National Physicians’ Day 2020 – Dr. Daniel Ontko

To pay tribute to the many dedicated physicians practicing at Island Health and in honour of National Physicians’ Day, we are profiling some of the doctors leading innovations and delivering high quality service to show the human behind the profession. Dr. Ontko is a hematologist and internal medicine specialist in Nanaimo. Originally, from Calgary, Dr. Ontko came to Bamfield on a school trip when he was 15 years old and wanted to return to Vancouver Island after completing his fellowship.

  • Why did you chose medicine and your speciality/field?

That’s a good question, I don’t know if that can be articulated but let me try. Out of all the different subspecialties, I like hematology in the sense that you get to measure a lot of stuff. There are very few organs that you can take out and see what it looks like. Hematology is an area that is growing rapidly and there’s a lot going on.

  • What is most meaningful to you about your work in medicine?

I think part of it is engaging with people who really like their jobs. Another part is that they really like people. If you are a physician who doesn’t like people, you’re probably going to be a poor physician to some degree. Many of the physicians here in Nanaimo are conscious of the fact we’re not in a major academic center and that contributes to our focus on trying to make our patients feel better and do right. We do medicine in pragmatic and practical way, we adjust based on the patient’s needs.

We have an interesting collection of doctors, too. I think it’s amazing I get to work with people like Dr. Kevin Patterson, a famous writer. We have such brilliant people like, Dr. Mike Kenyon, one of out intensive care doctors, and we have a very collegial environment, we get along very well.

  • What are your professional interests and notable achievements?

I scored in the 99 percentile in the MCAT, but I haven’t won any big awards. I am proud of participating in the development of a new internal medicine unit here in Nanaimo. We’ve been trying to get an inpatient rounding unit for many years with limited success. We were finally successful due to the work of many people over the years and my role as medical lead.

I’m very happy to help develop hematology here. Prior to my arrival, we did not have a permanent hematologist in Nanaimo but Dr. Denegri held things together by himself by visiting during the week. Developing the service has allowed for interesting experiences and patient care. We’ve been able to figure out what hematology should look like here. A lot of it has come down to what I call “cottage industry chemotherapy”. I treat a lot of geriatric patients who can’t travel to Victoria and we try to maximize quality of life.

My kids are also a big part of my life. A four year old, two year old and third on the way.

  • Who or what do you turn to for inspiration?

In medicine, there is no lack of good mentors. Many people, who have worked for many years and done quite spectacular things, are here in Nanaimo. Dr. Robin Love is a family physician who has done all sorts of medicine including minor surgeries and he’s set up the palliative care program, that I consider world-class. He is an excellent example of positive physician leadership. I’m also impressed with Dr. Sam Williams in Port Alberni. She is a great advocate for physicians and patients.

  • Where do you go, or what do you do, to recharge your batteries?

I’m a big reader and since moving to the island I’ve started playing chess, which I’ve never done before, it’s my non-mindless activity. But mostly these days it’s entirely work and chasing after children. 

  • What is the last book or podcast you enjoyed?

Kevin Patterson sent me “The Meaning Of Everything” by Simon Winchester. It’s a good story about making the dictionary. I’ve been reading a lot of ephemeral literature these days like the New Yorker, although it’s all about COVID, like the entire world, all the time. 

  • What change has occurred on during the COVID-19 pandemic that you want to remain? 

The alterations of the rules surrounding telehealth have allowed us to utilize technology to care for patients remotely more easily. It’s nice to be able to phone patients and have increased access to them. Most patients I still need to see in-person but this change has been helpful. It’s difficult because it will change a lot over the next few months. Patients we aren’t seeing are going to need to be seen and morbidity may increase as we have to assume heart attacks continue to occur.

Since the pandemic began, I’ve been working out of the hospital and talking to my patients remotely. I’ve split my hematology practice and been working on the COVID team, so it’s a big change. My colleagues working at the traditional clinic have a hard time booking patients. 

  • What do you wish more people knew about practicing medicine?

Although we strive to have answers, we often don’t. And this troubles doctors as much as it does the patients.

We need to be aware that in practicing evidence-based medicine you still need to consider the particular patient. For example, say we know of a medication that is statistically proven therapy to decrease the relative risk of heart attack by three percent. But at the same time the likelihood it will work for a particular patient may be quite low. This is because of the nature of the disease and medication, and on average, the person the medication works for is not the same as the patient in front of you.