GRANT’S DESI ACHIEVER
HE WANTS YOU TO BREATHE EASY
Dr Samir Gupta is a respirologist and clinician-scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Associate Professor in the Department of Medicine at the University of Toronto.
By SHAGORIKA EASWAR
Dr Samir Gupta plays a major role in respiratory care in Canada. He is the founder and Head of the Canadian Hepatopulmonary Syndrome Program – and the only doctor in Canada specializing in this rare lung disease.
“Not because I’m special,” he quips, “but because no one else is interested in this!”
The respirologist and clinician-scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Associate Professor in the Department of Medicine at the University of Toronto says the prevalence of asthma, chronic obstructive pulmonary disease (COPD) aka emphysema or chronic bronchitis, is increasing and causing an alarming burden on health systems around the world, including in Canada.
“They have been recognized by the WHO as a significant burden. Outside of giving birth, the most common reason for hospital admissions is a COPD flare. And it’s only getting worse, with pollution and climate change. Wildfires are dramatically worse. Pollution exacerbates asthma and COPD, but also leads to heart attacks and strokes.”
Over this past summer, there were days when Toronto’s air quality was listed as the worst in the world.
But aren’t there cities in other parts of the world with AQI levels that are at least ten times higher than Toronto, yet they are listed as being at “moderate risk”?
“We use AQHI, or the Air Quality Health Index, whereas most other countries use the AQI, or the Air Quality Index, so it’s a different scale,” Dr Gupta clarifies.
“On our scale, 10 is really bad and the GTA hit 9 during the wildfire season. Also, people have to be aware that it changes over the course of a day, it may be 3 now, but 8 in the evening. So we have to modify our activities to reduce exposure accordingly.”
As past chair of the Canadian Respiratory Guidelines Committee, Dr Gupta helped overhaul and update guidelines that impact healthcare.
“A major part of my research is focused on guideline implementation, but I am also interested in how we get to those guidelines. And why sometimes doctors don’t believe in those guidelines. Are guidelines fallible? Are we starting from the best knowledge? For example, what should we do when the data is based mainly on men? There were many holes. My colleagues have done tremendous work to create less biased and patient-friendly guidelines and we now have some of the best respiratory guidelines in the world.”
He holds the UofT Michael Locke Term Chair in Knowledge Translation and Rare Lung Disease Research. His main research interest is in knowledge translation across the spectrum of respiratory illness, with a focus on electronic tools for behaviour change.
His team built and launched the Electronic Asthma Management System, which essentially automates asthma care, including producing a personalized action plan that physicians can print out and give patients. This helps to reduce barriers and provides more agency to the patient. Steps they can take on a high pollution day, for instance. They feel better, get sick less and visits to physicians and hospitals are reduced.
“We’ve developed the technology and we bring guidelines to the provider contextually.”
With proven success with asthma, he has now expanded the process to include COPD and plans to provide similar decision supports for cardiac care and diabetes, etc. They’ve also expanded the program to include nurse practitioners and pharmacists.
“Six million Canadians don’t have a family doctor, and even among those who do, people see their pharmacist more often than they see a doctor. We realized that this point of intervention could be very potent. It’s casting a broader net for patients to access the care they need.”
Dr Gupta’s research team tries to identify gaps between best practices according to studies and medical guidelines and what is actually happening in the real world.
They measure the size of those gaps, why they exist, what barriers prevent people from receiving the best care, and design and test strategies to overcome those gaps. His team specializes in developing technology such as apps for patients and providers to deliver the best care.
He also co-founded and led the Canada-India Wellness Initiative (CIWI) – a medical and wellness initiative designed for children and families living below the poverty line in Chettipalayam, Tamil Nadu, India. Run through the Canadian-funded Global Pathways School, it grew from rooms rented in a matchbox factory to a facility with among the best facilities and best teachers in the state. With a multipoint education, prevention, treatment, and a health promotion plan, it is an elite school which is pulling families out of poverty.
“Always remember there’s someone doing more than you!”
When the Mersky family, who funded the project, said they could help feed and educate, but also needed to address the health of the students, Dr Gupta and his wife Renu, a family physician, stepped in.
“We wanted to be connected, to give back, and began with well child visits, working with a local NGO. We ended up treating nutritional deficiencies, parasites, chronic diseases... not just at the school but also in surrounding areas. I saw everything from cases of leprosy to a woman who had a heart attack right in front of me. Renu stopped going after our daughter was born but I continued. I’d also send volunteers including Loran Scholarship Summer Students that I supervised.”
