Remember, kindness is contagious,
Sincerely, Paul Drouillard
Please see this great article that Dr Crosby has written about our very own Dr Craig Albrecht regarding his work at the Bridges Shelter that appears in the Medical Post. Dr Crosby also writes well about the Bridges Shelter – well done Lynn
What it’s like to be a doctor for a homeless shelter
WRITTEN BY DR. JOHN CROSBY ON FEBRUARY 27, 2018 FOR CANADIANHEALTHCARENETWORK.CA
The Kindly Country Quack, by Dr. John Crosby
I recently tagged along with fellow Cambridge, Ont., family doctor Craig Albrecht on his Thursday-morning clinic at our local homeless shelter. I have driven by it for years and have seen the poor, unfortunate people outside shivering in the dark. I have always felt so sorry for them and have wondered how they ended up in this place of last resort.
As with everything in life there are many different causes for each person. They may have had mental health issues and/or addictions. They may have had physical problems with work, been mentally, physically or sexually abused, or have been born into poverty. Often it is more than one problem.
The shelter was clean and new—and jammed. It has a huge sleep room for 80 men and a separate one for 20 women. Residents have nice clean beds and their own lockable lockers. There are clean private showers and bathrooms. They can do their laundry for a $1.
There is counselling available on site but the clients are not pushed into it. They have a breakfast of sausages, eggs, toast, peanut butter, coffee, tea, milk or juice. The shelter inhabitants have a nutritious supper, too. Lunch is available at local churches on a rotating basis.
Dr. Craig Albrecht
The homeless people have to leave the shelter at 11 a.m. and can come back at 1 p.m., so many roam the downtown area looking for a warm place, such as the library or a mall. When the temperature is cold they can stay in the shelter 24 hours a day.
There are 700 volunteers and the police are there proactively as a positive force to help them if they have had a theft or have been assaulted.
The medical clinic
At the clinic Craig sees patients with a variety of problems. He has a nurse and social worker with him and they all sit in together with the patient.
Many patients do not have any identification, health cards or drug cards, so staff help them register for these services. Patients can also get help with looking for a job, assistance with welfare applications and help with housing.
Craig works every Thursday from 8:30 a.m. until noon. Most patients are drop-ins but they can also book an appointment.
Craig works in a local Community Health Centre (CHC) called Langs Farm the rest of the week and they pay him a salary for the shelter work. CHCs provide primary healthcare, social programs, and health promotion services with an emphasis on populations that face barriers accessing healthcare services. He connects remotely to the CHC’s EMR vis his laptop.
The patients that I saw Craig treat on my recent visit included the following cases:
A burns victim who had fallen into a campfire; he was living in a tent. There were third-degree burns to the patient’s legs and back, and the patient was getting dressing changes from a home care nurse who makes house calls to the shelter. With concurrent addictions and no adequate housing, the burns continued to reinfect.
Another man had insomnia but Craig could not give him any controlled drugs. This is a policy at the shelter, as so many people abuse narcotics and tranquilizers. They often come in for one appointment only, so can’t be monitoried. Craig referred him to a social worker and a nearby clinic run by a nurse practitioner who can prescribe and monitor controlled drugs if natural treatment for insomnia failed.
The workers in the clinic try to hook everyone up with a family doctor who is taking new patients. They drive patients to appointments with specialists, as well as for lab tests and imaging.
A third patient had a swollen left foot. She was an information technology specialist who had lost everything due to alcohol abuse. Craig was getting a bone scan because her X-ray was normal, but from the rundown condition of footwear (sneakers in the winter) she probably had a chronic sprain. She was very nice and very well-spoken.
I was an emergency room doctor for 20 years so I have have a lot of experience with homeless patients. We were their family doctors, for the most part. However, that was 25 years ago and now the problem is much worse. I even worked in downtown Toronto and it wasn’t nearly as bad as it is today. I think this is because the psychiatric hospitals have closed and dumped the patients out onto the streets. They are not getting their regular meds, clinical monitoring, meals and/or shelter.
Access to psychiatrists for all my patients took nine months a year ago and is now down to three months but these people can’t wait for help. Their need is now.
Another big cause is the high cost of housing. People get $600 monthly on welfare and apartments go for $600. Not much wiggle room.
There is more opioid abuse now than years ago because of us, and the availability of drugs on the streets. Ontario has just been declared the number-one place in the world for narcotics prescribing by doctors; Canada is the number-one country for narcotics prescribing. This is a gold medal we don’t want.
I was so impressed by the staff and volunteers at the shelter. Everyone was happy and in a good mood, and staff were not burned out. They had a very “can do” spirit.
What do you think of homeless shelters? Comment below or email me firstname.lastname@example.org.
Dr. John Crosby is a family physician in Cambridge, Ont.
Opinions expressed in this article are those of the writer, and do not necessarily reflect those of CanadianHealthcareNetwork.ca or its parent company.