Dr. Timothy Froats heads up collaborative program at BGH

Posted Jan 12, 2012 By Doreen Barnes

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EMC News - The following is another in a series of feature articles on health professionals at the Brockville General Hospital.

He heads up a hospital department that involves a true collaborative effort in dealing with patients.

"The one thing about our program is to be able to function and look after obstetrical patients in particular, with so many different people involved," explains chief of obstetrics and gynecology, Dr. Timothy Froats. "There are midwives, family doctors, obstetricians, pediatrician, an anesthetist, operating room teams, nurses and so everybody has to work together to provide the service 24/7, even in the middle of the night. We are up and running all the time and that's the challenge, to have a team that works together. When it's a small group and someone leaves it makes a big difference, but you adapt and adjust."

Froats' role is to supervise the activities of the Department of Obstetrics/Gynecology at the Brockville General Hospital and to ensure it is staffed with physicians who are monitoring patient care and addressing issues.

Right now there are two obstetricians/gynecologists - Drs. Timothy Froats and Basem Hafazalla who are waiting for a third physician to join them soon. There's an active recruiting process taking place right now.

"We have two family doctors who do obstetrical delivery in the hospital. So there are two obstetricians, two family doctors and two midwives," says Froats.

Although midwifery is on the rise, it still only accounts for two per cent of deliveries in the province.

Froats is self-employed having a private practice, like many other specialists at the Brockville General Hospital, but functions in a team environment having attended over 6,000 births during his career.

"We have a turnkey operation here. When we recruit somebody (physician), all they have to do is show-up as we have everything up and running," he explains. "That's a tremendous advantage for someone coming into the community to open up a practice.

TEACHING UNIT

"Because we are formally linked up with the Department of Obstetrics/Gynecology at Queen's University, we purport our unit as a teaching unit," says Froats. "Hence we have both clinical and academic responsibilities. Generally we have a senior medical student with us here, all the time, in the office."

Froats notes six out of 12 months of the year, they also have a PGY2, (post graduate, year two), resident from the obstetrics and gynecology training program at Queen's University.

The turnover rate for the senior medical student is each week, so every week they have a different medical student and the residents are here for about eight weeks."

Recently a medical student from Ottawa PGY2 program requested to come to Brockville for onsite training.

The added bonus to having students training at the Brockville General Hospital, it gives the physicians here an opportunity to learn from the students as well.

"The interaction is very positive, we like having them and I think our patients like having them as well," indicates Froats.

GYNECOLOGY

"Most of us are general obstetricians/gynecologists who practice both obstetrics and gynecology, sometimes as the physicians get older they drift more in gynecology away from obstetrics, especially in bigger centres," the department head explains.

Many patients, he adds, are sent to him for various reasons - abnormal uterine bleeding, patients with urine stress incontinence, bladder problems, prolapse (bulges coming out of the vagina meaning the bladder or uterus is falling), abnormal pap smears, patients with pelvic or abdominal pain, ovarian masses and infections.

"In gynecology there's a big push towards minimally invasive surgery and so operating on someone's abdomen or pelvis would require a big incision to open them up," says Froats. "There have been big developments in laparoscopic equipment with regards to facilitating that type of surgery, which is changing on a weekly basis. So that is one of the challenges every hospital is having is to institute more and more minimally invasive surgeries, shortening the recovery time."

OBSTETRICS

For a first-time mother-to-be, they can expect to have the physician ask about the family history, determine how far along the pregnancy is, discuss any risk factors that may be associated with the pregnancy, as well be asked if they smoke, are on any medication, drink alcohol or take pre-natal vitamins.

An examination is then conducted and if the pregnancy is over 11 weeks, then the mother-to-be can hear the baby's heartbeat.

Blood work is taken along with an early ultrasound to ensure a normal looking pregnancy. There's an offer to screen the blood work for Down's Syndrome which is a chromosome abnormality. If there's any indication of the possibility of Down's Syndrome then an amniocentesis can be administered. Should the test come back positive, counselling is available.

