Transcript: Ontario Hubs: Geriatricians Wanted | May 17, 2019

Jeyan sits in the studio. He's is in his thirties, with short black hair and a trimmed beard. He's wearing a gray suit, white shirt, and printed red tie.

A caption on screen reads "Ontario Hubs: Geriatricians wanted. Jeyan Jeganathan. @JeyanTVO. @theagenda."

Jeyan says OVER THE PAST
THREE-PLUS DECADES, THE MEDIAN
AGE IN ONTARIO HAS RISEN BY MORE
THAN 9 YEARS, TO OVER 40 YEARS
OLD.
40.6 TO BE EXACT.
MUCH OF THAT IS BECAUSE WE'RE
LIVING LONGER, WHICH IS GOOD.
BUT IT ALSO POSES SOME REAL
ISSUES FOR PROVIDING THE BEST
HEALTH CARE, PARTICULARLY FOR
MEDICAL STAFF SPECIALIZING IN
SENIOR CARE.
MARY BAXTER HEADS UP OUR
SOUTHWEST ONTARIO HUB, AND SHE'S
BEEN LOOKING INTO THIS.
SHE JOINS US NOW ON THE LINE
FROM OUR STUDIO AT WESTERN
UNIVERSITY IN LONDON.
WELCOME TO THE SHOW, MARY.

Mary is in her forties, with shoulder-length wavy brown hair. She's wearing a gray blazer over a pink shirt.

Mary says THANKS, JEYAN.
IT'S GOOD TO BE HERE.

Jeyan says ACCORDING TO AN
ARTICLE YOU PUBLISHED THIS WEEK,
THERE ARE 145 FULL-TIME
GERIATRICIANS IN THE PROVINCE.
HOW DOES THAT NUMBER COMPARE TO
WHAT'S ACTUALLY NEEDED?

The caption changes to "Mary Baxter. Southwestern Ontario Hub Editor."
Then, it changes again to "Not enough care for the elderly."

Mary says WELL, WE HAVE ABOUT
HALF OF THE GERIATRICIANS THAT
ARE ACTUALLY NEEDED IN THIS
PROVINCE.
SO THAT'S A BIG LACK.

Jeyan says IT SOUNDS LIKE A
SIMPLE QUESTION, BUT WHAT'S
CAUSING THE SHORTAGE?

Mary says THERE ARE A COUPLE OF
THINGS THAT ARE GOING ON.
ONE IS THAT GERIATRICIANS...
JUST TO BACK UP A LITTLE BIT TO
EXPLAIN WHAT THEY DID.
AS YOU SAID, THEY'RE INVOLVED IN
SENIOR CARE.
I THINK OF A GERIATRICIAN AS
BEING SOMETHING LIKE A
PEDIATRICIAN, ONLY FOR OLDER
PEOPLE.
SO, AS WE MENTIONED, THERE'S
ONLY ABOUT HALF OF WHAT WE NEED
IN THE PROVINCE, AND IT'S NOT...
THE REASON WHY IS THAT THEY'RE
HAVING TROUBLE ATTRACTING PEOPLE
TO ACTUALLY TAKE UP THE
SPECIALIZATION.
THAT'S ONE OF THE REASONS.
SO IT'S NOT, YOU KNOW, THE
SEXIEST OF THE SPECIALIZATIONS
IN MEDICINE.
YOU KNOW, WHEN YOU CONSIDER IT
TO SOMETHING LIKE BEING A
CARDIOLOGIST, FOR INSTANCE, OR
BEING A SURGEON.
THE OTHER BIG REASON IS THAT THE
PAY IS QUITE LOW.
GERIATRICIANS ARE THE LOWEST
PAID SPECIALISTS IN THE
PROVINCE, OR CLOSE TO THAT.
THE SHORTAGE, IT'S ACROSS
CANADA, AND IT'S BEEN THERE FOR
A LONG TIME.
IT'S QUITE A CHRONIC SHORTAGE.
AND THEY'RE STARTING TO LOSE THE
CAPACITY TO TRAIN GERIATRICIANS.

Jeyan says YOU SPOKE WITH ONE
DOCTOR IN THE AREA WHO IS THE
ONLY GERIATRICIAN SERVING THE
FOUR COUNTIES.
HELP US PUT THAT INTO
PERSPECTIVE.

