Arthritis Pain Downplayed in Healthcare Hierarchy

Dr. Gillian Hawker

Dr. Gillian Hawker

Osteoarthritis (OA) affects one in 10 adults. Many of these people are older, and OA poses a serious barrier to their ability to remain active and independent, and to look after themselves and others, such as an aging spouse.

“Because of their age, most people with OA have other chronic conditions, and most people with other chronic conditions have OA,” says Dr. Gillian Hawker.

Hawker adds that in spite of this, OA is generally underdiagnosed and undertreated, because health issues ranging from heart disease, diabetes and depression tend to dominate the attention of a family physician.

Yet Hawker’s research suggests that not adequately managing a patient‘s arthritis may lead to worse outcomes for those other conditions. People with OA tend to avoid physical activities like walking that exacerbate their pain.


It’s time for physicians to stop assuming that arthritis pain is just a normal part of aging, because this attitude puts patients’ health at risk. Quotation_Right_Blue

“The inactivity that results from untreated pain appears to increase people’s risk of dying from other health issues,” says Hawker. “It’s time for physicians to stop assuming that arthritis pain is just a normal part of aging, because this attitude puts patients’ health at risk.”

That’s why Hawker advocates for a new, more comprehensive approach to delivering care, one that treats patients as whole people instead of a cluster of diseases with varying degrees of importance.

“Today’s segregated approach to doing medicine, where patients are sent from one specialist to another, is not patient-centred care,” says Hawker. “It’s absolutely critical that we break down the silos in our healthcare system if we’re to deliver more effective health services and help patients get better outcomes.”

Gillian Hawker is the F.M. Hill Chair in Academic Women’s Medicine, a professor in the Department of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto, Physician-in-Chief of the Department of Medicine at Women’s College Hospital (where she directs the Canadian Osteoarthritis Research Program) and a senior scientist at Women’s College Research Institute at Women’s College Hospital.
In 2012, Hawker received the Queen’s Diamond Jubilee Medal for her record of creating positive change in healthcare delivery. In 2013, she received the Jeff Shiroky Award at the Laurentian Conference of Rheumatology, and was presented with the Robert Hyland Award for Excellence in Mentorship by the University of Toronto’s Department of Medicine. The University of Toronto has featured Hawker in its Boundless Campaign.




In addition to a remarkable body of research and a legacy of medical leadership as Women’s College Hospital’s Department of Medicine physician-in-chief, Gillian Hawker has made her mark by building research into the clinical fabric of Women’s College Hospital. She has also mentored many young researchers and collaborated with numerous clinician-scientists, including:

  • Dr. Cory Borkhoff, who built on Hawker’s early research by training standardized, undercover ‘mystery’ patients, a man and a woman with identical symptoms, and showed that orthopedic surgeons were half as likely to recommend joint replacement surgery to the woman patient.
  • Dr. Paula Harvey, who examines women’s unique cardiac health needs and collaborates with Hawker to understand the link between heart health and poorly managed arthritis pain.
  • Bheeshma Ravi, who is completing his PhD in clinical epidemiology at the University of Toronto, supported by a CIHR Doctoral Award, has been focusing on understanding the risks and benefits of joint replacement of the hip and knee in people with rheumatoid arthritis, the most common inflammatory arthritis, compared with osteoarthritis.