|February 2011, Issue 10|
Community FP's Career Mix
His friends knew before he did that Dr. Allan Grill should go into Family Medicine. When he finally did, after a year and a half as a psychiatry resident, he embraced it. Today, the mix of Dr. Grill's clinical and academic activities is a great example of the range of work available to a community family physician.
On the clinical side, Dr. Grill spends two and a half days a week as a community family physician with the Markham Family Health Team. He also spends a day and a half a week practicing long-term care of the elderly in the Veteran’s Centre at Sunnybrook. He has been a teacher since he was a resident and has taught medical students and residents in the classroom and in the clinic.
Dr. Grill is one of many dedicated Department of Family and Community Medicine (DFCM) faculty members who practice in the community and devote themselves to an academic mission in addition to teaching. Being a community family physician, he says, gives him control over his schedule so he has the flexibility to engage in non-clinical academic work.
“Family Medicine, as a career, allows you a lot of variety and tremendous flexibility. That’s something you may not be able to get in many of the other specialties.”
It is evident that Dr. Grill is a determined self-starter but he is quick to credit others for encouraging him along certain paths. Besides his friends, who he admits to following into medical school in the first place, he acknowledges remarkable teachers in medical school whose excellent clinical and academic work showed him that medicine was more than just examining patients. He names Dr. Brian Hodges, a psychiatrist with whom he did an elective, as making a particularly strong impression on him. Dr. Hodges is now the Vice President, Education at the University Health Network.
Dr. Grill calls Dr. Sharon Domb a mentor as well. She is also a DFCM faculty member and a family physician at Sunnybrook. Once Dr. Grill completed his Master of Public Health (MPH) degree at Harvard, Dr. Domb encouraged him to take a locum in the Family Medicine Teaching Unit at Sunnybrook where he trained. So he did, and shortly afterwards began to work in the hospital's Division of Long-Term Care, which led to a chance to help improve the Care of the Elderly FM rotation and serve as its residency coordinator .
The other academic side to Dr. Grill is his policy work. Positions on student council in medical school and as chief resident in Family Medicine were part of his career preparation - he knew clinical medicine wouldn't be enough for him. His step after residency, on the advice of some mentors, was to leave Toronto to get additional training in health policy work.
"At the time, an MPH degree was not so common for Canadians. I set my sights high and decided to attend Harvard. Once I got in, I didn't know how I was going to apply the degree, which focused on health policy and management. But once I came back, Toronto Public Health hired me as a consultant and I spent the next five years using my training to do public health policy. The degree also allowed me to attain a teaching position in the DFCM as an Assistant Professor and definitely helped me get selected for membership on the Ministry of Health and Long-Term Care’s (MoHLTC) Committee to Evaluate Drugs."
Dr. Grill is the Chair of the Committee to Evaluate Drugs/ Cancer Care Ontario (CED-CCO) Subcommittee, a group that advises the MoHLTC on which cancer drugs should be funded on the provincial formulary. Dr. Grill sat as a member on the sub-committee for two years and when the Chair spot became vacant, he was asked to take on the role. "I'm very proud to be representing Family Medicine at that table, I'm proud to be chair of this important committee."
“I hope to continue doing policy work throughout my career. I really enjoy it. The discussions that take place at the CED-CCO subcommittee meetings are very interesting as they focus on principles of evidence based medicine, drug safety as well as cost-effectiveness. When the committee reaches consensus and recommends a decision to the MoHLTC, I feel good that we’ve done something positive for the people of Ontario.”
The variety of work Dr. Grill takes on is part of his philosophy of how family physicians can improve care in Canada.
"Every family doc has a passion for taking care of patients and there is a lot to be said for that. For me, personally, there is a higher level of responsibility where in order to change the system you may have to do more than practice."