1. Jerry M. Maniate, MD, M.Ed, FRCPC Section of Haematology / Oncology, Department of Medicine St. Joseph’s Health Centre (Toronto) Assistant Professor, Faculty of Medicine University of Toronto INTRAPROFESSIONAL COLLABORATION IN PRACTICE A View From The Community

2. T RANSITIONS Moving to Toronto Moving from Downtown to the Community

3. O BSERVATIONS Relatively small group of physicians Most physicians at SJHC also have offices in the community Many have their clinics on-site –Family Medicine physicians have on-site clinic –Palliative Care physicians also on-site –Family Medicine residents on-site Collegiality & Respect

4. M AKING I T W ORK The culture of: –The institution: inter-professionalism is important –The professions / units: working in teams is important –Ensuring quality patient care

5. M AKING I T W ORK Communications between physicians –Electronic medical record –Paging system “711” –Streamlining the referral / consultation process

6. M AKING I T W ORK Shared care in Oncology –Surgeons, Medical Oncologists, Family Physicians, Palliative Care

7. W ORKING T OGETHER An example: –Family Physician pages to discuss a new suspected case of metastatic cancer (primary unknown) “This is what I’ve done so far…” “The patient is quite symptomatic and worried … can you see them soon?” Advice: Work-up investigations, fax referral, “fast-tracked” appointment

8. W ORKING T OGETHER Another example: –Family Physician sends a patient for a referral for a new diagnosis of metastatic cancer (lung and liver masses) –After consultation, a detailed consult letter is sent via EMR to the Family Physician that outlines the management plan for the patient

9. L EARNING T OGETHER Medical Education Committee –Members from all clinical departments ASCM –Joint teaching –Role-modeling for students and residents

10. L EARNING T OGETHER Inter-Professional Education in the Oncology Clinic Role-Modeling: interactions between physicians

11. I NTRAPROFESSIONAL U TOPIA ?