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CAMH Stories Centre for Addiction
and Mental Health

CAMH hospitalists: A small team playing a big role

On Doctors’ Day, meet the team that’s looking after CAMH patients “from the neck down”

By Mike Hajmasy

TORONTO, May 1, 2017 - When you think about CAMH – the largest mental health hospital in the country – it makes sense that physical health isn’t necessarily the first thing that comes to mind. It is, after all, a hospital that specializes in treating illnesses of the mind. 

But mental and physical health are often interconnected, and ensuring that patients are physically well enough to focus on treatment for mental illness is crucial.

And that’s where CAMH’s team of Hospitalists comes in. 

“Hospitalists are general practitioners for hospitalized inpatients,” explains Dr. Renee Logan, Hospitalist in CAMH’s Emergency Department.

“We’re here to provide physical, medical care to CAMH patients as a supplement to their psychiatric care. In the Emergency Department, for instance, I conduct basic medical assessments to determine if a new patient is medically stable enough to remain at CAMH.”

Dr. Renee Logan
Dr. Renee Logan is a Hospitalist for the Emergency Department (ED), Emergency Assessment Unit (EAU) and Early Psychosis Unit (EPU) at CAMH.

Renee is part of a small but mighty team of 11 Hospitalists – seven full-time, four part-time – that lead medical assessments, medication management and medical counselling for mental health inpatient beds across CAMH. Hospitalists also function as first responders for Code Blue emergencies. 

“It’s demanding work, but we divide and conquer, with each of us covering anywhere from one to four units at a time.”

CAMH's Hospitalist Service
CAMH’s Hospitalist Service, abridged (L to R): NP AnneMarie Scale; Amanda Robins; Dr. Dale Ryan; Dr. Monira Eskandar; NP Sherry Weiler; Dr. Sandeep Dhillon; Dr. Tania Tajirian; Susan Hall; Dr. Shakti Sivakumar; and Dr. Renee Logan. Not pictured: Dr. Louisa Shan, Dr. Payal Agarwal, Dr. Trisha Tulloch and Dr. Peter Selby.

“The Hospitalists team is more than a service. Their influence and impact has grown tremendously over the last few years as they have further established themselves as key members of the care teams to support the patients’ whole health,” explains Amanda Robins, Senior Director, Clinical Services. “CAMH’s patient profile has changed dramatically since I started working here in 2003 and the medical complexity and acuity of our patients have further cemented the need for this dynamic group. I am very pleased and proud to be working with such a dedicated group of practitioners.”

A collaborative approach to medical counselling

Complementing the medical training and expertise of Physician-Hospitalists, CAMH is fortunate to have two Nurse Practitioner-Hospitalists that bring a different perspective to their work with patients.

“What’s so great about this team is that we all have different professional backgrounds,” says Sherry Weiler, Nurse Practitioner-Hospitalist. “AnneMarie and I bring a wealth of nursing experience to the table [a combined 64 years], and because we all work on different units with different patient populations, there’s an emphasis on collaboration and ongoing consultation amongst the group.” 

And collaboration is key, because working with people who have a severe mental illness comes with its set of challenges, explains the Hospitalist Service’s Medical Head, Dr. Tania Tajirian.  “A big part of what we do involves determining what might be going on with a patient’s physical health; what might be contributing to their mental illness and teasing out the medical issues that might have been neglected while they were in the community. And in many cases, we’re working with people who do not openly discuss their physical health needs.”

“We work collaboratively with interdisciplinary teams – Psychiatrists, Social Workers, Nurses, Dieticians – to help patients understand their physical health needs and to encourage them to comply with the necessary treatments and investigations.”

Dr. Tania Tajirian
“Psychiatrists work with patients from the neck up. We work with them from the neck down.” Dr. Tania Tajirian’s playful description of the Hospitalist’s role at CAMH.

“Non-compliance is a big challenge, but it makes what we do and the successes we have with patients all the more rewarding.”

 

“A special calling”

 

For all of the Hospitalists at CAMH, working with marginalized populations who might not have access to regular medical care is a major motivating factor. 

“We love what we do,” Tania says about CAMH Hospitalists. “All of us have worked in community medicine and made the switch over to the hospital setting. It isn’t for everybody, but it’s a special calling to work with our patients and I personally love getting to know anyone I care for and enjoy every success – big or small – that I have with them.”  

In the Emergency Department, Renee is often meeting people who are experiencing one of the most challenging times of their lives. “It’s my goal to make patients feel safe, comfortable and cared for while they are here,” she says. “If I can do that, I know I’m having a meaningful impact.”

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