Rapid Rounds: 5 Minutes with Dr. Amy Tan

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Dr. Amy Tan is a Palliative Care and Family Physician working out of Victoria, BC. She is a passionate advocate for anti-racism education, health equity, and culturally-safe patient-centred informed decision-making. Such issues are delved into on her website. To further her efforts, she works on researching, writing about, and teaching these specific subjects. We are honoured to have spoken with Dr. Amy for our sixth “Rapid Rounds” blog series!

Continue reading the rest of our post to read her career story and what she believes it means to advocate in the medical field.

1. What inspired you to get into the medical field? Why did you choose to specialize in palliative care?

I was a summer camp counsellor as a high school student at a Childhood Cancer camp for children with cancer and their siblings. It was an incredible few summers that confirmed that I wanted to be in a helping profession. At the end of my first year of university, I lost a close friend to cancer and saw cancer, illness and grief up close, and this experience made me start thinking of a career in oncology or palliative care.

I had always thought that I would go into oncology, but I realized that I liked talking with families and palliative care counselling more. When I determined that I wanted palliative care to be a significant part of my practice, I also took some advice from others in the field that full-time clinical palliative care work could be too much emotionally. I always loved generalism, the cradle to grave and the continuity of relationships that Family Medicine centres on. I see palliative care as an extension of family medicine, in terms of relationships, helping patients with decision-making that considers their unique goals, desires and circumstances, and the patient and family-centred approach to both disciplines. Palliative Care has grown as a discipline in the 17 years I’ve been in practice, but I think there’s room for us all to the way in the space within Palliative Care that best suits our practice styles and philosophy. For me, that’s holding onto inpatient hospice care as an almost sacred, special place for patients and families at the end of life. I also really enjoy doing palliative care consults in a hospital or in the patient’s home where I’m advising on both symptom management and having the conversations around illness trajectory and the psychosocial support of the patient and family through the different problematic stages of a severe and life-limiting disease.

2. Can you explain the decision to put “Racism is a public health crisis” as your Twitter handle? What has the response been by leading with this message on your social profiles?

During the beginning of the pandemic, I had put in “Wear a mask” and then “Wear a Mask, Keep your Distance” in my Twitter name to underscore how important I felt the message was as I was advocating for COVID safety and health equity in May 2020 when speaking out for my family medicine patients, many of whom were essential workers during the March 2020 lockdown and not feeling protected. I changed it to “Racism is a public health crisis” after the racial reckoning that came to the forefront after Breonna Taylor and George Floyd’s killings. I also realized how disproportionately COVID-19 affects those vulnerable in society due to the intersection of race, poverty, immigration, migrant work, and essential work where they can’t distance solutions to COVID-19 must include combating systemic racism. I was told by some colleagues that there was only enough energy or attention for society to worry about COVID-19 right now. Still, I firmly believe that COVID-19 and racism in all its forms are inextricably linked. As such, I need to highlight that racism is indeed the intertwined public health crisis that has sadly always existed and will continue after the COVID-19 pandemic is over. The recent Anti-East Asian sentiments resulting in East and Southeast Asians being attacked for being blamed for the coronavirus have affected me profoundly and personally and added to my conviction to fight for racial justice in solidarity with all BIPOC.

3. What does it mean to be an advocate for health equity and antiracism in healthcare?

During the beginning of the COVID-19 pandemic, I heard from many of my patients in North-East Calgary who were essential workers that they didn’t feel supported in being safe at work. I helped them by listening to their concerns and writing letters, and making phone calls to their employers to advocate. This included asking employers to provide masks, ensuring distancing in the workplace, and other specific issues to my work situation. I began advocating in public for Public Health measures not to leave out populations that may not have the health literacy to understand all the messages or personal circumstances that distanced at home, work or transportation impossible. Being an advocate for antiracism means doing the individual work to ensure that I’m constantly anti-racist in my actions while teaching and hopefully bringing in others to also do this work. Given all that we know about how the Canadian healthcare system is causing harm due to racism, it’s so essential that all healthcare workers are working personally and systemically to reduce unconscious bias and racism that harms our colleagues and our patients.

4. What do you think is the most pressing issue in healthcare/medicine today?

Oh my, there are so many right now. All are related to what I imagine and am concerned will be the fall-out from COVID-19: complicated grief, what medicine will look like with helping patients suffering from Long COVID, including how this will affect palliative care, the mental health crisis that is raging and the effects of delayed diagnosis and management of cancer and chronic disease. I also worry about burnout and PTSD for those in healthcare who will have worked through the pandemic and whether there will be a mass exodus with early retirements and career changes as a result. All of this will affect patient care and capacity.

5. What is one message you would like to give Canadian physicians at The Rounds?

Please invest in listening and learning to other lived experiences, especially of people from the non-dominant race and ethnicities, so that we can work to make the healthcare system safer for our patients who are Black, Indigenous and People of Colour. Please listen and learn about how systemic racism exists in our Canadian institutions, including our healthcare system.  Please learn about the real history of Indigenous People in Canada to work to right the harms that our healthcare system enacts on Indigenous people.