Dr. Hasan Sheikh’s story is familiar to many physicians. Throughout medical school and his residency, he was surrounded by mentors and colleagues, people he was able to pull aside in a hallway to ask a clinical question, or debrief on a patient. But once he finished his residency, and started working in a clinic, that all ended. Sheikh describes the shift as like “being on an island”.
“You see your patients, and you treat patients and you hope that it’s what’s best for them,” says Sheikh. “But there is very little feedback about whether or not what you have done is the right thing.”
Fast forward to 2017, when Sheikh was asked to help head up a new rapid access addiction clinic in downtown Toronto as part of an initiative called Mentoring, Education, and Clinical Tools for Addictions: Primary Care–Hospital Integration (META:PHI). As part of the process, he also joined a newly-created Google group, for physicians working in similar clinics — a “community of interest” on addiction medicine.
Right away, he started getting emails, about everything from titrating medications to uncommon addictions like steroid addiction; information he could use to build his clinical knowledge, and treat his own patients. For him, the value of belonging to a community of interest was immediate.
“I have lots of emails in my inbox I choose not to read. But I read every single one of these,” says Sheikh. “We are able to support each other clinically and share and learn from each other’s cases, rather than just having to learn from our own cases.”
Sarah Clarke, META:PHI project coordinator, is part of the team that started the community of interest Sheikh belongs to. Back in 2015, when her team was getting it off the ground, they had just a few dozen email addresses, and a plan to build relationships amongst addiction clinic staff in different locations. Since then, the community has grown to more than 250 members, and includes physicians, nurse practitioners, therapists, and administrators, “anyone who works with people with addictions.”
The geography has grown as well, with many members from outside the Toronto-area, in smaller cities like Peterborough and Thunder Bay, and as far away as Manitoba and Nova Scotia.
“The network has really expanded,” says Clarke.
Having this network also makes it easier to scale up solutions. Sheikh explains that after his hospital introduced a program to distribute naloxone kits out of the emergency department, he was able to share some best practices within the community of interest, and explain the steps to replicate the program at other hospitals.
Clarke says this focus on solutions, within the community of interest, often extends to individual patients. “Someone will say, I have a patient in St. Catharines, and someone else will chime in and say 'I will see that patient',” explains Clarke. “People are eager to help one another.”
Sheikh says the connections he has built, through a community of interest, have helped him see his work as a part of a bigger whole.
“I think one of the biggest frustrations in medicine is when you hit systemic issues that you feel you can’t push beyond, from behind the confines of the clinic space,” explains Sheikh.
“To have a group of people who are enthusiastic…you feel like you’re building capacity and building up the system to take care of a vulnerable group of patients. It’s inspiring, and it supports us in feeling like what we do makes a difference.”
The CMA believes communities of interest can play an important role in building towards our vision of a vibrant profession, and a healthy population.
As part of our CMA 2020 strategy, we want to foster the work of these communities, through the CMA Communities of Interest grants. Grant recipients will receive targeted funding, coaching and other support, and grants will be available to support an existing community of interest, or to create a new one.
Stay tuned in the next few weeks for more information about grant criteria, and how to apply.