Less me and more we

Forum participants Will Webster, dean of the Faculty of Health Professions, and Gaynor Watson-Creed, Halifax's medical officer of health, continue discussions in the lobby. (Marla Cranston Photo)

Come together … right now … over me.
 
This famed Beatles song chorus could well be the rallying cry for patients, as a fresh approach to health care picks up steam in Canada and at Dalhousie (though “with me” would be even more apt).

There’s a growing movement toward better communication and coordination among the various health professions when treating a patient or client. On Tuesday, nearly 800 students jammed the Rebecca Cohn Auditorium to learn more at a forum titled “Less Me and More We.” They came from the Faculties of Health Professions, Medicine and Dentistry, and the clinical psychology program.

“Understanding your own expertise is one thing, but realizing that there’s expertise beyond that is something entirely different,” Gaynor Watson-Creed (MD ’99) told the crowd. “As physicians, we’re trained to be autonomous decision-makers … the other professions, in any type of collaborative context, also bring expertise to the table. Respect it.”   
 
As Halifax’s Medical Officer of Health, Dr. Watson-Creed brainstorms with everyone from early childhood development specialists to engineers, since potential public health threats run the gamut from new flu strains to noxious fume leaks. And during her residency at a community health centre, she learned as much from the RNs and social workers as she did from the doctors.

“What’s amazing to me is we each bring entirely different, yet complementary, perspectives,” she says.

This kind of collaboration adds up to better health care – “just because it makes good sense,” said Ivy Oandasan, director of the Office of Interprofessional Education at the University of Toronto. But making it the new standard in health care will require radical changes in “how we deliver health care and in how we think, learn and teach,” she said.

Joanne Cumminger works as a “patient navigator” in Pictou County, one of five across Nova Scotia who help guide cancer patients through the maze of options.

“We find out what their issues are, and we find the right people to take care of them,” she explains. Sometimes this involves financial or language barriers, or helping people access services or information. They also help streamline the process – for patients and the health care system. 

Dalhousie has been working hard to incorporate interprofessional collaboration into its curriculum, to prepare students for the changing work environment, said Will Webster, dean of the Faculty of Health Professions.

Harold Cook, dean of the Faculty of Medicine, agreed: “You are the millennial generation and things will be different in the way that we practice medicine in this century … it’s not an easy pathway, but we’ll get there by working together.”

Last year, 21 students in Medicine, Dentistry and Health Professions took part in the Interprofessional Tanzania Study Tour. Many other students have been involved in Seamless Care, a three-year pilot project designed to enhance teamwork among health professionals. And Dal’s classroom-based tri-Faculty Interprofessional Learning Program (IPL) is growing all the time. The Health Sciences Students Association, which formed in 2005, is another way students can help explore interprofessional approaches.

A patient’s perspective Carole Laurin “Imagine if one day suddenly you woke up half-paralyzed.” Thus began Carole Laurin’s frustrating journey into the health care system in 2004. The Winnipeg elementary school teacher was just 42 when a stroke left her hemiplegic, or paralyzed on the left side of her body. Now walking without a wheelchair or cane, she attributes her progress to a combination of therapies and approaches. But recovery is a slow process – on her flight to Halifax to speak at Tuesday’s forum, she was able to blink her left eye for the first time since her stroke. “I wonder if I’d be any better now if my health care providers had talked to each other about my treatment options,” said Ms. Laurin, who has seen at least 50 of them since the stroke, from rehab specialists to medical acupuncturists.  When she was discharged from the hospital, nobody told her about a local support group for young stroke victims. As an outpatient, she faced competitive turf-guarding and disapproval for trying various treatments. Her physiotherapist and occupational therapist, just down the hall from each other, wouldn’t collaborate on her case, explaining they weren’t funded to do so! Ms. Laurin now has an excellent, coordinated health care team but it should have been that way from the start, she says.   “You’re just starting your educational journey,” she told students. “Take the time now and in the future to learn about your colleagues, what they do and how you can work together. I’d also encourage you to never lose sight of the patient, and their perspective.”