"We would direct them to the genetics clinic in Ottawa or Kingston," says Froats. "So they get very careful counselling with respect to the implications that they have a baby with Down's Syndrome. They would also be offered termination of pregnancy."

"We recommend prenatal care, not to smoke, be active and be conscious of a nutritional diet."

Froats says there are a wide range of options available to patients and physicians for deliveries and the patients have a choice.

"When patients go into labour they never know how much pain they are going to experience, how they will cope and how long it will go on for, so we have a lot of options to use," says Froats.

"With vaginal deliveries the patients and babies are generally out within 48 hours," he says. "In earlier times, the patients stayed in hospital four or five days. The people who have Caesarean sections are generally out within two or three days. All because of the advances in anesthesia which are remarkable and in the post-operative state have the patient's pain well controlled which is a great advancement."

In Brockville there are not many requests for elective caesarean sections as in larger centers.

One reality that Froats shared is that 20 per cent of women delivering babies, in the Southeast Local Health Integration Network (LHIN) are over 35 years of age.

The reasons vary from couples marrying later in life, women pursuing a professional career or just waiting until later in life to settle down with a family.

Therapeutic abortions are not done in Brockville. The patient would be counseled in either Kingston or Ottawa as to their options. The local obstetricians/gynecologist would not see these individuals as the appointments are usually handled by the family physician.

INFERTILITY

With regards to infertility, Froats believes there's more understanding in evaluating people to determine the causes of infertility, especially with the aid of technology.

"There's so much more information known now, particularly with in vitro-fertilization and multiple pregnancies," he says.

Local Health Integration Networks (LHINs)

When asking Froats' opinion about the LHINs, he had this to say. "The health care system is very complex and I think the government has decided that the Local Health Integration Networks (LHINs) plays a role in supervising regional care and every region is different."

Froats indicates that Eastern Ontario is a very unique region compared to central Ontario. The numbers and distances are so different and each area has different needs.

"The potential advantage of the LHINs is that they can look at the needs in their particular region. It's very political, very complex and very complicated, but I think they are probably doing the best they can and are committed in trying to improve the system. The health care system is faced with a very huge costs and the government has to control those costs."

FAMILY

Froats grew up in Cornwall and later moved to Kingston because of his father's occupation, but after studying Queen's, he came back to live along the St. Lawrence River.

"I have a kayak, a Sea-doo, a boat and I like looking at it (river), sitting by it and being in it," the doctor admits. "The drive between here and Gananoque is one of the nicest drives in Ontario and we take a lot of that for granted."

As a high school student in Kingston, medicine caught his eye and the knowledge needed to help people was a stimulus to go in that direction.

"In Grade 12 or 13 we could apply to pre-medicine at that time," recalls Froats.

He remembers fishing when his three children were younger, then an illness took his first wife's life at age 42, with him having to raise their children alone. The youngest at that time was age 9 and he had to turn his attention to cooking.

Froats admits to making a rather tasty barbecue steak.

"My cooking is very basic, meat and potatoes," he says.

To relieve stress, Froats run three times a week on a treadmill going five kilometres, lifts weights and finds water activities very calming.

His children are now grown and away pursuing their goals.

"My daughter, Sommer received her Bachelor of Nursing Science from the University of Western Ontario and is taking her Master of Science in Nursing," beams Froats. "My son, Mark is a doctor, a third year resident in emergency medicine in Kingston, as well as Jamie is in his first year of law school at Queen's University."

He reads when he has time, especially business, finance, and biographies, books that are totally away from medicine.

"When you get engrossed in medicine," says Froats, "it's easy to become very narrow minded, so over the last 10 years I have read a lot of books that are totally unrelated to medicine."

Froats likes to read non fiction as opposed to fiction. He finds it very soothing.

"My wife, Mary Jean, takes me to the theatre once in a while," says Froats.

Although he admits it's different, he does feel that people should experience the unfamiliar, to widen their scope of life.

As for his work at the hospital he feels fulfilled.

"It's a privilege to be doing this...a satisfying job of delivering healthy babies and it is a happy time in peoples' lives."




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