Two Hamilton specialists do house calls to fill gaps
A team of Hamilton specialists are now making house calls after watching too many patients with addictions, mental health issues and mobility problems get lost in the health care system.
“We saw a lot of people falling through the cracks,” said Dr. Tim O’Shea, a specialist in internal medicine and infectious disease and co-founder of the Hamilton Social Medicine Response Team along with Dr. Christian Kraeker.
One major gap the duo has stepped up to fill will help Hamilton’s fight against opioid addiction. Until now, patients have generally had to wait until they leave hospital to start a rehabilitation program.
“We weren’t looking after people with addictions well in hospital,” said O’Shea. “It was more, ‘Here’s a pamphlet for when you get out’”
Now treatment can begin while the patient is still at an acute care hospital, after O’Shea and general internal medicine specialist Kraeker each got a methadone licence.
It’s significant considering opioid addiction has become such a crisis nationwide that a task force to tackle the epidemic of fentanyl overdose deaths was launched Feb. 3 by the Federation of Canadian Municipalities’ Big City Mayors’ Caucus. The task force convenes the mayors of 12 cities including Hamilton.
“It has been eye-opening and it has been a challenge,” O’Shea said about starting treatment in hospital. “But we’ve had some good successes. We’ve got some good partners in the community to make sure it’s a seamless transition.”
However, the main focus of the response team is bringing specialist care right to Hamilton homes and shelters.
“It has shown us the holes in the system,” said O’Shea. “For some, the barriers are huge.”
About half of the patients they see don’t have a family doctor. Some are seniors with difficulty leaving their homes. Others have mental health or addiction issues making it hard to get the right care even at a hospital. For many, paying a taxi, taking a bus or affording parking is a hardship.
“For a segment of the population, we have to shift the way we think and change how we deliver care,” said O’Shea.
The request for specialist help often comes from those already visiting the patient, such as homecare workers at the Community Care Access Centre, the Social Navigator Program run by Hamilton Police Service and Hamilton Paramedic Service or Mission Services of Hamilton.
“There are a lot of people who really can’t leave their home and who are very unwell,” agrees Dr. Dale Guenter.
Guenter is a family physician at the McMaster Family Health Team.
He says “Right now there are not nearly enough people willing to do home visits.”
The McMaster team also makes house calls and has turned to the visiting specialists when needed.
“We have found the service and their approach to be of huge value,” said Guenter. “Their work and their passion for this work really does put the patient first in a way that we often just give lip service to. We’ve been quite inspired by it.”
The response team has visited about 65 patients at home since starting up in September. It has no funding aside from what the doctors bill OHIP. A nurse and a social worker have been volunteering their time to help out. But as the demand increases, the team is hoping for donations to help pay staff.
“It has been eye-opening how lost people feel,” said O’Shea. “The hospital system has lots of resources. … But a lot of people are just not able to access that.”
Dr. Tim O’Shea, Social Medicine Response Team