ACPOC Professional Profile Series: Sheila Hubbard, OT/PT, BSc

Introduction: By Dr. Robert Fielden

Sheila Hubbard exemplifies what ACPOC is all about.

Our founding fathers developed a clinic profile for the management of children with limb deficiencies or deformities. They envisioned a team led by an orthopaedic surgeon or physician who would organize a program to deal with the many intricacies of children's physical and emotional issues. ACPOC has developed over the years, with this mandate as its background. [Image ]

However, times change and the ability to deliver these services is predicated on the availability of the specialists to perform and participate in these clinic settings. In Ontario, a province that encompasses an area covering the same area as 7-10 States in the USA, there has been one major centre to care for the children with limb deficiency and deformity and that has been the Bloorview MacMillan Centre. Over the years it has been staffed by orthopaedic surgeons of renown from Dr. John Hall, Dr. Gillespie and Dr. Krajbich. It has treated an extremely large population of children. The main anchor in this chain has been Sheila Hubbard. She has quietly developed the program designed by ACPOC and orchestrated the care of thousands of Ontario and other children to benefit from all the newest and best developments that the world has to offer.

Sheila has been a strong advocate and participant in ACPOC as a board member and as president. She is a leader. She developed and ran a clinic through all the changes in the health care systems, being sure that the children in Ontario continued to receive the best care possible for their limb deficiencies and deformities at a time when medical care was being undermined by a system of governmental controls that rationed health care to the population.

The choice of Sheila Hubbard as a profile in the annals of ACPOC is a wonderful representation of the organization. It is a multidisciplinary group that understands the contributions that all its members have to offer and Sheila has been a strong and continued supporter of this association.

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ACPOC Professional Profile:
Sheila Hubbard OT/PT, BSc


What event or person inspired you to become a pediatric therapist?

While trying to choose a university program with my guidance counselor in high school, we came across a description of physiotherapy that included an example of a therapist helping a handicapped child learn to walk. I decided that looked interesting and applied to the combined Physical & Occupational Therapy Program at the University of Toronto.

After my second year of training, I had the opportunity to do a summer internship at the London District Crippled Children's Centre and War Memorial Children's Hospital in London, Ontario. I loved the ability to combine acute care and rehab practice and having confirmed my desire to work in paediatrics, I eagerly accepted an offer of employment after graduation. How fortunate I was to be able to begin my career within the nurturing, familylike environment of such a closely-knit, multidisciplinary staff and to have had Pam Valentine as my first PT supervisor and mentor. I also had the good luck to be guided and inspired by a superb group of physicians including Dr. Kennedy, Dr. Hinton, Dr. Cameron and others. During my time in London, I also had my first experience in prosthetic care while treating a young child with bilateral lower limb amputations. [Image ]

After three years, I married, moved to Toronto and applied to work at the Ontario Crippled Children's Centre. After graduation, I had remained friends with a classmate who had been working in the prosthetics program and had been fascinated by her descriptions of the work being done for the thalidomide children. Fortunately, after a few months on the 0-6 Unit, I was able to join the prosthetic group and as they say, "the rest is history."

What do you like best about being a pediatric therapist?

I have always enjoyed working with children and their families. In paediatric rehab you have the opportunity to develop long term relationships and it is incredibly satisfying to see the children grow and develop over the years and to be a part of their lives.

Can you identify a mentor that influenced your career path?

I was fortunate to receive my early training in P&O from a distinguished group of individuals including Drs. John Hall, Hugh Thomson, Jim Murray and John Kostuik; researchers Colin McLaurin and Wallace Motloch; prosthetists Karl Ruder, Dieter Bochmann and Bill Sauter; and therapists Chris Killips, Elizabeth Hamilton and Elaine Trefler.

The one person who probably had the greatest influence on my career path was Dr. Robert Gillespie, an orthopaedic surgeon at the Hospital for Sick Children and our Amputee Clinic Chief. Bob fostered the development of a unique partnership of clinical care, scientific inquiry and education. He was always supportive of our clinic team and provided strong leadership. He helped me personally to stretch and grow professionally as he taught me to question existing beliefs, to investigate and to learn how to present/publish our findings and principles of practice. Bob treated each case as if it was his own son or daughter and this remarkable compassionate approach had a profound effect on my own attitude to patient care.

