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Dr. Jeff Turnbull gently peels off a dressing to examine a patient’s incision, discussing which antibiotic to prescribe, where the man plans to sleep tonight and where he’s going to get his methadone.

At another homeless shelter, he chats with a man in the cafeteria, then reaches over to examine his neck. The man has throat cancer and Dr. Turnbull makes sure he’ll get to TOH Cancer Centre for his treatments. “We have a plan to get you there – don’t worry.”

When Dr. Turnbull does his rounds, it’s not always in the hospital. Twice a week, he tours the homeless shelters and supportive-housing projects to inspect injuries, prescribe treatments and sometimes just to look into people’s eyes, hold their hands and assure them they matter.

“Whenever there’s something wrong, I wait for him to come and tell me what to do,” said Randy Duncan, a patient at the Ottawa Mission. “The doctor just does anything he can to help anybody. He doesn’t care about your creed, your colour, your ailment. He works hard, he looks after the homeless, he’s hands on.”

Dr. Turnbull has been working for years with Ottawa Inner City Health, which provides health services to the homeless. Now, with a new program called TED – Targeted Engagement and Diversion – he’s able to help people who would otherwise fall through the cracks and into an endless loop of living on the streets and going to the Emergency Department for non-urgent reasons.

The paradox is that many of these patients don’t want to go to hospital, but they’re routinely brought in by police, paramedics, fire fighters and even OC Transpo security. TED takes hospital services to places where the homeless gather, making it easier for people to get care when they need it.

“We’ve identified them as ‘familiar faces’,” said Dr. Turnbull. His patients often have mental-health challenges and addictions that keep them perpetually in crisis mode. He, along with other TED team members, tries to identify early on the people at risk and develop better care plans for them. “We stabilize them, with support, and then connect them to the appropriate resources, whether that’s supportive housing, managed alcohol programs or psychiatric services. It’s getting them into the system and out of crisis.”

Ensuring these people get regular medical care helps keep them out of EDs for all but true emergencies. One man, for example, was seen 191 times in six months in TOH’s ED, but after getting earlier care, he didn’t return to the ED, Dr. Turnbull said. Not only does this save the health-care system millions of dollars annually, but it also reduces wait times, reduces the number of unruly people in ED waiting rooms and frees ambulances for people who really need them.

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