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Dr. Harleen Toor

dr. harleen toor

Role at the Centre

Clinic doctor

Year started at the Centre

2017

Every physician finds a different path to palliative care, but Dr. Harleen Toor’s is perhaps more unusual than most. 

She did her undergraduate medical training at McMaster University and her Family Medicine residency at the University of Toronto. But it wasn’t until her first year of residency in Family Medicine that she got her first exposure to palliative care. “I think it was something that was missing from my education,” she says.

“It was only when I had the opportunity to work in a hospice with other palliative care physicians that I realized that my framework of understanding how to ease suffering or to contribute to the wellness of a patient was missing this dimension. It was a different model of care. I actually found it more fulfilling, not just in reducing suffering but also in promoting wellness in a way that was missing in a lot of other specialties. I really shifted my focus. Palliative care was never on my radar but I shifted completely.”

Harleen joined the Latner Centre in July 2017, in a unique role for the Centre. She runs an outpatient clinic at Mount Sinai Hospital, meaning her role has a different focus than that of the other physicians on the team. “A lot of my patients are actively undergoing treatments such as chemotherapy, radiation and surgery, so my role isn’t just always solely comfort focussed. In a lot of cases it’s getting them through chemo or recovering from multiple hospital admissions. In community settings, such as the patient’s home, we are able to be the most responsible physician and can make decisions independently. In clinic, I’m constantly collaborating with the oncologist, surgeon or internist. I might be trying to keep the patient’s appetite up and their pain controlled to get them through the next cycle of chemotherapy.”

Even so, she finds she’s been able to incorporate what she learned from working in the community to her practice in the clinic. “I’ve learned not to assume anything, and not to get into a mode of applying the same approach to different patients. A pancreatic cancer patient can experience their cancer in completely different ways than other people with the same disease. What I find most helpful is taking a step back. That’s the idea of patient-centred care in palliative care. We don’t set the agenda, we don’t direct treatment. In palliative care, it isn’t about curing or fixing everything. It’s about being responsive to what the patient is finding most distressing to them.”

 

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