The other person that had a very significant impact on my career was Dr. Morris Milner, Director of Rehabilitation Engineering. In 1980, Mickey encouraged me to return to work (after a few years at home with our two young children) to take over departing Marissa Marshall's role as research OT and project coordinator of a two-year project "to determine the most cost-effective approach to train young children to use myoelectric prostheses". Under Mickey's guidance, I had the opportunity to learn and develop the scientific/ academic skills required of formal research activity. Based on the success of this project, the Government of Ontario decided to fund powered upper-extremity prostheses for pre-school aged children and I moved on to assist prosthetists Bill Sauter and Rinchen Dakpa in the development of a clinical service program for them. In addition to my clinical role, I have been fortunate to have also been able to continue to be involved in a variety of research activities over the years and have never lost the interest or enthusiasm that Mickey inspired.

Where have you practiced?

I have always worked in paediatrics as a physiotherapist and/or occupational therapist. I spent three years at the London Crippled Children's Centre and then 40 years at Bloorview Kids Rehab (formerly Bloorview MacMillan Centre/Hugh MacMillan Rehabilitation Centre/Ontario Crippled Childrens Centre). Starting in 1995, in addition to my clinical work, I started to take on some administrative responsibilities as the Clinical Coordinator of the Amputee Program. In 1997, I became the full-time Manager of the Amputee Team and in 2003 the Manager of Prosthetic, Myoelectric and Orthotic Services. On a number of occasions, I also had the opportunity to be seconded to the government to act as a Consultant in Prosthetics and Orthotics for the Assistive Devices Branch of the Ontario Ministry of Health. Throughout those years of clinical and administrative work experience, I was fortunate to have been able to work with a great many talented and committed colleagues in a client-centered, multidisciplinary team environment.

How many years have you been a member of ACPOC?

I attended my first meeting (CPRD) in 1978 – Grand Rapids, Michigan. Later on I served on the Board of Directors from 1987 through 1990, and moved through the officer positions until becoming President in 1994. I have also participated in the Bylaws, Research and Amputee Registry committees. In 2002, I hosted the annual meeting in Toronto.

Obviously it was a huge honour to be elected to the position of President and I enjoyed my term immensely. In particular, as President, I had the opportunity to select the keynote speakers for the annual meetings and it was extremely satisfying to see how well the various presentations were received by the membership.

However, I must say that I found all of the positions and the work on the Board to be very rewarding. I got to know some wonderful people and have enjoyed ongoing relationships with many of them. As a member of the Board, I felt I had an opportunity to represent the views of our clinic team as well as to share my own personal opinions and beliefs, contribute to discussions, participate in the decision making process, help formulate policies, plan meetings etc. I also learned so much about the organization and the work being done by colleagues in the various clinics and groups in our two countries.

What was your first impression of the organization? What is your present assessment of ACPOC?

I was very impressed by the wealth of knowledge, the multidisciplinary nature of the group, the respect that members had for each other irregardless of profession and the obvious compassion and dedication to improving the lives of the children and their families.

I have just received notification of an emeritus membership and am honoured to receive this distinction. I would like to stay involved and would be very happy to contribute to the organization in any way that would be helpful.

What other organizations do you belong to and how does ACPOC compare?

I am a registered member of both the College of Physiotherapists and the College of Occupational Therapists of Ontario.

I am a member of ISPO and have been privileged to be able to attend and present papers at several of the international meetings over the years and have developed a network of colleagues in countries around the world as a result. In 2004, I became a member of the Board of Directors of ISPO Canada and part of the organizing committee for the 12th World Congress in Vancouver in August, 2007. In March, I was privileged to be invited to participate in an ISPO Executive Board, Strategic Planning Workshop in El Salvador. I am also a member of an international upper limb outcome measures working group (ULPOM) that is an outgrowth of a workshop held during the Vancouver meeting.

In many ways the meetings are similar to ACPOC (P&O interest specific, multidisciplinary, scientific program, workshops, exhibitors, etc.) but international and on a much larger scale. ISPO has over 3,000 members and 41 National Member Societies. In addition to its triennial Congress, the Society is also involved in a variety of other educational initiatives such as training courses, consensus conferences and assistance to P&O schools in developing countries throughout the world.

I have also attended most of the Myoelectric Controls Conferences (MEC) in Fredericton over the years. These biannual conferences are hosted by the Institute of Biomedical Engineering at the University of New Brunswick and provide courses, workshops and symposiums on topics relevant to the specialized field of upper limb prosthetics.

Each organization has so much to offer, however, ACPOC is unique in being dedicated to the care of children alone and I enjoy the extended family like quality of membership.

What is the most valuable benefit of your ACPOC membership?

