As the medical director on the team, Dr. Siden provides insight into the care of children and youth with the most complex health conditions, and the development of a new program that will serve them.
Dr. Siden is also the medical director for palliative care at BC Children’s Hospital, and the medical director of Canuck Place Children’s Hospice, the provincial pediatric palliative care and hospice program.
“I call myself a ‘complex chronicologist,’” says Dr. Siden. “For most of my career, I have been taking care of highly complex and seriously ill patients.”
“I'm more of a lumper than a splitter,” adds Dr. Siden, “so I would say it doesn't really matter whether you call me the complex care doctor or the palliative care doctor or the general pediatrician in the hospital. I'm seeing a complex, unique child and I’m dealing with important issues in their lives.”
We sat down with Dr. Siden to learn more about his role with developing a new clinical program for children with health complexity.
Even though my core work today is in pediatric palliative care, so much of that care is around children who live with serious illnesses for many years. So I've long had this experience of the intersection of all the issues that occur for these children. Long before anyone thought there might be a new centre for health complexity at BC Children’s, I was already thinking: what would be the practical ways that you could bring all these elements of the children’s care together? When I heard the first exciting whispers that we would have a centre and build a building, I was in on the early discussions.
One of the challenges is that there is a lot of unknown and uncertainty. There isn’t one pathway of care or guideline for treating a child with health complexity like there is for specific chronic health conditions like asthma or diabetes. It involves a lot of iteration and adjusting of care that is different for each family and may change year to year.
It's also very multisectoral. The health system itself is very complex. And then there's the social services system. And then there's the education system. The maps that families draw, showing all the different services they need to access, are so complex.
We talk a lot about coordination of care, about navigation. And I've said for a long time you can't just navigate a ship, you also need a captain. I would say almost every family I meet unfortunately sees themselves as having to become the captain, and [when they start out], they don't have the health-care knowledge, the background, the nursing or medical training to do that. Often, they have other important responsibilities. They have other children. They're trying to work but it becomes a full-time job for them to become their child's health-care manager. These are just some of the challenges for families of children with medical complexity.
Care Coordination will be one of the foundational services for children with health complexity at the new centre. We’re creating a team that will provide, the best health care possible for the child. Care coordination really means putting a lot of thought behind what's the right support at this time, and how is it provided, by whom, and what is the goal of that support.
It's the building giving a home to this program that we intend to be innovative. The building also means that all the people working on that program get to work together in the same space so they can interact and generate new promising care approaches for children with health complexity. We know for sure that care at the new centre will be provided in-person and virtually.
I unwind in a lot of ways. I'm physically very active, so every day I do something that involves moving. This morning, I was rowing at 7 am. Other days I’m hiking. In the winter, I’ll be skiing. If I move a lot, I get everything out of my head. And then late at night, when the house is quiet, I read and I've always have three books on the go, both fiction and nonfiction. And I keep my mind interested in other things. I'm learning French, so I hopefully spend 30 minutes on that every day.
