During the first weekend of the Citizens' Reference Panel on Health Services, panellists split into groups and received medical bios representing segments of Canada's population. Each group completed the personal history of the bios and invented one of their own. Afterwards, they presented the profiles to the rest of the panel. Most of the personas represented challenging health cases.
The object of the exercise was to motivate panel members to consider these 'people' and the population segments they represent when brainstorming ways to improve the health care system.
Take a look at the different personal and medical history bios below. Do any of them look familiar? Or has the panel missed any? If so, share your feedback.
Tony is from a small community of 4,000 outside of North Bay, Ontario. Tony is married and has two children (ages 13 and 15). His wife works full time in a low-paying job. After working in the forestry industry for several years, Tony established his own carpentry business, but he lacks insurance. His family's combined annual income does not exceed $45,000. Tony enjoys fishing, hockey, gardening, cross-country skiing, playing cards, and belongs to local community organizations like the Lions and Elks Clubs.
Tony is an active man who does not smoke or drink. There was no known family health history of heart problems. Until being flown to Sudbury for a triple bypass, Tony did not know he was genetically predisposed to heart disease. Tony's carpentry business does not afford him as much money as his previous occupation; his family's financial insecurity results in added stress, and his family cannot afford to visit him in Sudbury. His stress levels, already high as a business owner, have increased since being away from his family while receiving treatment in Sudbury. Tony is unsure when he will be able to return to work, and wonders whether he will be healthy enough to return to carpentry. His family worries about their future options if his income is lost.
Ethel lives alone in St. Thomas, Ontario, population 18,000. She has two sons, both over 70 years old. One son lives in western Canada and is in frequent contact, while the other lives in Australia. Ethel is a retired teacher, who spends much of her time active in her community. She is active in her church, loves playing bridge, and teaches it at the local seniors' centre. Ethel is fiercely independent and hates hospitals and doctors, only seeing them when she feels she absolutely must. She has a sharp mind, is a non-smoker, and only has a nip of brandy or scotch during the evenings.
Two years ago, Ethel was hit by her neighbour who was backing her car out of her driveway. Ethel broke her leg in the accident, but it she recovered completely. A neighbour recently brought her to the emergency room, presenting with confusion, a urinary tract infection and dehydration but she was quickly discharged. The doctor speculated that her illness might have been provoked by Ethel's unwillingness to drink water at night so she won't heave to leave her bed to visit the bathroom.
Albert lives in a small town ninety-five kilometres outside of Thunder Bay. Both of his parents earn high salaries but work late. He is looked after by his older sibling while their parents are away. Albert has been obese since age four and developed juvenile diabetes at age eight. He takes his medication inconsistently and hasn't changed his diet since diagnosis. His mother does not see a problem with his weight and feeds him generously. After school, Albert likes to play video games, watch television, play on his computer and send text messages to his friends. He doesn't understand his illness, nor does he closely follow treatment recommendations. He hates going to the doctor and his mother doesn't have time to take him, so he rarely visits. Their family doesn't have a GP; for this reason, they often go to the emergency room instead. Albert is picked on and bullied about his weight by his classmates. This discourages him from socializing and he prefers to stay home instead.
Mary Jane lives in Toronto with her husband of 38 years and her two children, 28 and 25. Her younger child still lives at home, while the elder just had a baby boy. Mary Jane is a non-smoker, and a social drinker. She loves running and gardening. She has been fighting breast cancer for three years, and recently received a terminal diagnosis. Mary Jane can no longer work, but was a former economics professor at the University of Toronto. She is in a lot of pain, is depressed, and has lost hope. Her grandmother also died of cancer. Until now, Mary Jane has been very healthy all of her life, running marathons and following the Canadian Food Guide closely. She has had a mastectomy, undergone chemotherapy and radiation, and was in remission until the cancer returned recently, spreading to her lymph nodes. She has an excellent oncologist.
Mary Jane has trouble accessing her GP. She wonders about home care and what her final months will look like. She had a positive experience at the hospital with the oncology unit, and would now like to arrange services with the CCAC for homecare. She can afford the cost of extra care services.
Rustlana has lived alone in Toronto since her husband passed away. She was a factory worker in Ukraine before she immigrated to Canada at age 15, where she was a homemaker in Toronto. Recently, she has been very frustrated with the local hospital ER and has difficulty communicating with health practitioners. She generally feels alienated from the system. She had respiratory problems, related to being a heavy smoker. She relies on her children to fill her prescriptions. Rustlana is on a fixed income and her living conditions are poor.
Michael was adopted by his parents (a real estate agent and construction worker) at 6 months old and lives in a town of 50,000. He doesn't like public spaces, is a computer nerd, and spends most of his time online gaming. He hates taking his medication, is depressed and moody, and is self-destructive. His mother is trying to find the appropriate services to deal with her son's bipolar disorder, drug and alcohol abuse and his mistreatment of his medications. Michael struggles in school, and says he struggles as a visible minority. The health staff he encounters are disheartened by his situation, and anticipate seeing him again.
Brooke lives in Toronto and has fetal alcohol spectrum disorder. Her mother, who has since abandoned her, benefited from neo-natal care and had a natural birth. Brooke was born prematurely with a low birth weight. She cries all the time and required a respirator when she was born.
Monica is from Thunder Bay and was raised by a single, alcoholic mother. Her father was absent and she had an abusive older brother. She is schizophrenic. She was in foster care as a child, dropped out of school at 16 and was pregnant by 17. She lived with the father of her child for 1 year, during which time she suffered from post-partum depression and her schizophrenia worsened.
She is currently unemployed, but is interested in tattoo art. She doodles often and gets tattoos every now and then instead of buying food. She goes to the ER and is often defensive, paranoid and combative with healthcare providers, although other times she visits the ER just for company. She has an unknown STD, hepatitis C, smokes and takes T3 and oxycontin. Her child is being raised by the province and may suffer from fetal alcohol spectrum disorder.
Phil is from Scarborough and has been happily married for 20 years and has 2 children. He is an accountant and likes astrology, basketball and baseball statistics, and running. He is diligent about keeping in good health, is a medical know-it-all and an online medical "expert." He suffers from hypertension, high blood pressure and is hyperactive. Phil is a label reader. He dotes on his children and often takes them to professional sports games. He often stops taking his medication when he feels better, but keeps the remaining pills just in case.