Authentic Medicine

Build back better. I’m hearing this phrase more and more lately. Last week,  there was a call from my provincial government for family doctors to pivot  back to ‘face-to-face’ care. But what if this isn’t the only missing link? I’m lucky. I’ve been making home palliative care visits for years. So, when the COVID-19 pandemic hit, the pivot to virtual home visits was challenging for me, but it was entirely conceivable.     I struggled trying to navigate the various virtual platforms so I could keep myself safe and continue to care for patients ‘in’ their homes. Technology is not my strong suit. It got to the point where I felt like my home office had turned into ‘Control Central’ without a skilled technician at the helm.    Eventually, I became savvier and before I knew it, I was providing 100% virtual care.  At first, I thought it was fantastic. This would make it possible to see more patients without the travel time.  I could add people ...

Caregivers as the backbone of the healthcare system   Through COVID 19 glasses, the invisible glue holding our fragile health care system together became unambiguously clear. I’m talking about the informal care teams, disguised as ‘family’ and ‘caregivers’. Their contributions have been unsung and sometimes even seen as obtrusive until now.  Shame on us for needing a global pandemic to see their true value.     At home, in hospital, in long-term care settings, family caregivers are hard at work.  They fill the gaps between the visits and support from the busy paid personnel; PSWs, nurses, doctors, occupational and physical therapists.  Not only do their charities provide respite for the formal care team, but they also translate the standard, ‘cookie-cutter’ care approach into something that works for that specific person.  The stuff that improves the person’s experience of the illness, while the biology of the illness is being ...

      I did a virtual home visit this week to meet a new patient and her daughter. The patient was an elderly woman with very advanced cancer.  When the video opened, her daughter was front and center with a warm and welcoming smile.  I introduced myself as one of the doctors on the team with the goal to help make her Mom 'the best that she can be...given the circumstances'.  Her facial expression changed.   "Umm," she said.  "So, now what?  Do you need to speak with my Mom or just me?" she asked.   I gently suggested that this decision was up to her Mom.  The daughter squirmed.   "Well, my Mom is hard of hearing and speaks mostly Italian. How about you just speak with me?" she said.   I asked to introduce myself to the patient.  The daughter carried the phone over to her so that I could say 'hi'.  I asked the patient if it was okay for me to speak about her care with her daughter.  She obliged, an...