LATIMER: Doctors prescribing income to patients

Toronto doctor develops four-step strategy to help address low income of patients facing physical or mental health issues.

Paul Latimer

Over the years, I have written many articles dealing with the connection between poverty and health.

Countless studies have shown direct links between all sorts of physical and mental health issues and poverty. Among those living in poverty we see higher rates of heart disease, diabetes, cancer, depression, addiction and stress.

Many times, when impoverished patients visit a doctor for a specific health complaint, they don’t seem to improve much even when they get the appropriate treatment. Without improvement in the socio-economic areas of life, it is a lot harder to get healthy.

A family doctor in Toronto, Gary Bloch, developed a strategy and tool when faced with this problem and now it is helping doctors across the country prescribe income to their patients.

Dr. Bloch asked the question: What can doctors do to actually treat our patients’ income? As a result, he developed a system to use in his own daily practice based on four steps.

First, he says, doctors should ask and listen. Doctors need to take time to ask their patients for their stories. Often, the patient will guide the doctor to root causes of surface health issues and this will help the doctor learn what really needs to be addressed.

Next, he says doctors should prescribe income. For him, this means that based on the individual needs of the patient, the doctor can help address issues such as inadequate housing, income or social supports. This might mean assisting the patient to access social programs, getting them in touch with an appropriate social worker or agency, helping them fill out necessary forms for disability supports, or other poverty related supports.

Third, he suggests doctors actively work to build a poverty team. Building relationships with social workers, nurses and community agencies so the various arms can cooperate to help patients with income-related issues. Meanwhile, it is very helpful to continue to build skills and stay up to date with available supports, program and legislation in the region.

Finally, doctors can add their voices to a demand for social change. Poverty is a leading determinant of health and it must be addressed on a systemic level as well as on an individual basis. Doctors and citizens of all professions and backgrounds can work for change by engaging politically and advocating on behalf of some of our most vulnerable neighbours.

I think these four steps are excellent and to complement them, Dr. Bloch also worked to create a poverty screening tool now being widely used by medical associations in our country. It is a four page brochure offering steps for doctors to use to address poverty in their practices.

It is very encouraging to see a cultural shift taking place in Canada with regard to our view of poverty and treatment of it. I hope governments at all levels will take up the challenge to fight poverty and ensure all Canadians can live healthy lives with dignity.

Paul Latimer is a psychiatrist and president of Okanagan Clinical Trials.



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