A map of southwestern Ontario appears on screen, showing the locations of Grey County and Bruce County, among others.

Mary says SO DR. ALEX PEEL.
SHE SERVES AN AREA, IT'S GREY,
BRUCE, HURON, AND PERTH
COUNTIES.
SO WHEN YOU LOOK AT THAT REGION,
IT IS LARGER THAN PRINCE EDWARD
ISLAND.
THE POPULATION THERE IS ABOUT
300,000.
IT'S ABOUT TWICE THE SIZE OF
PRINCE EDWARD ISLAND.
AND IT'S ALSO GOT A SENIOR
POPULATION THAT'S ABOUT A FIFTH,
OR ACTUALLY MORE THAN A FIFTH,
OF THE OVERALL POPULATION.
SO THEY HAVE... ON THE GROUND
THEY HAVE ONE GERIATRICIAN TO
SERVE THAT ENTIRE REGION.
BOY, DOES SHE HAVE A BUSY DAY.
BECAUSE ONE OF THE THINGS WITH
GERIATRICIANS IS THAT THEY STILL
MAKE HOUSE CALLS TO DO THEIR
ASSESSMENTS.
WHEN THEY'RE DOING AN
ASSESSMENT, WHICH IS THE
BEGINNING OF THE TREATMENT, IT
CAN TAKE LIKE AN HOUR AND A
HALF.
BUT SHE IS DRIVING ALL OVER THIS
REGION TO DO THOSE TYPES OF
THINGS.
WHERE SHE CAN'T DO IT THAT WAY,
THEN SHE WILL... THEY HAVE A
SPECIAL TELECONFERENCE SET UP
FOR THE MEDICAL COMMUNITY, AND
SHE'LL BE... SHE USES THAT WITH
THE AID OF A SPECIALLY TRAINED
NURSE WHO MIGHT VISIT SOMEONE
AND THEN THEY CAN CONVERSE THAT
WAY AND PERHAPS SPEAK TO A
PATIENT.
SHE ALSO HOLDS CLINICS.
AND IN DIFFERENT AREAS
THROUGHOUT THERE.
AND THEN A BIG PART OF HER JOB
IS TO TRY TO ESTABLISH THE
INFRASTRUCTURE TO HELP CARE FOR
OUR AGING POPULATION.
SO SHE IS INVOLVED IN A LOT OF
COMMUNITY COMMITTEES AND WORK
ALONG THOSE LINES.

A screenshot from the TVO website pops up showing an article. It reads "tvo.org/current-affairs, Ontario Hubs, On-the-ground analysis of regional issues. Southwestern. What Ontario's geriatrician shortage means for its aging population. By Mary Baxter."

The caption changes to "Specialized services."

Jeyan says SOME PEOPLE MIGHT BE
CURIOUS AS TO THE SORT OF
SERVICES A GERIATRICIAN LIKE
DR. PEEL CAN PROVIDE ELDERLY
PATIENTS THAT, SAY, YOUR GP CAN
OR CAN'T.
CAN YOU EXPLAIN SOME OF THE BIG
DIFFERENCES THERE?

The caption changes to "Connect with us: Twitter: @theagenda; Facebook, agendaconnect@tvo.org, Instagram."

Mary says ONE OF THE THINGS
ABOUT OUR HEALTH SYSTEM AND THE
WAY IT'S SET UP, WHEN YOU GO TO
SEE THE DOCTOR YOU GO TO SEE THE
DOCTOR ABOUT ONE ISSUE.
ONE OF THE BIG CHALLENGES ABOUT
TREATING OLDER PEOPLE, AND IT'S
A PARTICULAR PORTION OF OLDER
PEOPLE THAT THEY CALL FRAIL
SENIORS, IS THAT THESE ARE
PEOPLE THAT WILL HAVE MORE THAN
ONE MEDICAL ISSUE GOING ON AT
THE SAME TIME.
SO, FOR INSTANCE, IT MIGHT BE
SOMEONE WHO IS DEALING WITH SOME
DEMENTIA AND IS DEALING WITH
SOME HEART PROBLEMS AND MAYBE
HAS DIABETES AND THEY'RE STILL
TRYING TO KEEP THEM IN THE HOME
AND DEAL WITH THIS.
IT MEANS THAT YOU HAVE TO SPEND
THE TIME TO UNRAVEL KIND OF
WHAT'S CREATING WHICH KIND OF
CHALLENGES AND HOW TO TREAT THEM
AND TREAT THEM IN A WAY THAT
DOESN'T CONFLICT WITH THE OTHER
TREATMENTS.
SO IT'S A VERY COMPLEX
SITUATION, AND AGAIN, THEY HAVE
TO LOOK AT A NUMBER OF ISSUES,
WHEREAS YOUR FAMILY DOCTOR, WHEN
YOU GO AND VISIT, WILL USUALLY
LOOK AT ONE ISSUE AT A TIME.

