Unique challenges plague doctors

It is hard out here for a doctor.

East Scarborough is a diverse area and that can make life even harder for doctors working the emergency room at Centenary Hospital.

“There are always cultural challenges and impediments in terms of understanding,” said Dr. Eric Fonberg, interim head of emergency medicine for Rouge Valley Health. “And I don’t mean language alone.”

Scarborough's diversity can cause problems for local emergency room doctors.
Scarborough's diversity can cause problems for local emergency room doctors.

Cultural differences, when it comes to health, can make a huge difference, said a doctor who asked her name not be used. Some cultures are stoic about pain, while others are open about it.

“It can be difficult to assess need, because you’re not really sure what they’re experiencing,” she said.

The language barrier poses a problem sometimes even if there is a translator. The doctor once caught tuberculosis because a translator had trouble relaying whether a patient had been coughing blood or vomiting blood, and wrongly said the latter.

Getting TB is just part of the job, she said.

The times when a family member needs to translate for a patient can be thorny.

“If you’re dealing with a family member, there are some things they won’t say,” she said. “They won’t express their sex life through their daughter.”

Seeing a majority of middle class, native born Canadians in the emergency room is easier than working in an ER where most people don’t speak English, Fonberg said.

Even native born Canadians from the area can pose their problems, since Scarborough is lower income area, said Fonberg, who adds Centenary’s emergency room is bound to see more heart and lung problems because of the income gap.

It gets harder because some people from other cultures view the hospital as a beacon of health, Fonberg said. They don’t realize that some issues are supposed to be looked after by a family doctor.

That’s if they can find one.

There are approximately 90 family doctors listed as practicing in east Scarborough, according to a list of doctors from the Ontario College of Physicians and Surgeons. Only 10 or so of them are taking new patients.

More medical students aren’t going into family medicine, the doctor said, because the pay isn’t high enough for the job.

“You’re supposed to be an expert in all things, which is exhausting,” she said.

Despite the hardship, she said she loves her job. The surprises of working in a diverse area can be invigorating.

“You come in exhausted after work, saying ‘Oh, I don’t want to go back in tomorrow,’ ” she said. “But, really, it’s quite exciting to work here.”