A doctor exactly where he wants to be
A somewhat reluctant nominee for the AMA’s Shine A Light program, Dr. Francesco Mosaico’s main desire is that “the light be shone upon” the comprehensive health care provided by the entire staff of Boyle McCauley Health Centre to their valued patients, made up largely of marginalized populations.
“It takes a team!” stresses Dr. Mosaico, Medical Director of BMHC, the only non-profit,
community-owned and -operated health centre in the greater Edmonton area. The BMHC provides crucial, person-centered, primary health services to vulnerable Edmontonians with complex needs who face multiple barriers to health services access. Those barriers include poverty, homelessness, mental health, multiple addictions and social isolation.
An astounding ability
It was a grateful mother of one of the doctor’s young patients who nominated Dr. Mosaico for recognition by Shine A Light, after he helped her son find a warm, safe shelter in Ambrose Place. “His ability to work with people with addictions and mental health issues is astounding,” she explained.
A family physician with specialized training in the challenging field of addictions medicine, Dr. Mosaico has long held a desire to work with marginalized populations. Prior to beginning his work at BMHC in 2007, in a locum position, Dr. Mosaico had experienced the challenges and rewards of working at the health centre during a period of training there as a medical student.
During his initial work at BMHC, Dr. Mosaico wasn’t sure he could manage the emotional toll and stress of the addictions-specialized, family physician work undertaken at the centre. Now, 13 years later, he can’t see himself doing anything else.
Meeting patient needs, not system needs
“I don’t think there’s another place like this, where I could find a focus similar to this health care setting, where I could work with marginalized populations in a setting that allows us to be responsive to patient needs instead of system needs.”
As Dr. Mosaico takes me on a tour of the centre (including introductions to every staff member we encounter in the centre’s labyrinth of hallways and treatment and meeting rooms), it’s clear that the approximately 50 on-site employees are close-knit and dedicated to their patients and to each other. (Approximately another 70 employees staff the centre’s off-site programs).
Dr. Mosaico credits the centre’s long-serving executive director, Cecilia Blasetti, for setting the tone for the warm, strong morale of the centre’s staff and the equally welcoming and accepting atmosphere of the centre.
“Cecilia’s leadership creates a place that allows us to work with this population in an amazing way,” he says. “The people who work here are drawn to this place.”
Most, like Dr. Mosaico, would be hard-pressed to picture themselves anywhere else. They’re in the neighborhood, the building, the work environment, where they feel their skills and talents are best used to help a population that faces so many barriers to access to equitable health care.
While trying “to take the work we do seriously, but not ourselves,” the centre’s staff “provide support and advocate on behalf of people who don’t have support systems or families looking out for them,” says Dr. Mosaico. He describes the holistic health care approach of the centre as one where staff are committed to treating and understanding not just the patient in front of them, but how the patient’s background and history – their childhood and adulthood experiences and environments, frequently including trauma – contribute significantly to their physical and mental conditions.
“Studies have found that the more trauma you suffer as a child, the more risks you face as an adult, including chronic physical illnesses,” he explains. “Our clients carry a disproportionate burden of illness – physical and mental – relative to the general population.”
Brain science: “Instill(ing) hope with science”
One of the most influential factors in how Dr. Mosaico practices medicine has been his (and BMHC’s) increasing understanding and appreciation of brain science: the crucial role of the brain in a patient’s mental and physical health.
As described by the Alberta Family Wellness Initiative, “Lifelong health is determined by more than just our genes: experiences early in life and at other sensitive periods of development change our brains in ways that make us more or less vulnerable to health problems across the lifespan.”
With its mission of “linking science, policy and practice to improve public health,” the Alberta Family Wellness Initiative supports the holistic approach to health that is a key influencer of the vision and purpose of BMHC.
Understanding brain science “helps me re-frame how I approach patients,” explains Dr. Mosaico. “And in turn, we can help patients see why they face the obstacles they do. That’s one of my areas of passion: to instill hope with science.
“It’s rewarding to me to see clients become hopeful again, and for them to see me – their health care provider – as a partner in their journey to wellness.”
BMHC takes health care on the road
The expansion of services provided by BMHC continues with the January 22 launch of the Boyle McCauley Mobile Health Clinic. With it, the health centre is reaching out to its community of need, providing “essential primary medical and mental health care similar to what people can expect to receive at the health centre itself,” said Ms Blasetti, in a conversation with CBC News reporter Lydia Neufeld.
Introducing … Dr. Francesco Mosaico
Years in practice
13
Why medicine?
I felt the profession suited me and I suited it. I like to think we've been a good match. The great privilege for me is the experience of being trusted by another person to accompany them as they journey toward well-being.
Mantra/philosophy of life
Family first. My wife, four sons, and family of origin/extended family are my top priority and greatest source of joy.
Four favorite quotes
- “The best time to plant a tree was 20 years ago. The second best time is now.” [Old proverb, cited by Dieter Uchtdorf]
- "When people of goodwill labor cooperatively in an honest and dedicated way, there is no end to what they can accomplish." [Gordon Hinckley]
- "It's best to be on the right side of a battle, even if it's the losing side." [Author unknown]
- "Be happy for what you have." [Nunzia Mosaico]
About Shine A Light
Initiated by Dr. Alison Clarke during her 2018-19 term as president, AMA’s Shine A Light program recognizes and celebrates the special physicians of Alberta who, in their “everyday” practices, demonstrate an unwavering commitment to caring for their patients; to ensuring that their patients receive top quality, coordinated care; to seeking patient-centered ways to improve the delivery of health care in Alberta; and to always seeing the people in their patients.
Nominate a colleague
Do you know a physician who the AMA should ‘Shine A Light’ on? If so, please submit a nomination form.