Faces of U of T Medicine: Dr. Seema Marwaha

Oct 15, 2019
Claire Wiles

Dr. Seema MarwahaDr. Seema Marwaha Dr. Seema Marwaha is passionate about storytelling in healthcare. It’s a tool she often uses to translate health knowledge and medical information to the public and shed light on the patient experience. A general internist at St. Michael’s Hospital and assistant professor in the Department of Medicine, she can be heard regularly as a health columnist on CBC Radio. She is a contributor to Healthy Debate and, following Dr. Andreas Laupacis’s departure, Dr. Marwaha has taken over the helm of the website as its editor-in-chief.

Recently, Dr. Marwaha produced and led The Opioid Chapters, a multi-media series in collaboration with the Ontario Drug Policy Research Network and Healthy Debate, that explored the personal stories of people impacted by opioids in Ontario. Dr. Marwaha is now leading a photojournalism project in partnership with the Centre for Addition and Mental Health (CAMH), interviewing youth about their experiences navigating the mental health system.

Writer Claire Wiles spoke with Dr. Marwaha about her passion for finding new ways to educate the public about health issues, and the importance of communication in medicine.

What health issues do you think are the most challenging to distill for non-medical audiences?

Research is complicated and I think the most difficult thing to explain is how studies are done, and how the populations that we study are restricted. The best quality studies are randomized control trails, but in order to control a study to such a high degree you have to restrict who you recruit in the study and that might not be generalizable to a wide audience, which I think is really difficult to explain.

Another difficulty is that the media will often pick up a study and say, “this study finds this,” and people will take that as the truth. What’s hard to explain is that research comes in front of a body of literature behind it. There will be studies saying, “chemotherapy is given too often,” or “the flu vaccine was not useful this year,” and people will hear that one piece of news and then remember it as the truth moving forward, but the truth changes in medicine and in research based on new studies that come out all the time.

I imagine that can be really damaging.

Yeah, especially because there’s this partisan nature that’s happened now in the general public. What happens is people believe something and then they will look for something that reaffirms what they think, and they’ll ignore everything else.

What tips do you have for physicians trying to convey complex health and medical issues to their patients or the public?

Don’t sacrifice understanding for completeness. In medicine we are taught to explain all the risks and benefits, but often the patient might not understand what you’re saying because of the language you’re using, or they may not be interested in all of the details. The second tip is checking to make sure the patient is understanding what you’re saying, and the third tip is to think about if someone were explaining this to you, would you understand it? It’s really important for us to take the time and use the words that people understand.

Why is it so important to look beyond data when sharing health information?

This is something I’m very passionate about. Data is so limited. It often doesn’t tell the whole story. I really believe that the patient experience and the experiences of people going through the health system matters and should be captured as data in some way. Healthcare is a personalized industry and we take data from big groups of people, where in order to analyze that data we have to strip away everything that made that person individual. That person that has a family, a job, a culture and maybe a religion that you have to address. We always need to think about the experiences of people receiving care and moving through the system in addition to the best evidence and research available. We have to find a way to do both.

How does your role as a clinician educator support or facilitate your work in medical communications?

As a clinician educator I have the opportunity to think about how best to teach trainees these skills. Whether it’s a virtual reality experience, physically putting them in the shoes of the patients who are interacting with a medical team, getting them to write an article about a topic they’re passionate about and being able to effectively communicate it to a general audience or even getting them to understand the empathetic actions that patients really care about, I have the opportunity to influence how people are taught.

Is there anything else you’d like to add?

I stumbled upon journalism training once I had already become a physician. Once I went through the training and went through the experience of writing articles and being on the radio, I realized how important the basic communication skills that you learn in journalism are, and how important it is for us to teach that in medicine and not take it as a given that people will develop those skills. I think that in order for medical students to become advocates, good communicators and empathetic care providers, the skills that you learn in journalism are a measurable, practical way to teach those skills. In medicine we call this the “hidden curriculum” because you learn it as you go, but if it’s the hidden curriculum then people might escape without having developed those skills or realized how important they are.

I also think that understanding journalism forces you to explore both sides of an issue and introduce balance into your reporting. Whether or not you write about it, you have to talk to people on both sides and hear their experiences. Finally, it allows students and trainees to realize that they can advocate about issues that they are passionate about. They have a privilege and a pedestal as a physician where they can use that to amplify an issue that they care about responsibly. There should be more physician voices in the media. I think we’re very cautious to put our opinions out there and commit to saying that something is fact, but if we don’t put our voices out there then misinformation can reign.