Two Hamil­ton spe­cial­ists do house calls to fill gaps

The Hamilton Spectator - - LOCAL - JOANNA FRKETICH

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

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