Member Spotlight: Dr. Jessica Dy

• Medical degree from the University of Western Ontario
• Master’s degree in Public Health from the Harvard School of Public Health
• Completed residency training in Obstetrics and Gynaecology at the University of Ottawa
• Fellow of the Royal College of Physicians and Surgeons of Canada
• Currently: Head of the Division of General Obstetrics and Gynaecology and Vice Chair of Quality and Patient Safety within the Department of Obstetrics, Gynaecology and Newborn Care at The Ottawa Hospital
• Research interests: labour management, induction of labour, Caesarean section and VBAC, patient safety

A conversation with Dr. Jessica Dy: Building trust and responding to change

By Kerrie Whitehurst

Q: Dr. Dy, you have worked in the OB/GYN field for almost 20 years. What changes or trends have you seen in obstetrics in that time?

One of the most significant changes I’ve noticed is the dynamic interaction with patients, the shift from paternalistic medicine to shared decision making. These days, a lot of information is easily available. For example, study findings are out in the media faster and people are being informed more quickly. Patients are already well-read by the time I see them. Gone are the days when a patient came in unaware of possible diagnoses and management options.

Q: What are the impacts, good and bad, to that?

On the positive side, people are taking responsibility to educate themselves and are armed with some background information which is a good place to start. The downside is that Dr. Google may not always be the most reliable source. Not everything we read applies to every patient. The medical information, clinical diagnosis and treatment options have to be put into each person’s health context. And often, it takes more time to “unlearn” what someone has read up on google than it is to start fresh.

Q: How have you responded to this with your patients?

We need to be very careful not to dismiss a patient’s personal research. So, we are reframing our conversations with our patients. We’re taking care to validate the work people have done and gently steer them to appropriate and more credible resources. We need to listen to what they say, to know where they are coming from, before telling them what we think is going on and what our recommendations would be. I believe this is the best way to build trust between patients and the medical profession.

Q: How has your field changed practice-wise?

We are seeing women who are older with their first pregnancies, many more IVF pregnancies, and more pregnancies and births for same-sex couples. These changes could somehow be contributing to performing more inductions and more Caesarean sections. And some people are wary of inducing labour as generally people are wanting drug-free deliveries where possible.

Q: How do you manage all of that with your patients?

We have to lay out all possibilities and provide our reasoning. Some people accept it, and some don’t. Again, the education piece works. My job is to arm patients with the information and the facts, telling them, for example, why we are considering inducing labour. But even before that, we have many opportunities to lay down the groundwork at every appointment during the pregnancy, so that induction, if it’s needed during delivery, isn’t a surprise.  At an appointment I will typically say, for example, “Everything is going well. However, in the next visit, we will talk more about X.” I find this approach is better than having no preparation all.

Q: How do you separate the highly personal nature of the whole childbirth experience with the medical side of things, for which you are trained?

You don’t actually have to separate these – you have to marry the two. Our training is in recognizing when normal becomes abnormal. For the patient, we want their experience to be as normal and positive as possible. This is where Dr. Google comes in handy. People already have their personal knowledge. We share our knowledge when the patients are ready to hear it.

Q: What is your biggest challenge in your line of work?

Exactly what we have been talking about – change in the field. Personally, my goal is to let the public know that the face of obstetrics has changed dramatically. Unfortunately, the stereotype still exists that obstetrics is “that 60-year-old male doctor in the white coat” who only wants to do a C-section and that the only alternative, in contrast, is the “choose midwifery care only” model. It’s presented as either-or. But today’s obstetrics is both, and it’s everything in between.

Q: What would you like people to know?

Sadly, many Obstetricians are feeling villainized or misrepresented, as the media tends to paint a negative picture. Obstetricians are compassionate and trained health care providers, and can do the same or more as what midwives can do. There are 60-year old males in white coats doing wonderful work, and there are also midwives doing wonderful work. Unfortunately, policy makers are creating a system that has created more of a divide than a collaborative approach. That’s my personal and professional goal: tearing down mistrust and focusing on the comfort and safety of mother and child.

Q: Why did you get into this field in the first place? What’s your story?

I wish I could say I had a story… but honestly, it ended up being the path-of-least-resistance for me that turned into a passion. You go to university not really knowing what you want to do with your life. One of my initial projects was studying the human placenta, and even though I started in chemistry in undergrad, I came to realize “Hey – this is physiology. This is reproduction. This is medicine. I want to do this.” I really enjoyed surgery, too. Obstetrics and Gynaecology merged the two facets that interested me the most. It felt like home.

Q: What does your typical day look like?

I have three kids and my husband is an emergency physician who works shifts, so we have a very busy household to manage! So there is no “typical day”.  It could be a clinic day, an OR day, or a day or night shift in the birthing unit for me. Or all of the above. How the day starts depends on what my husband is doing that day too. It is not infrequent that we don’t see each other for 48 hours straight. It can be chaotic. Honestly, though, I feel very fortunate. I enjoy my work and have great colleagues, and a very supportive family so that helps a great deal.

Q: What do you, as a busy professional, do to unwind?

I try to run; my bucket list is a 10 k and a half-marathon every few years as a goal.

Q: What’s on the horizon for you?

I would like to travel more. I have been involved with the Canadian Network for International Surgery. Our work was mostly in Africa, where we are teaching life-saving skills by teaching the teacher. But it has been a few years since I’ve done that, it would be nice to be more involved again.

Also, at the hospital, I have recently taken on a more administrative role as the medical director for the Maternal Newborn and Women’s Health service line. This means more operational and program planning with hospital senior management and administration. I completed EXTRA training with CFHI a couple of years ago. Now I am in the middle of a Physician Business Leadership Program through the Schulich School of Business and am looking forward to applying what I learn to my new role. And, of course, I still maintain my clinical practice. I wouldn’t want to give that up, at least not anytime soon.