2012-2013 Annual Report

The Pit Stop

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A unique clinic for patients with pituitary disease adds convenience to care.

It was by chance that James Stirling of Chatsworth, Ontario learned there was something very wrong with his pituitary gland, a pea-sized organ at the base of the brain. An MRI scan for a shoulder issue had captured something extra - a pituitary tumour. 

When told he required various tests and consults with more than one specialist in London, 52-year-old James, a school bus driver, braced for multiple days off work and lots of travel. London was about 200 km away – about a three hour drive.

But James was pleasantly surprised. All of his appointments – four in total – were scheduled for the same day. 

"How often does that happen? Being so far away, it worked so well.  The first appointment was at 8:30 am and the last one ended at 2 pm. Even a lunch break was scheduled into my day. Not only was it convenient for me but since I needed a driver due to vision testing, it was convenient for my daughter too."

James is among the first patients of the One-Stop Pituitary Clinic created by St. Joseph’s in collaboration with specialists across the city and the Ivey Eye Institute. The clinic’s purpose is to streamline care for patients with pituitary disease. 

Dr. Van Uum

"When a patient has a pituitary tumour, it can cause a wide range of disorders requiring testing, imaging and the care of various specialists – ophthalmologists, endocrinologists, neurosurgeons and ear nose and throat surgeons," explains St. Joseph’s endocrinologist Dr. Stan Van Uum. "Previously, care for these patients was fragmented with the various medical visits scheduled on multiple days. If you look at the great distances patients are travelling for care in London and the number of trips they are making to receive services, it was clear we had to do things better."

With the clinic’s central referral process, initial lab testing, endocrinology consult, visual field testing at the Ivey Eye Institute and neuro-ophthalmology consult are arranged on the same day. “In addition to the logistical improvements, the streamlining and centralization of referrals also creates an excellent opportunity to improve patient education, facilitate follow-up visits, enhance teaching to residents and medical students, and improve understanding and care of this patient group,” says Dr. Van Uum

Prior to arriving at the One-Stop Pituitary Clinic, located at St. Joseph’s Hospital, patients receive an itinerary of their appointments – which may include London Health Sciences Centre - directions, as well as information about the pituitary gland and what they can expect during their visit. 

In the past, patients with pituitary disease from across the region made on average 2.4 trips to London travelling a total distance of about 300 km. With the first patients seen at the one-stop clinic, the total number of visits has dropped to one and the average distance to 116 km.  

Feedback from patients has been excellent, says Dr. Van Uum.  If successful, the clinic may become a model of care for pituitary disease across Canada.

Funding for setting up this integrated care model was supported by St. Joseph’s President’s Grants for Innovation. 

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