Patient Engagement

AMS 2016 Phoenix Fellow Dr. James Downar Talks Compassionate Healthcare

AMS would like to introduce you to our new 2016 Phoenix Fellow, Dr. James Downar. James is an Attending Physician in Critical Care and Palliative Care for both the University Health Network and Sinai Health System. He is also an Associate Professor in the Department of Medicine at the University of Toronto.


We asked James a few questions to get a better understanding of what brought him to medicine, why he values compassionate care and the work that AMS Fellows are doing and why he wanted to be involved. Here is what he had to say.

Q. Why did you decide to become a healthcare professional?

“My father is a physician, so I was always interested in a career in medicine.  One summer during my undergraduate degree I decided to join a public health project working in rural Kenya. We ended up working a fair amount in the local hospital, which was exciting but very difficult at the same time. I saw a lot of people dying of malaria and AIDS, and I had never seen anyone die before. I learned a lot about medicine and a lot about myself, and when I came back to Canada I knew what I wanted to do for a living.”

Q. What was the catalyst for your interest in compassion in healthcare?

“Many of us go into medicine thinking that we are going to save lives and stamp out disease. The reality is that most of the time we are more focused on managing diseases that cannot be cured, and helping people stay well enough to keep out of hospital. It is remarkable how much patients and family members appreciate it when you can treat a symptom or help them make care plans for the future. These interventions, which are rooted in compassion, make such a difference in the lives of the patients we see.”

Q. What inspired you to apply for a Fellowship?

“There are many gaps in our healthcare system, but the one that bothers me the most is the fact that we have essentially no system in place to follow up with family members of patients who die. We know that they experience a tremendous burden of symptoms and social needs, and they are often left to fend for themselves. Studies have shown that many do not do well, and the psychosocial and health consequences are significant.”

Q. What value does being an AMS Fellow bring to you professionally?

“The AMS fellowship is a recognized award that brings legitimacy to a project, and a sense of community to those involved in education and provision of compassionate care. I am really excited to learn more about the other projects and how we can work together to help each other.”

Q. What one little thing could we do to make our healthcare system more compassionate?

“I don’t think that there are any easy answers here. One system problem we have is that we are funding programs rather than funding patients. Patients need to move around the system to find services to meet their needs. This means that the onus is on patients and families to find out about the services and then be able to go and access them, which is not always possible.”

Q. Have you ever been given advice by a patient that changed the way you practice medicine?

“A close friend of the family once had a bad experience with an oncologist, and she shared her frustration on me. She told me that “You doctors think you should control everything and you just don’t listen.” There’s a fair amount of truth in that. It changed the way I looked at some end-of-life decisions and how I spoke with patients and family members.”

Q. What advice do you have for healthcare professionals to avoid/overcome compassion fatigue and burnout?

“I would make sure that you understand your own experiences with health, illness and death. When you understand the issues that have caused you distress in your own past, you will better understand the kinds of things that will cause you distress in the future. You cannot avoid burnout and compassion fatigue by trying to avoid death and other things that make you feel uncomfortable, and if you know yourself, you are better equipped to handle future stressors.”

About the author

Dr. James Downar

Dr. Downar, is a Critical and Palliative Care Physician with both the University Health Network and Sinai Health Systems. He is also an Associate Professor in the Department of Medicine at the University of Toronto

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