Jeyan says I WANT TO PULL UP
SOME STATS FROM A REPORT ON
SPECIALIZED GERIATRIC SERVICES IN ONTARIO.

A slate appears on screen, with the title "Frailty among seniors."

Jeyan reads data from the slate and says
IT STARTS WITH 3 percent OF THE 65 TO
69 AGE GROUP AND THEN PRETTY
MUCH DOUBLES EVERY FOUR YEARS TO
A QUARTER OF SENIORS BETWEEN THE
AGES OF 80 TO 84 AND 50 percent OF
THOSE 85 AND OVER.
HOW MUCH MIGHT THESE NUMBERS
DIFFER FROM COMMUNITY TO COMMUNITY?

Mary says WELL, AND THAT'S THE
INTERESTING THING.
THE MINISTRY AS A RULE OF THUMB,
I'M TOLD, USES A PERCENTAGE JUST
ROUGHLY WHEN YOU LUMP ALL THAT
TOGETHER, ROUGHLY AROUND MAYBE
10 percent OF THE SENIOR POPULATION
WOULD BE CLASSIFIED AS A FRAIL
SENIOR.
BUT WHEN YOU GO FROM COMMUNITY
TO COMMUNITY, THAT CAN CHANGE
RADICALLY.
ONE PERSON TOLD ME THAT IN
NORTHEASTERN ONTARIO, FOR
INSTANCE, THERE ARE SOME
COMMUNITIES WHERE ABOUT 20 percent OF
THE SENIORS POPULATION WOULD BE
CONSIDERED FRAIL SENIORS.
SO THERE'S QUITE A RANGE WHEN
YOU GET RIGHT DOWN ON THE GROUND.

Jeyan says NOW, ACCORDING TO
THE REGIONAL GERIATRIC PROGRAMS,
IT'S ESTIMATED ONE MILLION OLDER
ADULTS IN ONTARIO LIVING WITH FRAILTY.
HOW MUCH DOES THAT SHORTAGE OF
GERIATRICIANS FACTOR INTO THE
PROBLEM OF HALLWAY HEALTH CARE,
WHICH WE HAVE HEARD, YOU KNOW,
WITH THIS GOVERNMENT IN ONTARIO?

The caption changes to "A costly shortage."

Mary says WELL, GERIATRICIANS
SAY... AND THERE ARE THE
NUMBERS, THEY SAY, TO PROVE
IT... THEY HELP KEEP PEOPLE OUT
OF HOSPITALS.
THEY HELP KEEP PEOPLE OUT OF
LONG-TERM CARE.
THEY CAN... THEY'RE VERY MUCH
TEAM PLAYERS.
SO THEY'RE NOT JUST WORKING WITH
OTHER DOCTORS TO TREAT
CONDITIONS, THEY'RE ALSO WORKING
WITH PEOPLE IN THE COMMUNITY
THAT MIGHT DELIVER SPECIAL
SERVICES, FOR INSTANCE, MEALS ON
WHEELS, THAT SORT OF THING, AND
THEY WORK TO FIGURE OUT HOW TO
KEEP THAT PERSON SAFE IN THE
HOME.
AND EVEN IF THERE'S A DIFFERENCE
OF A COUPLE OF YEARS, IT'S A
CONSIDERABLE SAVINGS, ACTUALLY,
WHEN YOU LOOK AT IT IN TERMS OF
HEALTH CARE.
I THINK WHAT I WAS TOLD, IT'S
ABOUT... TO TREAT SOMEONE IN THE
COMMUNITY LIKE THAT, IT'S ABOUT
1500 dollars A YEAR COMPARED TO A
LONG-TERM CARE BED, WHICH IS
ABOUT 50,000 dollars A YEAR.

