Winnipeg Free Press - PRINT EDITION

Doctor's dream for city dashed

Can't find a job in his hometown reinventing care for geriatrics

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It's an old story.

The young man wanted to come home to Winnipeg, where his family and friends were.

What he wanted to bring with him was a gift for the frail and elderly.

He is Dr. Samir Sinha, the young gerontologist who may have the answer to a multibillion-dollar question of how Canada will be able to care compassionately for aging boomers without bankrupting universal health care.

And what he wanted to bring home with him was his own approach to looking after the elderly, one that has already attracted the attention of Maclean's and the Globe and Mail.

One that relies heavily on an old concept. Doctors making house calls.

Turns out the Winnipeg Regional Health Authority did offer him a job. Why wouldn't they want such a promising young geriatrics specialist in a country that has so few and needs so many? Especially in a city with one of the oldest demographics in the nation.

It's just that the job he was offered wouldn't have allowed him to create a centre of geriatric excellence at Victoria General Hospital, which is what he pitched to the board a couple of Christmases ago. His pitch was to make it a place where the frail elderly were cared for by a dedicated geriatric team that got them home as quickly as possible, where they would be seen by a house-calling specialist and a family physician.

As it happens, though, the WRHA already has its programs for keeping members of the public in the community as long as possible.

But it's not Sinha's idea of what's needed.

So last summer, Sinha went where both he and his concept of the future of geriatric medicine were wanted.

Toronto.

The 34-year-old accepted a prestigious position as director of a groundbreaking geriatrics program at Mount Sinai Hospital in Toronto.

Instead of where he wanted to be.

At home, close to his aging parents, Meera and Sach, who are also physicians.

Actually, he was home this week.

He has been here visiting and lecturing for the last couple of days. And Monday we sat down at the Winnipeg Free Press News Café to discuss where he's been and where he's going. Just half an hour earlier he was taking questions from students at his former school, St. John's-Ravenscourt, where Sinha was named a Rhodes scholar.

It was being chosen a Rhodes scholar, and feeling the obligation that honour carried to give back in a significant way, that led the young Sinha into geriatrics.

Not willingly at first.

His mentor at Oxford University, an esteemed British physician named Charles Webster, noted Sinha had worked with First Nations people in northern Manitoba.

"He said, 'We don't have First Nations people in England,' " Sinha recalled.

But there was another growing population of people with special needs.

The frail elderly.

Webster convinced him if he set his sights on being a specialist in geriatrics he would graduate in 2010, the same time as the first wave of baby boomers turned 65.

" 'You could make an enormous contribution,' he told me."

It was Webster who outlined what that contribution should be.

Not simply caring for elderly patients, but changing the way they're cared for.

That's what he's trying to do in Toronto and what he'll be talking about to fellow medical professionals during a lecture this morning at Health Sciences Centre.

While he's at it, he'll probably be telling them things they know.

That while Canadians 65 and older accounted for nearly 14 per cent of the population in 2005, they account for 60 per cent of acute-care costs.

And that 65-and-over population will double in the next 20 years.

And what's needed is a new system of delivering health care to the fastest-growing and most needy population in the country.

So he'll try to do that at a hospital in another city where they don't just want him to create a centre of excellence for geriatric medicine, they insist it be the best in North America.

It's bitterly ironic that a doctor who is all about keeping elderly patients in their homes decided he couldn't come home himself.

I asked if he still wanted to.

If he would come back and work in Winnipeg.

"Yeah," Sinha said.

I didn't ask him what it would take.

He's already showing that to the whole country.

Somewhere else.

Like I said, it's an old story.

gordon.sinclair@freepress.mb.ca

Republished from the Winnipeg Free Press print edition April 12, 2011 B1

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