Saint John doctor says physicians should treat poverty

Physicians in New Brunswick could play a stronger role in ending poverty if they had the right tools to help their low-income patients, according to Saint John family doctor Mike Simon.

Doctors in Ontario have developed a 'Poverty Tool' that lays out a three-step approach for doctors, nurses and health workers to identify and address poverty.

They ask everyone about their income, learn about how poverty is impacting their patients and connect patients with income benefit programs and community resources to improve their situation.

The approach has been taught to thousands of healthcare providers across Canada and versions are being developed in Nova Scotia, British Columbia, Alberta, Saskatchewan and Manitoba.

Many New Brunswickers, who are living with incomes below the poverty line, could benefit from this type of approach, said Simon.

"You have to identify these patients and if you don't have the subtle cues, you have to ask directly about their income, about their budget and what they're paying for," said Simon.

"Sometimes it's difficult to pull out what issues are going on, maybe they were kicked out by their parents, maybe there are drugs, maybe it's mental illness that puts them on the street, but you have to say it's not your ingrown toenails, it's not your moles, it's the homelessness and the fact that you can't pay for your medications."

Poverty impacts everything

Simon runs he practices this approach himself in his office in the city's north end. He says he deals with many patients living in poverty.

"You're attuned to their mannerisms, their facial expressions, what they're wearing ... is there a depressive mood? So you sort of click into these subtle cues … and you tie that in with their complaints, which may be related to poverty issues," he said.

He says poverty impacts "just about every chronic disease you can have," from heart and lung disease to diabetes.

It's difficult to bring hypertension down to non-life threatening levels if you can't pay for a simple water pill.- Dr. Mike Simon

"Poverty has a negative effect on your life potential, on your morbidity, your current illness, on just about everything and that's why it's so important to treat that as part of the whole picture," he said.

"It's difficult to bring hypertension down to non-life threatening levels if you can't pay for a simple water pill. What's the point in me doing all this work, bringing down his risk factors if he can't get the basics of life?"

Simon says linking patients to social resources already available in the community could prevent them from slipping through the cracks.

"Someone who gets the test results sent to them, who can talk to the patient, talk to a social worker, bring it all together to get the most effective plan — you need that," he said.

"We have high flung ideas about getting cholesterol levels down and blood pressure … but we're forgetting the basic things that they can't afford the drug, or they're eating fast food all the time because they can't afford to buy good food."

The Canadian Medical Association has said high poverty rates are leading to poor health across the Maritimes.

The national health organization said Canada needs to invest in social programs to prevent poverty, which it cited as the underlying cause of many cases of poor health.

Most Canadian provinces spend close to half of their budgets on healthcare.