Jeyan says OBVIOUSLY IT SEEMS
LIKE THE NUMBERS MAKE SENSE, TO
HAVE MORE GERIATRICIANS, BUT
WHAT DOES THE PROVINCE SAY?

Mary says WELL, THE PROVINCE IS
SAYING THAT THE NUMBER OF
GERIATRICIANS IS ACTUALLY
INCREASING, WHICH IT IS.
NO ONE DISPUTES THAT.
IT'S ALSO SAYING THAT THE NUMBER
OF GERIATRICIANS IS INCREASING
AT A PACE THAT IS... IT'S KIND
OF OUTPACING THE INCREASE IN OUR
FRAIL SENIORS.
BUT, AGAIN, JUST TO LOOK BACK AT
THE MEASURE THAT THE PROVINCE
USES, JUST THAT THUMBNAIL, 10 percent
OF THE POPULATION, IT'S VERY
DIFFERENT WHEN YOU GET ON THE
GROUND.
SO THERE'S SOME QUESTION ABOUT
THAT AS WELL.

Jeyan says WHAT ARE SOME OF THE
OTHER EFFORTS UNDERWAY TO KIND
OF HELP WITH THAT SHORTAGE?

The caption changes to "Efforts to aid aging seniors."

Mary says WELL, GERIATRICIANS
THEMSELVES ARE TURNING TO THEIR
PEERS IN OTHER AREAS OF
SPECIALTY AND PRACTICE AND
WORKING ON DOING THINGS LIKE
ADDING SENIOR CARE TO THE
EDUCATIONAL CURRICULUM.
THAT'S A PROJECT, FOR INSTANCE,
THAT'S GOING ON AT WESTERN
UNIVERSITY, SO THAT ALL MEDICAL
STUDENTS WILL HAVE COMPONENTS IN
WHAT THEY'RE LEARNING THAT WILL
INCLUDE SOME EDUCATION ABOUT
TREATING SENIORS.
IN MY AREA AS WELL, THEY'VE
ESTABLISHED... THEY'RE WORKING
ON A FRAIL SENIORS STRATEGY, AND
THAT'S TO BASICALLY ALIGN ALL
THE PEOPLE THAT ARE WORKING WITH
SENIORS AND FIGURE OUT A WAY TO
SHARE INFORMATION AND CREATE
MORE OF LIKE A ONE-STOP-SHOP
KIND OF SERVICE FOR SENIORS, AND
THAT TYPE OF ACTIVITY HAS
HAPPENED ELSEWHERE IN THE
PROVINCE.
ALSO, THROUGH FAMILY DOCTORS,
QUITE A FEW YEARS AGO A FAMILY
DOCTOR IN THE KITCHENER AREA
STARTED A MEMORY CLINIC, AND THE
IDEA JUST CAUGHT ON LIKE
WILDFIRE, ACTUALLY, AND THERE'S
NOW I THINK MORE THAN A HUNDRED
MEMORY CLINICS ACROSS THE
PROVINCE, AND THOSE ARE
SPECIALLY TRAINED FAMILY
DOCTORS, AND THEY WORK WITH THE
PEOPLE IN THE COMMUNITY AND
REFER ON TO SPECIALISTS AS
NEEDED OR THEY MIGHT CONSULT
SPECIALISTS.
SO IT'S A WAY OF BRINGING THAT
CARE MORE DIRECTLY INTO THE
COMMUNITY.

The caption changes to "Producer: Patricia Kozicka, @TrishKozicka."

Jeyan says ALL RIGHT, MARY.
ALWAYS INTERESTING STORIES THAT
YOU BRING TO THE TABLE. THANK
YOU SO MUCH FOR JOINING US.
THAT'S MARY BAXTER, OUR ONTARIO
HUB EDITOR FROM SOUTHWESTERN
ONTARIO.

Mary says THANKS, JEYAN

An animated slate reads "Ontario Hubs. Ontario Hubs are made possible by The Barry and Laurie Green Family Charitable Trust and Goldie Feldman."

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