JGH’s Goldman Herzl Family Practice Centre continues long history of care

The Family Practice Centre, headed by Dr. Mark Karanofsky at the Jewish General Hospital (JGH), relies on donated funds to pioneer innovative programs.

There’s a good reason family medicine is called primary care. It’s where it all begins.

“Family medicine encompasses everything and is always in demand,” said Dr. Mark Karanofsky, Director of the Goldman Herzl Family Practice Centre at the Jewish General Hospital (JGH). “We provide care for all.”

The latter phrase is not used lightly by Dr. Karanofsky – it is rooted in the long history of family medicine at the JGH. That story began with the Herzl Dispensary, founded in 1912 to provide free medical care to Montreal’s Jewish community when waves of impoverished Jewish immigrants were arriving from Eastern Europe.

The Herzl Dispensary, which later became the Herzl Clinic, was a pioneer in providing free medical care to all, helping build the model that became Canada’s universal Medicare system. Its doctors also played a significant role in creating the JGH, which opened in 1934. In 1974, the Herzl Clinic became part of the JGH and has been a vital element of its service to the community ever since.

“We’re here to help people, it’s as simple as that,” said Dr. Karanofsky. “Just like the Herzl Dispensary did. Our role is no different.”

100,000 patient visits per year

It helps a lot of people. The JGH’s Family Practice Centre and its 170 doctors and staff conduct more than 100,000 patient visits per year, including 20,000 in the urgent care clinic. There is a very active Teenage Health Unit and family physicians who specialize in pregnancy and obstetrics, so patients range in age from two weeks to more than 100 years.

“We care for absolutely everything except teeth, though sometimes even teeth!” quipped Dr. Karanofsky.

More than 30,000 patients are officially registered with the Family Practice Centre’s family doctors, including 10,000 in practices with family medicine residents. These new doctors follow about 200 patients each for the two years of the residency program, before handing them over at the end to a new resident.

Dr. Karanofsky knows the residency program well because he was part of it when he completed his initial medical studies in 2002. Even though he is busy now as the Director of the Family Practice Centre, he still has a personal practice roster of 1,000 patients and since 2007 has cared for one of the inpatient units at the Donald Berman Jewish Eldercare Centre, a long-term care facility. It’s work he calls “very rewarding.”

How donors support the Family Practice Centre

About 60 per cent of patients come from outside the JGH’s official territory, a fact not fully considered when public health system resources are allocated, said Dr. Karanofsky. As a result, the Family Practice Centre counts on funding from the JGH Foundation and its donors to allow it to launch many of its innovative programs and services, as well as to purchase useful equipment, conduct research and provide staff education programs, with some 60-70 people participating in courses or activities every week.

“Without the generosity of donors and the funding we receive, we could not offer such a high standard of care,” Dr. Karanofsky said.

For example, Dr. Karanofsky notes the recent acquisition of eight Butterfly IQ probes. These are handheld ultrasound imagers that plug in to any smartphone to display the image on its screen – no bulky unit needed. They allow medical staff to see images instantly to help find the source of a problem or the best spot to insert a needle in a vein, even if they are away for a visit to a residence or a house call – which doctors at the Family Practice Centre do regularly for about 100 patients.

“These devices enable us to be best equipped to offer care to residents and patients,” said Dr. Karanofsky. “We’re able to use them because of a generous donor.”

A new initiative made possible thanks to seed funding from the JGH Foundation is The Fourth Trimester program, developed by Dr. Judy Hagshi as part of a multidisciplinary program to assist parents in adapting to the many challenges of a new baby. “It’s intended to help parents cope better through what can be a very tough, if exciting, time,” Dr. Karanofsky said.

Donor funding was also critical during the COVID-19 pandemic, when equipment was purchased to allow a rapid shift to virtual services. Donations recently made possible the purchase of a supply of Holter monitors, which patients wear to record their heart activity. Similarly, 24-hour blood pressure monitors have also been acquired.

The Family Practice Centre also conducts research in different ways to improve care, most of which is also funded by donations and grants. Current topics include the use of artificial intelligence in improving care, as well as collaborations with McGill University into better care for dementia, diabetes, high blood pressure and in simplified methods of testing for viral illnesses.

Teamwork is key to the success of the Goldman Herzl Family Practice Centre, Dr. Karanofsky said. “By working together, we are able to coordinate care, such as having a team pharmacist review complex medication needs, sharing care visits with our nurses and maintaining coordinated record-keeping.”

All these innovative programs and services are made possible, Dr. Karanofsky said, by having a large critical mass of patients and staff. However, he added, “Donor support gives us opportunities to pilot projects and be innovators and leaders. It sets us apart.”

To make a donation to the Jewish General Hospital Foundation, please go to www.jghfoundation.org