Medical students to tend to elderly


Can’t find a family doctor? you won’t hear residents of Providence Manor saying that.

Students in the family medicine training program at Queen’s University are spending half a day a week caring for Manor residents under a new initiative launched by Queen’s and Providence Care, which owns and operates the Manor.

The program gives young doctors first-hand experience caring for the elderly and also fills an important gap in the home’s medical coverage. With family doctors in such short supply in this area, nursing homes and long-term care facilities scramble to find physicians who are willing to see their residents.

The doctor shortage is so acute that some long-term care administrators in Kingston have hired doctors from the Toronto area to care for their residents.

“It’s fabulous,” Marilyn Benn, administrator at the 150-bed Extendicare Nursing Home at Bath and Queen Mary roads, said of the new initiative. “I’m absolutely thrilled this program is going on at Providence Manor.”

Extendicare has had steady and reliable medical coverage for years, but Benn said she has yet to find a doctor who will care for residents in the new 160-bed Extendicare facility planned at St. Lawrence College.

“I think it [the program] is neat, not just for the coverage and care for the residents,” Benn said. “What I like about it is the exposure the doctors are getting to long-term care.”

The program was proposed by the Manor’s medical director, Dr. Ivan Stewart, a palliative care specialist who has been concerned for some time about the effect the family doctor shortage has had on long-term care.

Providence Manor was a logical choice for the program because Providence Care is part of the teaching hospital system used by the medical faculty at Queen’s.

“About 10 years ago, it started to get extremely difficult to get young doctors to come and work in long-term care,” Stewart said. “But if physicians and medical students, during their training, get exposed to people who really enjoy what they’re doing, that influences what young doctors will do when they qualify.”

Stewart said there was some initial resistance on the part of Manor relatives to having student doctors look after their loved ones, but the fact that an attending physician is always present was reassuring.

Manor residents also enjoy the extra time and attention they get from the young doctors.

“I’m encouraged,” Stewart said. “I think we will see more young people interested in caring for the elderly through this.”

Dr. David Barber, a family physician with the Queen’s Family Health Centre, said the feedback from medical residents has been very good. Sixteen student doctors are assigned to residents on the Manor’s fifth floor, where they work one-on-one with them for four months. Then the next rotation of 16 medical residents takes over.

Although they work in teams, each doctor is assigned to care for specific residents. That means being on-call round the clock for unexpected problems and emergencies.

“They [students] enjoy it,” Barber said. “It’s time for them to get out of the office and see some sick people.”

Barber, who recently returned to Canada after practising family medicine in Indiana, thinks the number of emergency room transfers has decreased during the first four months of the program. He hopes an actual study will confirm his hunch.

Meantime, other long-term care facilities are looking with envy at Providence Manor these days.

Extendicare’s Benn said she tried to start a similar program a few years ago, but it fell through because she was unable to”guarantee that we would have a physician in the building all of the time.”

“Unfortunately, that was a few years ago and then we kind of left it.”

A group of long-term care homes in Kingston that includes Extendicare recently applied for a couple of nurse practitioners under a new program run by the South East Local Health Integration Network [LHIN], the regional health authority in this area.

“The idea is that having nurse practitioners in long-term care might also attract physicians to long-term care,” she said.

Benn said that the addition of a nurse practitioner, who could do some of the routine work that doesn’t require a medical doctor, “would help us a great deal -but I’d give anything to have the same thing happening here” as Providence Manor has.

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