Now the program is managed by the state government, but Dr Gupta says they didn’t leave with “too heavy a heart”.
“The government is doing so much more now to improve access to things like vaccines, deworming treatment, and micronutrient supplementation, that it was like, maybe they don’t need us so much now. Which is a great feeling!”
He was also instrumental in setting up Canadian Doctors for India, working with the Maple platform to provide virtual access to Canadian doctors for people in India during the peak of the Delta COVID wave in India.
Dr Gupta also has a specific interest in science communication, and serves as a medical correspondent for various media outlets. He started his television career at Global with a segment called On Call With Dr. Gupta and went on to a role as medical correspondent on the CBC, including every Wednesday on Morning Live and weekly on Canada Tonight (now Hanomansing Tonight). He appears on multiple networks and shows and communicates about health and science across electronic, print, radio, and television media.
“Misinformation and disinformation are always growing, but spiked during the pandemic in terms of scope and consequences. I thought, I have the skills, I have to use them. This is a crisis. I also soon realized that I didn’t really need to convince my television audience – an older, educated demographic. It was the younger people who were getting their information almost exclusively on online platforms whom I needed to reach. So I started to push into online content.”
As a leading media voice in the COVID-19 pandemic, his online “explainers” with the CBC around vaccines, masking and gloving, etc., were viewed over 10 million times. It was evident how vital it was to be online. And TheFeedWithDrG was born. He’s created videos on a wide slate of topics, including:
Are you drinking enough water? Here’s what science says.
Are ultra-processed foods the new tobacco?
Is yoga actually good for your health?
“The distinguishing feature is that they’re long form and I do a deep dive into the subject. After each video, I’d leave thinking I don’t drink enough water, I consume too much ultra-processed food... it was a wake-up call for me, too.”
His take on “Should you get a full body MRI” addresses another issue he’s deeply invested in – the proliferation of unnecessary tests and scans. And as part of Choosing Wisely Canada, he aims to reduce those. “We have a culture that more info is better. This is true in most areas, but can be a fallacy in medicine. Because more is not necessarily meaningful.”
He refers, in particular, to unnecessary and expensive MRIs.
“The technology is so sensitive that used with a physician’s recommendations, it can pick up a host of issues and help save lives. However, just getting a whole-body MRI done because Kim Kardashian does it does not improve mortality rates on a population level and can cause a whole lot of stress and actual medical harm. But it’s a health fad – it’s available.”
Originally from Delhi, Dr Gupta’s father – from the pioneer batch at IIT Kanpur – came to Canada to do his master’s. The family settled in Montreal, where Dr Gupta was born and raised.
“I consider myself French Canadian!”
His parents’ experience during their early years in Canada, he says, was the experience of immigrants of that time. “You had to be a knowledge or skilled immigrant and so they didn’t face some of the barriers immigrants coming in today do. But of course, there were challenges. The reliance on the job, you came with no money, no savings, and you were likely still supporting family back home. My father, as the oldest brother, got his four sisters married. He did so happily, but with that responsibility comes related stress.”
The Guptas have a 10-year-old daughter, Arya. To her and to those who seek his guidance on how to succeed in Canada, he stresses the importance of hard work.
“You have to put in the work! So many people sit on their talent while the less talented get ahead by sheer dint of hard work. Imagine if you are talented and put in the work – where that could take you.
“Humility is another important element. Always remember there’s someone doing more than you! Someone to be inspired and motivated by, to aspire to. And always remember where you come from and thank the people whose sacrifices contributed to your success.”
Dr Gupta says he is grateful for the opportunities he has had to make different levels of impact.
“I am thankful for personal interactions with patients every day. But if I never interacted with anyone outside of my clinic, how many people would I be able to impact over the course of my whole career? My research affords the opportunity to impact the arc of science, though, of course, most research is incremental, and moves slowly. That’s why my media work is so important to me, being able to reach vast numbers of people simultaneously. It’s very rewarding to be able to help even a fraction of those in any way, empower some of them with knowledge that improves the quality of their lives.”
• Check out www.easthma.ca, www.asthmadecisionaid.com, http://www.HPScare.com and www.thefeedwithdrG.com.
• Grant’s is proud to present this series about people who are making a difference in the community. Represented by PMA Canada (www.pmacanada.com).