The network of experienced colleagues and the ability to contact any of them to discuss a case, seek advice, discuss a problem, etc. The meetings provide a venue to hear the results of recent studies and to learn about any new developments, changes in practice and products. There is also an opportunity to socialize and spend time with colleagues who have a shared interest and passion for the care of children with prosthetic and/or orthotic needs.

Do you have a favorite conference or conference memory? And why?

I have many wonderful memories. In particular, the social program has always been a highlight of the ACPOC meetings and has enabled teams and the membership as a whole to get to know each other and to have fun together. I can't think of a better way of developing teamwork. Some examples include: eating crayfish in New Orleans, dancing to a blues band in St Louis, dinner boat cruise in Vancouver, enjoying the beach in St Pete's and attending the mediaeval banquet in Banff to name but a few.

The most memorable, in respect to its effect on my career, was hearing Dr. Rolf Sorbye present his experience in fitting powered upper limb prostheses to children in Sweden (Clinic Chief's Meeting in Grand Rapids – 1978). I cannot recall another occasion where I have seen a speaker generate as much excitement and controversy as Dr. Sorbye. He certainly stimulated our team to return home and experiment ourselves – the beginning of a long history of involvement in pre-school myoelectric fittings at our Centre.

Do you remember a "most embarrassing moment" at ACPOC?

Probably best untold!

Would you like to share any information about your family and other interests?

I was married for 28 years to Keith, a high school history teacher and history coordinator for the city of Scarborough until his death in 1995. We have two daughters. One is a child psychologist in Newfoundland and the other a lawyer in Toronto. As a family we shared a passion for travel and I have been fortunate to have visited many parts of the world over the years.

I celebrated retirement with trips to Newfoundland, Alaska, India and Italy this past year. Still have many places I would love to see, health and finances permitting. I also enjoy attending the arts (theatre, opera, symphony, and ballet), book club, bridge group, and gardening.

Since retiring, I have become involved as a volunteer in an Archives project at Bloorview Kids Rehab to try to collect and chronicle the history of P&O at the Centre and I continue to be involved in some research activities at the Centre.

What are you passions, goals, or pet projects for the next 10 years?

Goal - live life to the fullest!

This includes taking some university courses and to explore some areas of interest that I have not previously had time for, spend more time with family and friends, read, walk, improve my bridge skills etc.

I hope to return to Africa to visit Tanzania and Namibia in the near future.

I would like to continue to stay involved and contribute time to projects of interest in the field of P&O and become involved in some developing country educational activities. I am planning to attend MEC'08 in August and have accepted an invitation to be a key note speaker for the 25th scientific meeting of the Japanese Society of Prosthetics and Orthotics in Kobe, October, 2009.

Please share any advice to the membership regarding the orthopaedic care provided to children

  • he physical, emotional and prosthetic/orthotic needs of a child are very different to that of an adult and are best handled by an experienced, multidisciplinary team. As health care costs continue to rise, facilities (public and private) will be challenged to find ways to preserve the staffing required to support a team-based approach to the care of children with prosthetic/orthotic needs.
  • I would love to see ACPOC develop some educational resources (outlining basic practice guidelines) for use by practitioners new to the field of paediatric P&O and for those working in the developing countries. There is so much collective experience and wisdom (particularly amongst the long term members) that should be collected and documented while it is still possible to do so.
  • I believe there is a need to study the changing demographics of the pediatric populations we serve in order to plan effective services for the future.
  • There is also an ever increasing demand for evidence based practice. Governments, insurance companies and charitable agencies are seeking proof that the services and equipment they are paying for are proving to be cost-effective. ACPOC is ideally positioned to foster collaborative, larger population outcome studies.

What challenges are ahead for ACPOC that may need to be addressed to ensure its future?

I believe that ACPOC will continue to play an important role in the field of P&O. It will certainly face some challenges and may have to adapt and change with the times such as:

  • Attracting new, younger members and get them involved and committed early in their careers. ACPOC is a largely volunteer organization and it is increasingly difficult for practitioners to find the time for volunteer work or scientific inquiry/academic activity.
  • The cost and frequency of meetings may be prohibitive to hospital staff with small education budgets – may need to reconsider the annual meeting approach, find less expensive accommodation etc.
  • The potential loss of the team approach and fewer allied health members able to participate in annual meetings as the cost of health care continues to rise. If hospitals continue to try to cut costs (decrease in staff hours and more frequent changes in staffing) it will become increasingly difficult to maintain experienced P&O teams.
  • Encourage a higher standard in papers in scientific sessions to attract delegates and justify costs of attendance.
  • Develop a stronger partnership with researchers and manufacturers to ensure that new products are produced to meet the needs of the paediatric population.