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The Business Matters Interview: Dr. Ali Ghahary

Dr. Ali Ghahary is a family physician who practices at Brentwood Medical Clinic in Burnaby, British Columbia.

His responsibilities include caring for patients with problems ranging from simple infections to chronic kidney failure.

Dr. Ghahary also supports patients with mental health challenges by recommending appropriate medication, and facilitating their connection with clinical psychologists.

Dr. Ghahary obtained his B.Sc. in Medicine and M.D. (with honors in research) at the University of Alberta. He subsequently completed his residency specializing in family medicine at McGill University in Montreal, Quebec. His credentials also include Certificate of the College of Family Physicians (CCFP) and Licentiate of the Medical Council of Canada (LMCC).

Dr. Ghahary proudly gives back to the community by supporting organizations such as the ALS Society of Canada and Grind for Kids. Outside of work, he is also interested in technology and gadgets, film and media (including script writing and acting), fitness (such as weightlifting, skiing, biking, and kiteboarding), travel, food, and music.

Learn more about Dr. Ghahary at https://alighahary.ca

What does the road look like to becoming a doctor? What struggles did you find along the way?

“I excelled academically, and was admitted to medical school very early. I got in after two years, which is quite rare. Most people get in after four years. I was around 19 or 20, and everyone in my class was 24 or 25. However, it was quite challenging, and far more difficult than I was expecting. Also, things have changed a lot since I attended medical school. Back then, it was extremely competitive and evaluations were based on marks. In fact, my class was the last year they did it that way — the next year, they switched to pass-fail.

“As for making the transition from school to practicing, I would suggest that aspiring physicians who are going to start medical school, or who are already attending medical school, appreciate that while marks and competence are important, people who have the highest grades do not automatically make the best doctors. What makes a great doctor is the ability to explain things to patients with clarity and compassion. And I am not just talking about treatment plan details or things of that nature. Even when there is nothing that a patient needs to do or change, the best doctors explain why.

“I also think that sometimes patients can misunderstand why their physician may seem to be rushing things along. For starters, it must be acknowledged that the healthcare system itself, as it is currently structured and implemented, is not necessarily conducive to a high-quality interaction dynamic. The problem is rooted in demographics. A patient who sees his or her physician is naturally going to want to cover a lot of ground, because they know they cannot come back in two days.

“In a similar sense, some patients are quite determined to check a lot of boxes during each appointment with their physician, because they need to maximize the opportunity. In turn, their physician is compelled to work faster — sometimes at the cost of their bedside manner — not because they are impatient or pushy, but because they are truly trying to respond to their patient’s demands. As you can see, this dynamic really doesn’t serve patients or physicians well. I could elaborate on what I think the root problems and potential solutions are, but then we would be here for another few hours at least!”

What advice do you have to those struggling in residency, especially during COVID-19?

“Struggling in residency is an unfortunate rite-of-passage, but it is obviously different during COVID-19 and there are different kinds of challenges and dynamics. The advice I would give is to have a strong support system, and to be as flexible as possible. For example, when I was in medical school I had planned on going into surgery, but then pivoted to family medicine when the former path was no longer a viable option. Looking back, I can see that it really was a blessing in disguise. I love family medicine and cannot imagine doing anything else. Sometimes it is not our actions, but our responses, that really shape our lives and futures in very positive ways.”

Any mentors in your career that have helped you along the way or given good advice to follow through with?

“When I was in medical school, during one of the psychiatry rotations I met a psychiatrist who took a liking to me. He told me, ‘I don’t care what you learn during this rotation. I’m not going to ask you about the signs of bipolar or mania, or what the side effects are of a certain medication. I just want you to learn one thing, which is when you are analyzing and assessing a patient, it is very important to look at the biological, psychological, and social components of their life in order to understand and truly be able to help them’. This is called the bio-psycho-social approach, and I have never forgotten that insight.”

“What this psychiatrist meant, and what I have embraced as my fundamental approach and philosophy, is that when you’re going to help someone — say, in family medicine a patient has a broken knee — obviously, he has a biological injury. But if you look at it more holistically, you start to focus on how the broken knee is going to affect his work and his psychological health. Let’s say that he normally goes kiteboarding, but he can’t do that for the next four months. That is going to adversely impact his mood, which in turn is going to hinder his recovery. He may not make the connection, and so that is why it is essential that his physician does. Otherwise that broken knee could trigger a whole range of problems and challenges. It could even diminish his quality of life for the rest of his life.

“In family medicine, another way to approach helping the patient is through the FIFE model, which explores a patient’s feelings (about their problem/illness), their ideas about the cause (of their problem/illness), the effect on their function, and their expectations of for how you can assist them. It’s a very helpful and provides a patient-centric roadmap. What’s more, in family medicine the more complex and nuanced the case, the more important it is to look at the bio-psycho-social aspects of a person’s health and to use FIFE as a guide for the discussions. That is where my direction in family medicine started, and where it is continues to go.

What made you decide to become a family doctor?

“Coming out of school, I had an interest in surgery procedures. However, where I wanted to go and what I wanted to do wasn’t in the cards. I was also very interested in family medicine. The questions that came out of family medicine — how people think, how they operate, how they get sick, how they get better, and so on — were and remain very fascinating to me.”

What helps you connect with your patients? Importance of good bedside manner?

“First, patients who feel that there are being heard and that their bio-psycho-social needs are being acknowledged usually have a higher chance of making progress and will have a better response to the treatment plan, which of course is the top priority. Second, a good bedside manner makes the day-to-day work experience better, and alleviates a lot of stress — both for doctors and patients.”

Did you have any other career aspirations aside from wanting to be a doctor?

“When I was back in elementary school, to my surprise I was cast in the lead role of a school production. I had absolutely no training or experience as an actor, and unlike some other kids I never even dreamed of it. And then the next year, I was cast in another leading role in the school play. That is when I really fell in love with acting, and it was something that I pursued all the way through school. Even in medical school, some of us who were into theater put on a school play. Of course, I had a very strong foundation and direction in medicine, and I was very passionate about it, and so I didn’t pursue it. But I still have an interest in film and media, including scriptwriting and acting. For example, I really enjoy developing my YouTube video series where I focus on topics like the importance of nutrition and the truth about weight loss. Perhaps in many years when I retire from the medical field, I might explore this passion in more depth.”

How do you manage a good work life balance with a really demanding job?

“It takes time to develop work-life balance. After a while, you learn to become very organized. You don’t want to take your work home. The two most important skills in this area are prioritizing and planning. And let me add something for those who may not be natural-born-organizers or time management masters: don’t worry. Even if you aren’t born with these skills — and many doctors aren’t — it is something you can learn.”



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