DFCM announces new divisions in Care of the Elderly and Mental Health and Addiction

The University of Toronto Department of Family and Community Medicine (DFCM) is pleased to announce four new Academic Divisions: Care of the Elderly, Hospital Medicine, Mental Health and Addiction and Clinical Public Health. Care of the Elderly, led by Dr. Sid Feldman, and Mental Health and Addiction, led by Dr. Peter Selby, will launch this fall, while additional development work continues on the others.

We spoke with the new Division Heads about the role of family medicine in caring for these populations, and why it’s important for DFCM to have these new divisions.

Care of the Elderly

Dr. Sid Feldman is an Associate Professor at DFCM, a family physician with the North York Family Health Team, and Chief of Family and Community Medicine at Baycrest Health Sciences. He is currently the Chair of the Members’ Interest Group in Care of the Elderly at the College of Family Physicians of Canada. Dr. Feldman brings a wealth of experience in caring for older adults in community and long-term care and will be the new Division Head for the Division of Care of the Elderly.

What is the role of family medicine in caring for older adults?

We have a tremendous opportunity in family medicine because we see people throughout the spectrum of their lives. This means we can intervene through prevention to maintain abilities and to avoid some of the debilitating conditions seen in older adults. In addition, we know that older adults are the segment of our population that is going to show the greatest growth in the next few decades, and they will become the largest component of many family physicians’ practices. Through prevention and management, we have a unique opportunity to support older adults in living meaningful lives, while limiting disability.

Why do you think it’s important for DFCM to have a Division of Care of the Elderly?

We already have tremendous strength in caring for our older adult patients within DFCM. I see the new division connecting our faculty already making great strides in this area and to continue to build together. For example, I see education as a critical component of our new division of Care of the Elderly, to support the great work of our education programs in ensuring that all students and residents have the desire, confidence and competence to care for older adults, and to ensure our Faculty have the necessary tools to facilitate this learning.

A new division can also help support the wonderful work DFCM is doing to address inequities. For example, we know that low-income seniors are twice as likely to be frail-how can we focus our efforts to avoid frailty in this group in particular? The new division will further allow us to develop a hub for scholarship and creating new knowledge, in partnership with our older adult patients. Together, we can build new care practices, such as in caring for older adults with dementia. The division can help develop future leaders in the field as well. These components will all be critical if we hope to care for the large number of older adults that we will be seeing in the coming decades and to ensure that older adults continue to thrive in our communities.

Mental Health and Addiction

Dr. Peter Selby is a Professor at DFCM, a Clinician Scientist in the Addictions Division and Campbell Family Mental Health Research Institute, as well as a Senior Medical Consultant, at the Centre for Addition and Mental Health (CAMH). His research focuses on innovative methods to understand and treat addictive behaviours and their comorbidities. Dr. Selby will be the new Division Head for the Division of Mental Health and Addiction.

What is the role of family medicine in caring for patients with mental health and addiction disorders?

Family medicine is based on the doctor-patient relationship and whole person care. Most patients with mental health and addictions receive their care from family doctors: 60-80% of visits to a family physician involve some aspect of mental health. So it is important for family doctors to have the skills to identify, treat and manage this chronic relapsing disease in the context of that longitudinal relationship that we have with our patients over their lifespan.

Why do you think it’s important for DFCM to have a Division of Mental Health and Addiction?

Due to the long standing stigma, and lack of training and integration of these skill sets in family medicine practice and education, we need a dedicated group of family physicians and other members of our department to spearhead the integration of these competencies across the field, from undergraduate to continuing education, for family doctors. In addition, the division is required to spearhead scholarship in this neglected area of practice through Quality Improvement, Implementation Science studies such as collaborative care models, and other research that is unique to patients in primary care practices.

This division hopes to meaningfully engage all those members of our department who have an interest in mental health and addictions – be they clinical, educational, QI and or research focused, to have an academic home. Through that, I do hope that our residents leave with greater competency in this area of medicine and scale the impact of our department on the public health problem of mental illness and addiction, wherever they might practice in the future.

In the coming months, we will also be launching two other divisions: the Division of Hospital Medicine and the Division of Public Health. Development of these divisions is already underway, so stay tuned for the announcement.