Canadian Medical Association

Dr. Naheed Dosani

During his final year of residency at the University of Toronto, Dr. Naheed Dosani learned a tough lesson: despite the strengths of Canada's health care system, many people fall through the cracks.

Dr. Dosani was on rotation at a shelter when he met Terry, a homeless man dying of cancer. Dr. Dosani earned Terry's trust and developed a pain management plan that would help ease his suffering during the final stages of the disease. But that plan was never used, because Terry was found dead the next day. He had overdosed on the only pain relief he knew: alcohol and street drugs.

"That was a real turning point for me," says Dr. Dosani. "I realized that when it comes to palliative care access for the homeless and vulnerably housed, there's a huge equity gap."

Challenging the status quo

To address that gap, Dr. Dosani approached Toronto's Inner City Health Associates (ICHA) with an idea to expand its programming. In July 2014, after completing residency, he launched the Palliative Education and Care for the Homeless (PEACH) program.

PEACH now delivers community-based, trauma-informed palliative care 24/7 — at shelters and on the streets — using a first-of-its-kind mobile unit. The goal: to provide accessible care to society's most vulnerable and marginalized people.

"PEACH works because we are collaborating in ways that health and social service systems usually don't," says Dr. Dosani, explaining how PEACH brings together palliative care providers, community care providers, housing agencies, hospice volunteers, case management providers and others. "Only by doing so can we break down the silos that marginalize the people we work with."

Growing the program

The PEACH model has been replicated in several communities across Canada. At the University of Toronto, a stint on the front lines with the PEACH team is a core rotation for palliative care residents. In 2019, Dr. Dosani established the Healing Circles program at PEACH: this program offers group sessions that help staff deal with issues of grief and bereavement when a patient dies under their care.

Even as PEACH expands, it remains focused on its mandate: to address the emotional and psychosocial pain and isolation that marginalized people at the end of life may experience. Its Good Wishes program looks to bring comfort and joy by granting special wishes for patients. Examples of wishes granted include gifting tickets to a sporting event, enabling patients to enjoy a special dinner and buying one man a guitar so he can, in Dr. Dosani's words, "play that Led Zeppelin riff one more time."

"I care for people who are so often stigmatized and thought of as lesser humans, but they're actually my heroes," Dr. Dosani proclaims. "I'm so inspired by their courage and ability to deal with life's most difficult situations. This award is a testament to their dedication."

Dr. Naheed Dosani is receiving the CMA Award for Young Leaders (Early Career) in recognition of his exemplary creativity, initiative and commitment to making a difference at the local, provincial/territorial or national level.

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