A Generalist at Heart
Council Award — Dr. Elizabeth Shouldice
When Dr. Elizabeth Shouldice received the email notifying her she would be one of four recipients of a 2021 CPSO Council Award, she thought it was a mistake. “I remember writing back and saying, ‘I think you emailed the wrong person for this award,’” she says. “But then I was just so delighted and humbled when it turned out that it wasn’t a mistake. What means the most to me is that my colleagues, who are all extremely busy during this pandemic, took the time to put my name forward.”
It really shouldn’t come as any surprise that Dr. Shouldice added a CPSO Council Award to her long list of honours, as she has been receiving awards from the very beginning of her medical career. Born and raised in Ottawa, Dr. Shouldice did her medical training at Dalhousie University in Halifax, NS, earning her Doctor of Medicine in 2005 and completing her Family Medicine Residency program in 2007. She’s now back home in Ottawa and, since 2008, has worked as an emergency room physician at the Queensway Carleton Hospital. Dr. Shouldice holds numerous other positions in Ontario’s health-care system, most notably as an assistant professor in the University of Ottawa Faculty of Medicine (Emergency Medicine department) since 2015 and as an addiction medicine physician at the Recovery Care West in Ottawa’s Bells Corners since 2018, where she has helped countless patients in their fight against opioid and other forms of addiction.
Through her work, Dr. Shouldice found a tremendous intersection between emergency medicine, helping patients struggling with addiction, and the impact of COVID-19 on mental health, addiction and access to primary care. She says she has seen many people who use drugs come through the emergency department who then become her patients at the addiction clinic. She has seen many addiction patients, unable to find a family doctor, turn to the clinic for many of their primary care needs. And she has seen how the lockdowns and other stresses of the pandemic derailed many patients’ progress with their mental health and further limited their access to care. It is Dr. Shouldice’s mission to help connect all these dots to ensure her patients get and maintain the best possible treatment possible.
She attributes her ability to make these connections to the fact that she is a generalist at heart and has been since the beginning of her training. Indeed, that was the appeal of a career in medicine in the first place: it spoke to her dual interests in science and the humanities, in clinical care and critical thinking, and in the ability to listen to patient stories and to problem-solve in a high-stress emergency department. This generalist approach has helped her become a deeply humane and caring clinician.
We caught up with Dr. Shouldice to ask a few questions about her life and career. We also have a video of her remarks 🎥 when she accepted the award at the September meeting of Council at the end of the article.
Were emergency medicine and addiction always the areas you wanted to focus on?
No, I always thought I’d do family medicine. I’m a generalist by nature and family medicine seemed to speak to that side of me. I had a grandfather who was a family doctor in the United States, so I did have a sense of what the job would entail. But then I did my first shift in an emergency department during my training and it changed my mind. The emergency department shift was mandatory of course, and I remember being very nervous beforehand and thinking, Okay, you just have to get through this. But then I loved it. I loved the art of it, solving problems on the fly, listening to patients that you just met. I realized then that this was what I wanted to do.
Tell us more about some of the crossover between emergency medicine and addictions medicine.
There is a lot of crossover. We see people suffering with addiction come through our emergency department and this is often how I connect them with the addictions clinic where I also work. Sometimes those emergency-department patients are ready to get the help they need right away and sometimes they need some time. I remember one patient who came through the emergency department and it was clear he was suffering quite a lot with his addiction. I gave him my card and invited him to reach out when he was ready to get help. He probably carried that card around for 18 months, but then right before the pandemic started, he sought help. I’m happy to report that he’s now enjoying one year with negative urine test results and has gotten a job. He’s a real success story.
For a lot of addiction patients, their primary care is us. We do COVID-19 and other vaccinations, and provide care for patients with Hepatitis C. My work with addictions is giving me what I thought I would get from family medicine: an opportunity to build long-term relationships with patients, as well as develop relationships with family physicians in the community who can help them. To see these patients get the help they need is so rewarding.
How has the opioid crisis evolved since you began working in this space?
I’ve realized how anonymous this crisis is. There are people you wouldn’t expect to be dealing with the problem of addiction. I think people have a certain idea of the kind of person battling addiction, battling opioids, but the reality is it affects so many different types of people. I think we’re slowly realizing that as the opioid crisis evolves.
COVID-19 has also had a huge impact on the crisis — that is, things have gotten a lot worse during the pandemic. For example, I’ve had three moms who were stabilized with their addictions, but then became destabilized because their kids were home learning rather than in school during the pandemic. That was a big change for them and it was enough to destabilize their progress. Thankfully, all three of those women are back on track, but it’s quite revealing about how the pandemic has impacted people who are struggling. I mean, I’ve had my own young kids at home and I have all the resources in the world, and I’ve found it hard. I can’t really imagine what it’s been like for some of my patients with addiction.
Tell us about your teaching at the University of Ottawa and Algonquin College.
You know, I often feel like I get more from my patients than they get from me, and it’s the same with teaching — that is, I get more from students than they get from me. I find teaching is a fantastic way to refocus on my career and why it’s so important to me. When I’m with my students, it really reminds me how much I love my job. Educating others is a great way to reinforce the importance of why I do what I do.
One of the things I discuss with my students is work-life balance. It’s something they ask a lot about. My advice to them is to start slow with your career: you can always add more work as you go along, but it’s hard to take work away once you’ve started. I also talk about the importance of family and family support in their success. There are balls in this career you can drop and balls you can’t, and your family is one you can’t. No one can be a truly successful physician on their own. We need that support to do what we do.
You have a husband who is a pharmacist and two young sons. What does work-life balance look like for your family?
We love getting active as a family. We like to get to the cottage; we like to bike and swim. As I said, I did my medical training in Halifax and I still have some close ties out on the East Coast, so we like to travel there — at least prior to the pandemic — as a family as much as we can. Music is also a big part of our family life. We’re always playing music and the boys are both taking piano. Beyond the usual conservatory repertoire, they’re learning a lot of music from the Star Wars and Harry Potter movies, which they really love.