As a doctor, I have focused on Canada’s broken health-care system. But I decided to challenge myself to write a health-care good news story.
Constance (Tasia) Patmore became Manitoba's first IBD nurse practitioner when she joined the University of Manitoba’s IBD Clinic and Research Centre in 2023 after more than 15 years of practice in emergency care, critical care and gastroenterology (gut medicine).
Dr. Charles Bernstein, the centre's director, is a distinguished professor of medicine at the University of Manitoba’s Max Rady College of Medicine.
Nurse practitioners are independent health-care providers who clinically assess patients, order tests and treat patients. They generally focus on practices such as primary care and emergency care.
Patmore focuses on patients with inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis. She is the first Manitoba nurse practitioner to lead such a program.
Her position, along with a clerk, are cost-shared between Crohn’s and Colitis Canada and Shared Health, with funding guaranteed through September 2025.
Crohn’s and Colitis Canada defines Crohn's disease and ulcerative colitis as diseases that inflame the lining of the GI (gastrointestinal) tract and disrupt the body's ability to digest food, absorb nutrition and eliminate waste in a healthy manner. These are lifelong diseases, it says, during which people can experience acute periods of active symptoms (active disease or flare), and other times when their symptoms are absent (remission).
About 320,000 Canadians — about 15,000 of them in Manitoba — live with IBD and the annual number of new cases has risen over the last decade. “[The] Canadian healthcare systems will need to prepare for the rising number of people living with IBD,” says the Journal of the Canadian Association of Gastroenterology.
Since September 2023, Patmore has fielded more than 600 phone calls, texts and other queries. She has also seen about 100 new patients in her HSC clinic. In addition, she is a resource to physicians and other health-care workers.
Patmore says she was attracted to the position because it provides “access to holistic care to underserviced, marginalized individuals with complex chronic diseases” and “establishes relationships with patients.”
Patmore’s job involves holistic case management for patients, resulting in reduced visits to emergency or urgent-care centres. She provides a “bridge to care” beyond the classic medical model, including linking patients with social workers or psychologists.
She has the time to spend with patients to help them manage their disease, including providing direct care or referral to other care providers. Her role spans from helping patients get through acute flare-ups of their disease to helping them figure out how to pay for their prescriptions.
Melissa Vickar, a Manitoba school educator, has lived with both Crohn’s disease and ulcerative colitis for more than 20 years. She has had many IBD-related surgeries, flare-ups and complications.
Vickar says she appreciates the care she gets from her gastroenterologist, Dr. Charles Bernstein, the IBD centre’s director.
Dr. Bernstein is a caring and empathic doctor who works tirelessly to come up with ways to improve the quality of life of his patients through his research studies and commitment to best practices says Vickar.
Unfortunately, with all of the health-care cutbacks during and after COVID, her access to urgent care became limited and increasingly stressful. Then, one day, during an IBD procedure, Vickar met Patmore, who said, “Let me help you through this.” This was a game-changer for Vickar.
After building a relationship with Patmore, Vickar says, she felt relief and a renewed hope that “things could get better.”
Vickar’s quality of life has significantly improved. She feels less health-related anxiety, has renewed faith in the health-care system and has had fewer emergency visits. She says that Patmore’s position as Manitoba's first IBD nurse practitioner is the “glue” that binds all IBD services and helps “her navigate the muddy waters of IBD.”
Vickar has this message for the health-care system: “We need more Tasias!”
Patmore’s vision for the future includes treating children living with IBD and expanding the IBD team to include dedicated social workers, clinical psychologists and dieticians — and, of course, continued program funding.
Another model of IBD nurse-coordinated care is the PACE IBD Telemedicine Program, run through Toronto’s Mount Sinai Hospital. The PACE program provides IBD telemedicine services to patients who reside in underserviced areas throughout Ontario and live at least 100 km from Mount Sinai Hospital.
A recent Ipsos poll found that fewer than half of Canadians are satisfied with their provincial health-care systems. Despite increased funding and government rhetoric about fixing health care, Canadians' feelings about it are not improving. Access to the health-care system remains a significant point of contention.
The University of Manitoba’s IBD Clinic and Research Centre and the Mount Sinai Hospital telehealth PACE program are good examples of how to regain patients' trust in their healthcare system. These models rethink how chronic disease medical services are provided and should serve as models for other jurisdictions.
Dr. Sandor Demeter is a Nuclear Medicine and Public Health physician and an Associate Professor in the Department of Community Health Sciences at the University of Manitoba. He recently completed the Fellowship in Global Journalism program at the Dalla Lana School of Public Health – University of Toronto.
Epilogue -
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If you know of local media outlets who would run this story please send them my way. I find it difficult to publish "good news stories" versus critiques. Go figure.
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