Growing up in Columbia had a profound impact on Dr. Juan-Nicolas Pẽna-Sànchez. In this episode, hear why the former family physician pivoted, becoming Saskatchewan's lead in finding the best ways to treat Crohn's disease and ulcerative colitis in rural and Indigenous patients.

Even as a teenager, Juan-Nicolás Peña-Sánchez could see stark differences in health for those who had medical coverage — and those without, thanks to his stepfather, an emergency department physician.

“I used to go with him sometimes on shifts to learn and shadow him,” said Peña-Sánchez said. “The healthcare system was quite fragmented and most of the population was not covered.”

In the 1990s, the Colombian healthcare system was reformed within the context of “neoliberal health reforms” promoted by the World Bank and International Monetary Fund, integrating privatization of the care delivery system, individual health insurance as the mechanism for receiving healthcare, the development of basic benefit plans, among other reforms.

“It changed the way to practice medicine,” said Peña-Sánchez, who observed among his stepfather and his medical school instructors’ grew dissatisfied with limits imposed under the new tiered coverage system.

Peña-Sánchez went on to work for non-governmental organizations in Bogotá, providing healthcare to individuals living in marginalized communities and with limited resources. After witnessing the inequities amplified by healthcare reforms, Peña-Sánchez began to analyze health systems themselves. He moved to Spain, Poland, and France to continue his graduate studies, and then to the University of Saskatchewan, where he joined the Department of Community Health and Epidemiology as an associate professor after researching physician satisfaction and alternatives to ‘fee-for-service’ payment models.

Still, Peña-Sánchez missed interacting directly with patients, and hearing their stories. Through the College of Medicine, he began learning about inflammatory bowel disease (IBD) and moved his focus to innovative models of care for IBD.

Canada’s high prevalence of IBD, particularly Crohn’s disease and ulcerative colitis, stood in stark contrast to his experiences in Colombia.

Dr. Peña-Sánchez formed the IBD among Indigenous Peoples Research Team after realizing in 2017 there was virtually no data on the incidence, prevalence or treatment of IBD for First Nations and Metis people.

“We learned that IBD is increasing among First Nations in Saskatchewan,” said Peña-Sánchez, who started zeroing in on disparities in those patients’ healthcare access and outcomes. Peña-Sánchez and his team explain their findings in this episode.

“Having that regular access is critical,” he said, advocating for innovative approaches to healthcare delivery.

Dr. Peña-Sánchez also explored the potential of virtual care, particularly telephone consultations, to improve healthcare access for rural populations. He found rural residents were more satisfied with telephone care compared to urban dwellers, an insight that underscores the need for adaptable healthcare models.

Currently, Dr. Peña-Sánchez is focused on patient navigation interventions to support individuals with chronic gastrointestinal conditions, particularly in rural Saskatchewan and for Indigenous community members. His research aims to improve access to specialized IBD care and patient outcomes through peer support and patient navigators.

"When I got into medical school, the last thing in the world I wanted to be was a surgeon because I couldn't stand the sight of blood," said Dr. Mike Moser.

Fast-forward to the present day, where Moser is now one of Saskatchewan's top kidney transplant surgeons, winning last year's Golden Scalpel Award for Pre-clerkship Education, the 2022 Logan Boulet Humanitarian of the Year Award, and numerous teaching awards.

In this episode, the professor of general surgery at the University of Saskatchewan's College of Medicine takes us back to one pivotal day where everything changed, propelling forward his career in Hepato-pancreato-biliary (HPB) surgery and organ transplants

Moser’s research has pushed forward transplant science, and led to safer kidney biopsies. Along with interventional radiologist Dr. Chris Wall, Moser led the charge to bring NanoKnife technology to Saskatchewan. His team has now spent a decade using the tool to treat otherwise inoperable tumors.

The NanoKnife relies on irreversible electroporation (IRE) — using electrical pulses to create tiny holes in tumor cells, causing them to die without harming surrounding structures.

"I love making those little, elegant, tiny connections," said Moser, whose work focuses on destroying cancer cells, while preserving delicate tissue.

Those two interests led to collaborations with various departments, including biomedical engineering, as well as chemistry, immunology, and pharmacology.

Moser is most excited today to see IRE combined with immunotherapy, to enhance the body's immune response against cancer.

"It's like a killed cell vaccine situation because we've got these dead, helpless cancer cells. They're still exposing their proteins," said Moser.

Although the research is still in its early stages, Moser said the results so far show "great potential" in treating metastatic cancers.

"One could actually treat the area where the tumor started without directly treating it,” he said.