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Family and Community Health pilots first palliative care consultant service

Toronto, November 25, 2013

By Kendra Stephenson

Dr. Irene Ying explains the merits of symptom management medications in palliative patients to Dr. Holly Knowles, a family physician at the Department of Family and Community Medicine.
Dr. Irene Ying explains the merits of symptom management medications in palliative patients to Dr. Holly Knowles, a family physician at the Department of Family and Community Medicine. (Photo by Yuri Markarov, St. Michael’s Hospital)

Did you know?

Studies found that patients diagnosed with non-curable illness who received palliative care immediately were not only happier, more mobile and in less pain, but lived nearly three months longer.
(Source – 2010 study in New England Journal of Medicine)

Dr. Irene Ying saw gaps in palliative health care and developed a solution – an outpatient palliative service at the family physician level.

In August, the Department of Family and Community Medicine piloted the service that focuses on optimizing quality of life by alleviating symptoms such as shortness of breath and pain. It also helps patients face life-threatening illnesses through supportive counseling and honest discussions about advanced care. To Dr. Ying’s knowledge, this service is unique in Canada.

While finishing a fellowship in palliative medicine, Dr. Ying identified two gaps in the current health care system: early palliative care options and palliative treatment for patients with non-cancer diseases such as COPD or advanced liver disease. After finding almost no medical literature on the subject – especially at the primary care or family physician level – Dr. Ying approached the department with the idea.

“In the few short months it’s been running, the response has been overwhelmingly positive from both staff and patients,” said Dr. Ying, the palliative care consultant. “It’s always hard to start something from scratch, but this service is so important and I love what I do.”

Working with the Family Health team, Dr. Ying holds outpatient palliative clinics at 80 Bond St. on Tuesday and Thursday mornings. She has an open-door policy, inviting other staff members to attend the clinics and learn about her program. She manages patient symptoms, provides counseling and tries to enhance the quality of the time patients have left. Dr. Ying even makes house calls to patients who can’t get to the clinics.

“That’s what patients want. They don’t want to be in the hospital,” said Dr. Ying. “If pain and symptoms like shortness of breath for example, are managed at the primary care level, patients can continue to live their lives without having to do so from inside a hospital.”

The program is not only cost effective by preventing emergency department and ICU admissions, but studies show that palliative care can help people live longer.

“The medical community often associates palliative with everything that can’t be done,” said Dr. Ying. “I like to think of everything that can be done and that’s what I do here. My dream is that one day every hospital has an outpatient clinic like this one, making people feel better so they can live their best life.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.