SPEAKING THEIR LANGUAGE CREDIT VALLEY FAMILY HEALTH TEAM MEETS COMMUNITY’S URGENT NEED FOR PRIMARY CARE IN FRENCH

By Alisa Kim

Research shows people do better when they receive medical care in their primary language.

A study published in the Canadian Medical Association Journal in 2022 shows people who speak languages other than English are up to 54% less likely to die or have other severe health outcomes when cared for by a doctor who speaks the same language as them.

“There are many benefits to patients’ health when they are served in their first or maternal language,” says Dr. Kerrie Shaw, a faculty member of the Department of Family and Community Medicine (DFCM) and a physician at the Credit Valley Family Health Team’s bilingual site which cares for Francophone patients.

L’Équipe de Santé Familiale Credit Valley was established in 2012 to serve French-speaking residents of Ontario’s Peel and Halton regions. Under the French Language Services Act, these are designated areas in which access to primary health care in French is guaranteed.

Being attached to a Family Health Team has significant benefits. Family health teams specialize in proactively managing chronic conditions like depression, asthma, diabetes and chronic obstructive pulmonary disorder. They are recognized for their expertise in health promotion including weight management, smoking cessation and newborn wellness.

Dr. Paul Cheung, who is also a faculty member of DFCM and a family doctor at the Credit Valley Family Health Team’s bilingual site, says the clinic serves about 2,100 patients. It is one of just a few Francophone Family Health Teams in Ontario Health’s Central Region, an area that serves more than five million people. Dr. Cheung notes some of his patients come from as far away as Hamilton or Belleville to receive primary care services in French because it is an urgent need. The interprofessional team includes three family physicians, a nurse practitioner, registered nurses, a dietician, social worker and a diabetes specialist team—all of whom speak French.

Dr. Cheung, who was born and raised in Quebec and did his medical training in French, notes patients of the bilingual site have diverse backgrounds; many are Canadians, but they also hail from Europe, Africa and the Caribbean. “Our patients describe their care as ‘one-stop shopping,’” he says. “We are bringing everything we’ve done well in team-based primary care in French. Our patients benefit from a team of bilingual health care providers who promote wellness and manage chronic disease together in our journey to offer high quality comprehensive care to the Francophone population.”

Dr. Sandra Toutounji is the clinic’s third family physician. She completed her residency at DFCM in 2020 while working at the Credit Valley Family Health Team’s bilingual site. She, like other residents and clerks, was drawn to the site for clinical training in French. For Dr. Toutounji, who grew up in Mississauga and attended French elementary and high schools in the area, working there as a staff physician is a full-circle moment. “I love this community. I find it’s a rewarding patient population. They’re quite appreciative for the care in their primary language. It’s special to be able to provide that care,” she says.

Dr. Toutounji’s former teachers and other staff of her high school are also patients of the clinic, which speaks to its connections to the local Francophone community. “Whenever new immigrants get here, they’ll choose a francophone school for their kids. The principals or leadership of the school board know us and direct them to us to get their vaccines updated and health care needs taken care of,” says Dr. Cheung.

He recalls one patient in particular—a pregnant single mother who was a refugee. She was referred to the clinic by the principal of her children’s French school. Over time, the patient was able to set down roots, trained as an early childhood educator and now works as a teacher. “We managed her medical care and helped her settle in the community in collaboration with our team and social services agencies. Our patients feel safe here and they feel like they get complete care,” says Dr. Cheung.

In addition to the clinic’s ties with the local French school boards, it also works closely with community organizations. For example, staff at the clinic refer patients to Oasis Centre des Femmes, a Francophone organization that helps women and children experiencing domestic violence. In turn, the centre refers its clients who are in need of a family doctor to the clinic. “I think because the francophone resources and services that exist are so sparse, you really do have to work as a community to maximize what’s out there,” says Dr. Shaw. “We can provide preventive care, update vaccinations, screen for diabetes and all the great stuff family doctors do, but we also have to be mindful of the social determinants of health and whether this person is connected with different community resources, or their kids are in school. Everything we do is at the level of the community because it is very hard to find services in French.”

Caring for patients in their primary language is gratifying, but can also be tricky at times, says Dr. Shaw. “It definitely adds a layer of challenge—oftentimes patients may not understand specialists’ recommendations. You have to spend more time explaining things,” she says. For Dr. Toutounji, who did not do medical school in French, taking care of Francophone patients was initially daunting. Still, she encourages trainees who speak French—even if they are rusty—to pursue clinical opportunities working with Francophone patients as the experience is deeply rewarding. “Patients are so appreciative. Even in those tough conversations where I’ve had trouble finding the words, they’re able to get their feelings across so much more easily and feeling heard in their language means so much to them. Even when I have to use the odd English word here or there—I struggle a bit more with those conversations—it still goes a long way. It’s normal for people to feel anxious if French is not their first language, but I would encourage them to pursue it.”