Jerry M. Maniate, MD, M.Ed, FRCPCSection of Haematology / Oncology, Department of Medicine

St. Joseph’s Health Centre (Toronto)

Assistant Professor, Faculty of MedicineUniversity of Toronto

INTRAPROFESSIONAL COLLABORATION IN PRACTICEA View From The Community

TRANSITIONS

• Moving to Toronto

• Moving from Downtown to the

Community

OBSERVATIONS

• Relatively small group of physicians

• Most physicians at SJHC also have offices in the community

• Many have their clinics on-site– Family Medicine physicians have on-site clinic

– Palliative Care physicians also on-site

– Family Medicine residents on-site

• Collegiality & Respect

MAKING IT WORK

• The culture of:

– The institution: inter-professionalism is

important

– The professions / units: working in teams

is important

– Ensuring quality patient care

MAKING IT WORK

• Communications between physicians

– Electronic medical record

– Paging system “711”

– Streamlining the referral / consultation

process

MAKING IT WORK

• Shared care in Oncology

– Surgeons, Medical Oncologists, Family

Physicians, Palliative Care

WORKING TOGETHER

• An example:– Family Physician pages to discuss a new

suspected case of metastatic cancer (primary unknown)• “This is what I’ve done so far…”

• “The patient is quite symptomatic and worried … can you see them soon?”

• Advice: Work-up investigations, fax referral, “fast-tracked” appointment

WORKING TOGETHER

• Another example:

– Family Physician sends a patient for a referral for

a new diagnosis of metastatic cancer (lung and

liver masses)

– After consultation, a detailed consult letter is sent

via EMR to the Family Physician that outlines the

management plan for the patient

LEARNING TOGETHER

• Medical Education Committee

– Members from all clinical departments

• ASCM

– Joint teaching

– Role-modeling for students and residents

LEARNING TOGETHER

• Inter-Professional Education in the

Oncology Clinic

• Role-Modeling: interactions between

physicians

INTRAPROFESSIONAL

UTOPIA?