recognised outside of Canada as level I, II or III physicians. In addition, the BC WBC is locked in a dispute with BC physicians over recognition as level I physicians. The WCB says only it can certify physicians at that level and the physicians say if that is the case, WCB should pay for the courses to qualify. The result is a deadlock that ended in the cancellation of a level I course offered at U Toronto this summer. He concluded diving medicine is not a growth industry in Canada but it could be.

He then reviewed hyperbaric medicine and it's current status in Canada. It appears to be in a steady state for the conservative or ethical treatment of certain diseases though there has been a recent spurt of activity such as the treatment of athletic injuries a few years back and the more recent treatment of children with cerebral palsey. Fortunately, a multicentre study has been funded to see if there is any real benefit. Koch thinks the study will have a negative result, such like the studies done on the treatment of multiple sclerosis. A lot of these diseases that are treated on an anecdotal basis need properly designed research studies done in order to prove there truly is a benefit. One area that is very under served in Canada is that of the teatment of problem wounds, especially diabetic wounds and vascular wounds. he cited a study he did at the Toronto General Hospital that should a lot of in-patients had or developed problem wounds but the hospital did not have and was not interested in instituting a wound care program. A lot of these patients end up in home care and that overwhelms that system. If only a good wound care program with the proper use of hyperbaric oxygen were undertaken, a lot of patients could be healed, made more functional and lead pain free lives. Hyperbaric medicine is also not a growth industry but it too could be, especially in the area of wound healing.