How to find a doctor who supports specific needs
How does a psychiatric survivor with a history of institutionalization find a new family doctor?
We’re only now starting to create the kinds of networks in Ontario that can help you to find a family doctor with this kind of specialized knowledge. Liberty Village Family Health Team, in downtown Toronto, specializes in treating people who are also seen at the Centre for Addiction and Mental Health (CAMH), although you don’t need a referral from CAMH or anywhere else to become a patient there.
If you live in a neighbourhood with a Community Health Centre, it is an excellent place to look for a family doctor who might be able to support your mental health goals and needs. CHCs try to address a person’s whole health needs in a holistic way, and they may know of a good family doctor for people in psychiatric recovery.
If you’re already seeing a psychiatrist, it’s a good idea to ask for a referral to a family doctor who is particularly knowledgeable about psychiatric issues. You might also want to consider looking for team-based care. A practice, such as a Family Health Team, that includes social workers and members of other health professions offers more options for providing social support to people living with psychiatric disorders, and addressing some of the social issues that can arise, such as poverty or lack of housing. Dr. Michael Roberts is a Toronto family doctor and assistant professor in U of T’s Department of Family and Community Medicine. Dr. El-Sohemy mentioned that new research shows eating a lot of the gluten-free foods might lead to unfavourable changes in the bacteria lining of our gut. I’m concerned because my son has ulcerative colitis and is on a glutenfree diet due to a food tolerance test that shows he has a high intolerance to wheat.
The study I mentioned on the effects of a gluten-free diet on gut bacteria is very small and preliminary. Ten healthy adults ate a gluten-free diet for a month, and then their fecal microbes were analyzed. Researchers found the amount of healthy gut bacteria decreased, while unhealthy bacteria increased. The authors suggested that people following a gluten-free diet might benefit by supplementing with prebiotics and probiotics.
Despite this evidence, I want to be very clear that nobody with celiac disease should be thinking of eating gluten. The health benefits of being gluten-free for someone with celiac disease clearly outweighs any potential harm caused by a shift in gut bacteria — if such a shift even occurs in those with celiac disease. Dr. El-Sohemy wrote that people probably feel better on a glutenfree diet because they ate fewer carbohydrates. If we’ve learned anything from the anti-fat movement, shouldn’t we stop demonizing any particular food group?
I suspect many people feel great when they cut out gluten simply because they reduced excess carbohydrates. I don’t think one should equate “cutting out excess carbs” with “avoid all carbs because carbs are bad.” The statement was meant to explain why some people lose weight when they go gluten free. Their weight loss is more likely caused by the reduction in carbs rather than by the reduction in gluten per se. I do believe limiting carbs is a good way to eat. Take weight loss. Although carbs and protein contain the same amount of calories, the metabolic consequences can be quite different. Cutting down on carbs increases your resting energy expenditure so that you burn more energy even when you’re not exercising. Higher protein intake has also been shown to increase the feeling of fullness. So, there’s growing evidence that “a calorie is not a calorie.” Dr. Ahmed El-Sohemy is an associate professor of Nutritional Sciences at U of T.