Rethinking women’s health: new endocrine clinic promises one-stop care

​For many women managing complex hormonal health conditions, accessing care often means juggling multiple appointments across different locations, navigating long wait times, and coordinating between different specialists. St. Paul's Hospital (SPH) is transforming this experience through an innovative initiative that brings comprehensive care under one roof. 

What started as a conversation between two physicians in 2022 has evolved into a groundbreaking program, thanks to the Department of Medicine’s (DOM) Innovation Platform and Providence Health Care’s (PHC) commitment to moving care forward. Dr. Sabrina Gill recalls the journey: "When our proposal was selected for support by the DOM  Innovation Platform, our dream of what we would really like this clinic to develop into came to fruition." 

The DOM Innovation Platform played a pivotal role, providing not just funding but a pathway to bring the idea to life. This support mechanism helps physicians develop transformational projects aligned with PHC’s strategic vision. ​

"We've had a lot of support from the Department of Medicine," notes Dr. Gill. "Having all these multi-faceted partners provide their input to help support us and develop this clinic has been remarkable. We've been really blessed in that way."   

Partnerships facilitated by DOM Innovation included the Doctors of BC Shared Care Value Based Health Care Initiative, which brought the Family Physician perspective into design of the clinic.  One example of the focus on patient perspective is the integration of patient reported outcome measures (PROMs). Health care providers can now evaluate outcomes that matter to women with endocrine conditions. ​

Breaking down barriers 

Dr. Angela Liu, endocrinologist at St. Paul's Hospital, explains the current challenges: "If patients have a condition that affects multiple systems, they get referred to different specialists with different appointments. There isn't necessarily a lot of communication between all the people involved in their care." 

This fragmentation can be particularly challenging for patients from rural areas or those transitioning from pediatric to adult care. The new centre utilized a Value Based Healthcare framework to put the patient at the centre of care and address these barriers by offering: 

• Coordinated appointments with multiple specialists
• Virtual care options for remote communities
• Seamless communication between health care providers
• Comprehensive care plans that address all aspects of a patient's health 

For patients in rural areas, including northern BC and the Yukon, accessing specialized care has historically been a challenge. "Access to care is more difficult in rural regions, where most endocrinologists practice in the Lower Mainland, and very few are available in northern BC or the Yukon," explains Dr. Liu. To address this gap, the new clinic emphasizes collaboration with local primary care providers and offers virtual appointments, allowing patients in remote locations to receive specialized consultations.  

By connecting with health care providers close to the patient, the clinic aims to streamline care and ensure continuity, particularly for those who may not have a primary care provider or are geographically isolated. This innovative approach helps to bridge the gap to rural patients, improving health care accessibility across BC and the Yukon. ​

Building for the future 

The centre begins by focusing on two common conditions—Polycystic Ovary Syndrome (PCOS) and Premature Ovarian Insufficiency (POI). "There are other complex disorders that need multidisciplinary care that we will develop clinics for," shares Dr. Gill. "We started with two to keep it simple, but the plan is to expand."  

While these might seem like specific conditions, they often require coordination between multiple specialists and care providers. For instance, a patient with PCOS might need to see an endocrinologist for hormone management, work with a dietitian on metabolism and weight management, consult with a fertility specialist about family planning, and receive support from a mental health professional—all while coordinating with their family doctor. 

The centre strengthens primary care partnerships by reducing administrative burden. "We're here to partner with family physicians, not take over their care," emphasizes Dr. Gill. "Instead of making ten different referrals, it's a one-stop shop. We provide them with all the information so they can take care of these patients with proper support." ​

As part of Providence Health Care's commitment to advancing care, the centre serves as a vital training ground. "One of the biggest points of this clinic is educating young residents and fellows," explains Dr. Gill. "We want to give them exposure to women's health issues and hopefully attract them to the field." ​

A model for tomorrow 

The vision is ambitious yet practical.  "In the ideal world, we would have a multidisciplinary center where a woman could have all their health care issues dealt with in one or two appointments," shares Dr. Liu. "This would greatly improve access to care and flow through the health care system." 

Beyond improving access, the clinic helps patients make sense of conflicting advice from multiple sources—specialists, online content, and alternative providers—ensuring safe, evidence-based care. 

Proposed in 2023 for support through the Department of Medicine Innovation Platform, this initiative exemplifies Providence Health Care's commitment to transformative health care solutions. It demonstrates how innovative ideas, when properly supported and nurtured, can evolve into programs that significantly improve patient care and outcomes. 

As the centre develops, it represents more than just a new clinic—it's a blueprint for how health care innovation, backed by institutional support and driven by compassionate care, can address complex health challenges and improve lives across British Columbia and the Yukon. ​

This project has been supported by the Department of Medicine Innovation Platform in partnership with the Doctors of BC Shared Care VHBC project, and the SPH Foundation. DOM Innovation is the avenue for Department of Medicine members to address gaps in care at PHC. Initiatives could span divisions, departments and beyond. If you have a great idea and want to learn how to move it forward, visit the DOM Innovation Platform website.  

The Department of Medicine Innovation Platform is a part of Innovarium, Providence Health Care’s innovation engine that connects people, systems, infrastructure, and partners to accelerate health innovation. Learn more at innovarium.org. ​​