When your family physician also provides obstetrical care: streamlined care at St. Michael’s Academic Family Health Team
Toronto, September 29, 2020
By Selma Al-Samarrai
Kristi and Matt with their sons Kaleb and Kolby.
The St. Michael’s Academic Family Health Team (FHT) has six clinics across Toronto that provide multidisciplinary health care services, including a group of 12 family physicians with a specialty: low-risk obstetrics.
“There’s a beautiful continuity of care that’s so special to the Family Health Team’s Obstetrics Team,” explained Dr. Tali Bogler, Chair of the Family Practice Obstetrics group at St. Michael’s Hospital.
“What’s really great about this model of care is that we see the family as an entire unit and we get to follow them through the pregnancy, post-partum period and through multiple stages of life, while knowing exactly what they have been through.”
Kristi and Matt both started seeing Dr. Bogler about five years ago, when they were just starting to consider having children. Now, they have two healthy boys: a 3-year old, Kaleb, and a 6-month old, Kolby. Dr. Bogler followed Kristi during both of her pregnancies and now cares for her two sons in her practice.
“Advocacy and a proactive approach to our health are two key reasons that I really like being cared for by the Family Medicine Obstetrics Team at St. Michael’s,” explained Kristi.
“Not only is Dr. Bogler well-connected to our care journey, but she has been extraordinarily proactive about ensuring that we are receiving the best care possible. If something comes up, we have someone advocating for us through what can be a very complex health care system.”
Kristi experienced this first hand following a frightening incident during her first pregnancy when she had a pregnancy-related hemorrhage at 28 weeks while at work.
As she was being rushed to St. Michael’s in an ambulance, Kristi feared the worst. She received urgent and dedicated care as an inpatient on the Labour and Delivery Unit at St. Michael’s for three weeks where she was also seen by the High-Risk Obstetrics Team. Since Kristi was already a patient of the St. Michael’s FHT, Dr. Bogler was easily able to connect and work with her care team.
Kaleb was born healthy shortly after, at 35 weeks.
“These difficult experiences can leave you feeling very traumatized, but because we had such good care, I now don’t focus on the terrible parts but rather on the fact that we got through it, were very well-supported, and received exactly the type of care we needed,” said Kristi.
During Kristi’s second pregnancy, Dr. Bogler was on-call on the Labour and Delivery Unit the night she went into labour and gave birth to her second son, Kolby.
“It was incredibly special to have Dr. Bogler available to help deliver our second child. As my primary care provider, she was there for me and my family right from the beginning. It was wonderful to have someone I trust so much, and who knows me and my family so well, guiding us through the labour and delivery process,” said Kristi.
Kristi, Matt and their two sons have since used many of the FHT’s other health care services including Paediatrics and the after-hours care clinics.
Dr. Bogler emphasized two key ways in which patients benefit from having a family doctor who also provides obstetrical care. First, the physician is aware of health issues that arose during pregnancy that can impact the patient’s future health, such as high-blood pressure or diabetes. Second, the parents receive post-partum support for as long as necessary.
“Some people perceive pregnancy as an isolated event in someone’s life, but it’s not. It really informs what they could potentially be at risk for later in life,” said Dr. Bogler.
Because the focus is on the baby, many women don’t get support on common post-partum issues such as breast feeding, post-partum anxiety and depression, or pelvic floor support, she added.
“This doesn’t happen for new mothers who are seen by our Family Practice Obstetrics Team. In our care model, we see both the new parents and babies in our clinic during the initial newborn period and onwards. We become like a one-stop shop for the entire family; it really exemplifies the term ‘family practice.’”
When the pandemic began in March, the St. Michael’s FHT clinics transitioned to virtual care, with in-person appointments available when needed. When a patient of Dr. Bogler’s requires an in-person appointment, such as a vaccination for a newborn, she schedules pre-visit calls with the family in order to ensure their in-person appointment is only for the in-person items and as quick as possible.
Dr. Bogler also helped create the Pandemic Pregnancy Guide along with Drs. Eliane Shore and Sheila Wijayasinghe, and medical students Sepand Alavifard and Sarah Freeman of the Family Medicine and Obstetrics teams from St. Michael’s. It is a virtual platform that provides medical information on pregnancy and COVID-19 and helps form a community for expecting parents during the pandemic.
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 more than 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.
About Unity Health Toronto
Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.