Dr. Dolores Logan – Medical Practitioner

Dr. Dolores Logan is a family physician based out of the Regina Community Clinic. In addition to her work as a general practitioner, she is Saskatchewan’s foremost medical doctor providing FASD diagnoses.

The importance of FASD to the field of medicine and to society in general

Dr. Logan explains that FASD diagnosis is as significant to the medical field as every other medical health disorder – be it autism, cancer, diabetes or any other disease or disability. Moreover, ensuring the health of her patients promotes a strong and healthy community overall, she says.

“The ultimate goal in diagnosis of a condition is to improve the life of the individual with the condition by starting appropriate treatment for that condition,” she says. “In turn, the hope is that the individual becomes less of a burden on society and becomes someone who contributes to society in general.”

The most intriguing aspect of the profession with regards to FASD?

Dr. Logan, Dr. Block and Dr. Mela all describe their amazement and respect for the strength and resiliency that many individuals with FASD display – despite the many challenges and setbacks they face daily.

“FASD is interesting in the field of medicine because it is so variable in its presentation,” Dr. Logan notes. “Actually, FASD is not so interesting – for me what is most interesting are the people affected by FASD and how they cope and survive, often in spite of massive obstacles and barriers in society.”

The biggest risks associated with FASD and most effective ways to address them

According to Dr. Logan, the greatest danger associated with the disability is the ultimate one: death. She says FASD unfortunately leads to early death more often than most other mental health conditions.

“The best supports to overcome the hurdles associated with FASD are caregivers, employers, friends and relatives who take the time to understand and learn about FASD so that they can walk with the individual affected and help him or her to become the best they can be – and in doing this the caregivers, friends and relatives and employers become better people themselves,” she says.

Dr. Logan adds, “Diagnosis of FASD needs to go hand-in-hand with treatment. Diagnosis is of no benefit if we do not figure out how to treat and help individuals affected by FASD. Also, as FASD is preventable, with diagnosis prevention can also take place. Hopefully we can stem the tide of FASD so that individuals born in Canada are not adversely affected by prenatal alcohol exposure.”

FASD diagnosis rates

Despite recent research studies suggesting the occurrence of FASD is much higher than the official estimated rate of one per cent of the Canadian population, Dr. Logan has not personally seen a dramatic increase in diagnoses. However, she does suspect rates are much higher than estimated. She attributes the plateaued number of diagnoses to the relatively high fees that accompany diagnostic procedures (neuropsychology testing can cost as much as $1,500 or more, she says), as well as a lack of awareness that still surrounds the disability.

“Most of those with the disability are not aware that they have the disability and are not being diagnosed. Many of these people are where they should not be, for example in jail or homeless living on the street or being exploited by gangs and pimps where chances are they will die an early violent death. Other people with FASD are being looked after by family who don’t understand why this person cannot go out and find a good job, or go to university, etc.,” she says.

Areas of improvement within the diagnostic field

Dr. Logan agrees with both Dr. Mila and Dr. Block in that she believes it’s imperative that more experts be trained in and capable of FASD diagnosis. Further, she says it will greatly benefit individuals with FASD and the general public if more physicians are better aware of the disability and properly equipped with referral, diagnosis and support information for clients prenatally exposed to alcohol.

The current state of FASD within the medical system

As far as how the medical system reflects the needs of those with FASD, Dr. Logan is frank in her opinion. Noting that FASD is recognized as the most common preventable cognitive disability in the world, she is disappointed that many physicians have only a baseline understanding of the effects of prenatal alcohol exposure.

“It is a condition which, though not curable, is modifiable with the correct interventions for the individual affected,” she explains. “Unfortunately, we do not have enough of those interventions available to meet the needs of all the people affected by FASD. Most individuals, especially adults with FASD, are left to stumble through life being seen as a nuisance, worthless or a danger to society. How sad is that?”

Potential of tenth domain

As explained in the FASD Diagnosis Introduction, currently multidisciplinary assessment teams examine nine areas of the brain, or domains, to determine an FASD diagnosis. Pending guideline updates – being undertaken by the Canada Fetal Alcohol Spectrum Disorder Research Network (CanFASD) – include adding a tenth domain called “Affect Regulation,” or more commonly referred to as “mental health.” The potential for a tenth domain is something Dr. Logan says reflects the current accepted thought and practices when considering diagnosis.

“Anyone working in the field of FASD knows that mental health is a significant factor in FASD diagnosis and was already taking it into consideration as part of the diagnostic process. I am okay with this being a domain,” she says.