Dr. Jennifer Reynolds on the St. Paul’s Lupus Clinic —AGM 2008

Good evening and thank you for inviting me to speak tonight.

I’d like to start by telling you a bit about myself and the other rheumatologists involved in the clinic, then review the goals or objectives of the clinic, and thirdly, I’d like to review some of the clinic details as it is currently operating.  I haven’t prepared a long speech and would welcome the opportunity to answer any questions you may have following my talk.

With significant input from Drs. Ken Blocka, and Stephanie Ensworth, I have taken on the role of organizing the new lupus clinic, now running through St. Pauls.   Many other members of the UBC division have also offered their suggestions.  Although the clinic is operating, and accepting referrals, it is still evolving in terms of day to day operations, and overall objectives.

I am a rheumatologist, and member of the St. Pauls Division of Rheumatology, as well as a Clinical Instructor with the UBC Division of Rheumatology.  My background is as an electrical engineer.  I completed my medical school training in Calgary, my internal medicine residency training in Halifax at Dalhousie, and my rheumatology training here at UBC.  Following my fellowship, I did some additional training at the Toronto Lupus clinic, working with Drs. Dafna Gladman, Dr. Paul Fortin, and Dr. Murray Urowitz.

Two other rheumatologists are currently committed to seeing patients in the lupus clinic.  Dr. Ken Blocka is a very experienced rheumatologist, originally from Saskatchewan, who is currently head of the St. Paul’s division of rheumatology (until July). He has been a major proponent of the idea of developing a lupus clinic at St. Pauls, and has been key in developing our goals, and helping to sort out the logistics of getting the clinic going.

Dr. Lucie Wilk is another British Columbia trained rheumatologist who was involved with Dr. Ensworth in the previous lupus clinic and has many lupus patients in her private practice who has agreed to see patients in the current clinic.  Dr. Stephanie Ensworth will not be seeing patients in the clinic but has agreed to act as a consultant for us on any patients whose disease is challenging.

Our goals focus on three areas: Clinical Care, Education, and Research.

Clinical: We hope to provide additional clinical support for patients with lupus, and plan to see two different groups of patients:

· We will accept referrals from family physicians for suspected or newly diagnosed SLE, with patients being seen quickly for confirmation of the diagnosis, and initial treatment recommendations, then subsequently being referred to a private rheumatology practice for ongoing management and follow-up as necessary (analogous to the current early RA clinic).  GPs or patients may state their preference for a specific rheumatologist to become their primary rheumatologist, or we will refer to one of the local rheumatologists who has expressed an interest.

· We will provide a consultative service for other rheumatologists and specialists for patients with SLE that is difficult to manage.  We would initiate work-up and referrals as necessary to manage any acute issues, but patients would not be followed solely by the lupus clinic.

· In the future, we plan to create combined clinics with other specialists, such as nephrology, dermatology and neurology.

Teaching: We will provide enhanced exposure and education about lupus for the rheumatology trainees, as well as medical students (future family doctors) and residents (future rheumatologists). Trainees in the UBC Rheumatology Program (fellows), and in the UBC Internal Medicine Program (residents) would regularly be seeing patients with the staff rheumatologists.

Research:

· We will participate in the Canadian Network for Improved Outcomes in Systemic Lupus Erythematosus, or CaNIOS, an alliance of Canadian lupus researchers working together to create a large multi-center database to investigate many areas of lupus epidemiology.  Patients are currently being enrolled in the ‘1000 Faces of Lupus’ study.  As part of this, they will be seen at least annually through the lupus clinic.  As members of the CaNIOS network, we will also be able to access data from other centers for our own research.

· We will initiate independent research locally.  Dr. Antonio Avina, a rheumatologist from Mexico with a strong interest in lupus, and I have been discussing potential projects but this is very preliminary.  We will likely also be collaborating with dermatology with Dr. Jan Dutz, and possibly others, such as members of the St. Pauls Nephrology division.

Some caveats:

· We do not have the resources to become the primary rheumatologist for the patients referred to the lupus clinic.  Even with annual follow-up, as part of the research database protocols, resources will have to be expanded in the future in order to continue to see patients with acute flare-ups and new diagnoses.

· We will not be able to see Rheumatic Diseases in Pregnancy patients, though we recognize that need.

Some basic information:

             Where: St Paul's, Rapid Access Clinic, 5th floor, Burrard building

             When : Wednesday mornings

             Staff: Dr. Jennifer Reynolds, Dr. Ken Blocka, and Dr. Lucie Wilk with 2 physicians present at most clinics

 

Send referrals to:

Lupus Clinic

c/o: Dr. Jennifer Reynolds

408-1160 Burrard Street

Vancouver, BC V6Z-2E8

Phone 604 646 4637

Fax 778 370 1822