The face behind "Faces of Health Care"

Despite all of the technological advances and complex policy debates in the medical field, health care is still ultimately a personal, human experience. Those who work with patients on a regular basis know this well. And for the past year, department of medicine Professor Andreas Laupacis, general internal medicine specialist and the executive director of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, has been sharing this human side of health care in Ontario through a stunning adaptation of Humans of New York called Faces of Health Care. He recently shared his reflections on the project with Faculty of Medicine writer Carolyn Morris.

What inspired you to start Faces of Health Care?

My wife and I were at the Tenement museum in New York City when I came across the book Humans of New York. I thought it was brilliant. I stood there in the book store and said, “I want to do something like this for health care in Ontario.” That was the “aha” moment. I had started the health-policy website Healthy Debate, and we had been talking about including more human faces, human stories. So this really made sense.

Why do you think it’s so important to hear that human side of health care?

There’s very little that’s more emotional and human than health care. People often say the most important things in their lives are their family and their health. And I’ve had several doctors tell me that the reason they love Faces is it reminds them of why they became a physician. You get to meet a whole variety of people as a doctor – everyone from a homeless guy to the CEO of a large company; from a recent immigrant to someone who’s been in Canada their whole life. But even though I’ve been in the system a long time and seen lots of patients, I’ve still only been exposed to an incredibly small part of health care. With Faces, we’re able to share the diversity of health care and health experiences, although it will be while before our site starts to reflect its full diversity.

Do you think the stories on Faces could help inform policy decisions?

We always have to remind ourselves when we’re at the policy table that the policies we make really do affect human beings. I’ve heard from health-care leaders that the stories on Faces are a good reminder of how their decisions affect real patients. And that’s important. For instance, we had a story about a young woman whose mom died of ALS. She had gone to the clinic with her mom, who was incontinent at that point, and throughout a day of appointments, no one asked if she needed a diaper change. With all the talk of patient-centered care, she felt the way the clinic treated her mother wasn’t patient-centered. If I were the head of that clinic and I read that story, I’d be looking at how we organize our clinic. I suspect her mom’s experience wasn’t unique.

Have you had any surprising feedback from readers?

One really sticks with me. There’s a story on the site about a couple, Bruce and Lynne. Bruce has very severe chronic obstructive pulmonary disease. He’s palliative and is short of breath all the time. It’s a sad story.

A researcher I know from another province sent me an e-mail out of the blue, saying she found Bruce and Lynne’s interview incredibly moving. It turned out that she had looked after her mom with the same disease towards the end of her life, and she had always felt guilty that her mom was so short of breath and there wasn’t much she could do about it. Somehow it was reassuring and really emotional for her to read that other people also had that experience. Her comments blew me away – it was very touching that she connected with that story in such a very human way.

How is it different – interviewing people as a journalist versus as a physician?

It’s fascinating to me how doing these interviews is so different from taking a history from a patient in clinical practice. For a patient history I start out with inquiring why the patient is in to see me, and then explore the characteristics of the chest pain, or whatever reason has brought them in. Then there’s a series of questions I have to get through in the short time I have with a patient – such as the medications they use, their family history, etc. In contrast, the Faces interviews are totally open-ended. I basically sit down and say, “So tell me your story.” I think it makes the person I’m interviewing a little more in the driver’s seat than in a medical interview, and I am happy for them to drive me wherever they want to go.

What are your plans for Faces, in the future?

We started with a crowd-funding campaign. Associated Medical Services (AMS) have given us funds to help keep Faces going for another year. And the Ontario SPOR SUPPORT Unit (Support for People and Patient-Oriented Research and Trials) has given us some money for Healthy Debate and Faces as well. And we have various other supporters. Soon I’ll need to find more funding. But right now Faces is what I enjoy in my professional life the most, so I’d like to keep doing it. At some point I may run out of money. Or I may run out of energy. If either of those happen, then I’ll stop. I hope that isn’t soon.