A shining example of collaborative practice – Dwayne Lyall and Dr. Darlene Bilawski
Dwayne Lyall has been practicing under the supervision of Dr. Bilawski for over two years in a Family Health Team (FHT) in Barrie, Ontario. The clinic where they practice services over 2700 patients. Dr. Bilawski and Dwayne have a team based, collaborative approach to care and work quite closely with a number of other health professionals including a Nurse Practitioner and Registered Nurse. The focus of care is centered on the patients and meeting their needs. By incorporating a PA into her practice, Dr. Bilawski was able to increase her patient roster to take on an additional 500 new patients. This is incredible when you think of the number of patients without a primary care physician in Ontario and the impact that this has made on the community. The addition of the PA has enabled the clinic to dramatically improve access to care as well as enhance the level of service that patients are receiving. Dwayne and Dr. Bilawski are able to offer same day appointments which has helped the community to access care in a timely fashion and decreased the risk of potential complications due to medical conditions going untreated.
A specific example of this is a 7 year old female whose mother requested a same day appointment because of increased thirst, urination and fatigue. Dwayne decided to do a quick random glucose in the office. The patient’s reading was 20.0. Dwayne quickly made the decision to have her sent to ER and she was aggressively treated and stabilized for acute onset type one diabetes and ketoacidosis.
Another example was a 48 year old male who was being followed for low back pain. During one of his visits he said “oh I just thought I should mention to you that I had a brief fainting episode while working at a construction site a couple of weeks ago.” After further questioning by Dwayne in consultation with Dr. Bilawski, tests were ordered and it showed severe aortic stenosis. The patient was referred to cardiology and a few days later he had a new prosthetic heart valve.
Prior to joining the Barrie Family Health Team, Dwayne was practicing as a PA in the Canadian Armed Forces (CAF). While he enjoyed his role and providing care for CAF personnel, Dwayne is enjoying using his skills to improve health care in his local community. Prior to hiring Dwayne, Dr. Bilawski had never worked with a PA. After having worked with Dwayne for some time now she describes it as a very enjoyable experience and would now not know what to do without having a PA practicing alongside her.