A tidy strip mall near Calgary’s Marlborough Mall seems an unlikely place for a medical clinic that is reinventing how caregivers approach women’s health care.
But since it opened in 2007 as the Northeast Women’s Clinic, what is now known as The IUD and Women’s Health Clinic has helped address the most intimate needs of more than 50,000 female patients. The clinic targets clientele from communities that often feel marginalized by the traditional health care system, including recent immigrants and women concerned about racial or gender discrimination.
Menses, childbirth, menopause – and the dozens of minor ailments that accompany women because of reproduction – used to be treated as separate medical events at doctors’ offices. The clinic’s founder, Dr. Rupinder Toor, has taken an innovative approach to those health issues with both her clinics.
The IUD Clinic, founded in 2018, is dedicated to helping women – especially younger women – understand and plan for their reproductive lives as part of lifelong caring for their bodies. Dr. Toor likes to ask teenage girls, “When in your life do you want to become pregnant?” and watch their eyes widen as they realize they have a choice.
Dr. Toor founded the first clinic when she was in medical school to reach immigrant women whose traditional customs and culture blocked them from seeking intimate health care.
“We were studying cervical cancer, so I asked my mother if she’d had a Pap smear. She said, ‘Sure.’ I asked her, ‘When?’ And she said, ‘Oh, when your brother was born,’” Dr. Toor recalled with a laugh, noting that her brother was 20 years old at the time.
“She said she didn’t want to talk to her male doctor about such things.”
To launch the original Northeast Women’s Clinic and make communities aware of the new women’s medical service, the clinic reached out to local community groups and placed public service announcements on the radio in multiple languages. The clinic has signs and literature in different languages, along with female doctors and staff who speak and understand them. Dr. Toor is fluent in English and Punjabi and can understand most Hindi and Urdu.
In addition, Dr. Toor says the clinic’s all-female team of family doctors and staff offer expertise and comfortable familiarity, especially for patients from the same immigrant communities.
Even with the clinic’s emphasis on meeting the needs of immigrant communities, when it opened, half of its patients were Canadian-born. “The need was greater than we anticipated,” Dr. Toor said.
The IUD and Women’s Health Clinic specializes narrowly on women’s health rather than broader family practice to provide intimate care to as many patients as possible, Dr. Toor said. Patients may be reluctant to take intimate health concerns to whoever’s staffing their local walk-in clinic, the way they might visit the clinic for sore throats and upset stomachs.
Dr. Toor’s approach to women’s health care has won her a slew of accolades, including alumni awards from the University of Calgary’s Cumming School of Medicine, the Governor-General’s Diamond Jubilee medal and the College of Family Physicians of Canada Recognition of Excellence.
Since Dr. Toor founded the clinic, other family doctor clinics in Calgary have opened variations on the model, including the Calgary Women’s Health Clinic, which offers to treat 16 women’s health concerns including pre- and post- pregnancy checkups, pelvic exams, breast problems and skin issues. Other Calgary clinics include the Well Woman Clinic and Maud Medical Clinic, which offers vaginal health services including Pap smears, sexual function, and menopause hormone therapy.
Primary-care specialized clinics are not unusual, said Michelle Cohen, a health care expert at Queen’s University. She cited examples such as specialized clinics for sports injuries, weight loss, and chronic pain, even cannabis users.
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“Women are demanding more from the medical system these days,” Dr. Cohen said. “IUD insertion is not a commonly required skill. Not a lot of family doctors want to do it. The tricky thing with any procedure is you have to do it often to be proficient.”
Dr. Cohen noted that reaching new Canadians with health care can be difficult.
“A lot of that population lapses with medical care, just out of not knowing a lot about the health care system,” she said. “And not many family doctors are taking new patients these days.”
Dr. Cohen said women need this type of integrated care because women’s health concerns tend to be undervalued. For example, her own research has found that provincial health insurance plans often pay doctors lower fees for procedures common to women, compared with procedures common for men.
Dr. Toor’s clinic is located just a stone’s throw from a mall full of small shops and bustling food markets in a part of the city with a high proportion of immigrants and racialized Canadians. The location, Dr. Toor said, protects her patients’ privacy – for example, by allowing them to quickly step across the street to the clinic while shopping, and return home in time to put supper on the table.
“We really pushed the health care system to accommodate all members of the community,” Dr. Toor said. “Health care has to be delivered in a way that’s acceptable to the patient.”