Dr. John A. Staples

Location

Vancouver General Hospital

Bio

I’m a hospital-based general internal medicine physician and mid-career clinician-scientist. My program of research concentrates on ‘before medically advised’ hospital discharges (also called ‘against medical advice’/AMA discharge). This focus is motivated by my direct clinical experience with the persistent gaps in care that contribute to BMA discharge and associated harms among marginalized patients.

My research training includes a Master of Public Health (Harvard), an Editorial Fellowship (New England Journal of Medicine) and a fellowship in health services research (Institute for Clinical Evaluative Sciences, Toronto). I have published 70 peer-reviewed manuscripts (46 as first or senior author). Work from my lab has been featured in over 400 articles in the popular press, including pieces in The New York Times, The Washington Post, TIME magazine and The BBC.

Research Focus

• ‘Before medically advised’ (BMA) hospital discharge
• Unplanned hospital readmission
• Medical fitness-to-drive

My lab uses large population-based linked administrative health datasets and the techniques of clinical epidemiology to understand the causes and consequences of BMA discharge. Recently, we reported that patients initiating a BMA discharge have a 30-day risk of illicit drug overdose that is 10-fold higher than controls (CMAJ 2024, J Hosp Med 2024). This finding was featured on the CBC’s flagship television news program ‘The National’in a segment that received ~4.7M views. Another recent publication from my lab developed a statistical model that could be used to predict drug overdose and death after BMA discharge (CMAJ 2025), a tool that could be used to target interventions to the highest-risk patients.

My lab has evaluated other aspects of hospital care. We examined 3.4M hospitalizations and found that patient complexity had increased substantially over a 15-year study period (JAMA Intern Med 2024). This finding resonated with clinicians and was widely discussed in the popular press, prompting an invitation to present our findings to an audience at Brigham and Women’s Hospital (Boston, USA). We’ve also examined the effectiveness of physician financial incentives for discharge planning (J Gen Intern Med 2021, J Gen Intern Med 2024, Am J Med 2024), the validity of a popular hospital readmission prediction tool (J Eval Clin Prac 2021), and the real-world outcomes and costs of outpatient intravenous antibiotic therapy (Clin Infect Dis 2023).

Some of my previous work used population-based health and driving data to examine medical fitness-to-drive, examining crash risks associated with acute psychosis (Can J Psychiatry 2026), schizophrenia (BMJ Open 2024, CMAJ 2025), cardioverter-defibrillator implantation (JACC Clin Electrophysiol 2025, Heart 2025) and syncope (JAMA Int Med 2022, Can J Cardiol 2023). Some of these publications are among largest and most rigorous studies ever published on medical fitness-to-drive. Two of these papers are cited on UpToDate, the most widely used point-of-care clinical resource for physicians worldwide.

My other traffic safety research found that Halloween is associated with a 10-fold increase in traffic fatalities among pedestrians aged 4 to 8 years (JAMA Pediatrics 2019) and that the annual “4/20” cannabis celebration is associated with an increase in the risk of involvement in a fatal crash (JAMA Int Med 2018). I am part of a research group that found cannabis legalization in Canada was associated with a doubling in the prevalence of tetrahydrocannabinol (THC) ≥2ng/mL among injured crash-involved drivers (NEJM 2022). These findings have been cited by policymakers and politicians to support initiatives designed to reduce traffic injury and improve population health.

View publications on NCBI or Google Scholar

Teaching and Supervision

Prospective Graduate Students: Dr. Staples will consider co-supervision of graduate students in Experimental Medicine for the upcoming academic year. Please refer to graduate admissions for details.

Prospective FLEX medical students: Dr Staples will consider supervision of FLEX students for the upcoming academic year.

Grants