A new palliative care team at St. Joseph’s Healthcare Hamilton has found a way to bring its services to more people with life-threatening illnesses.

Dr. Mino Mitri, one of the founders of Pegasus says his team brings palliative care directly to the offices of patients’ other specialists at St. Joe’s, making it more accessible than if they had to travel to a separate appointment to access such care.

“We chose the name Pegasus because we fly to the different clinic areas within our hospital campuses,” said Mitri in an interview with CBC Hamilton on Tuesday. The model will allow palliative care doctors to see more patients and spread themselves further, he said.

“We see patients who have had long-standing disease have a well-established relationship with their specialist, and we didn’t want to take that away from them,” he added.

As the program is still new, Mitri says doctors don’t always think to call them in the moment the patient is at their office — but when they do, a member of the team can often respond immediately.

Pilot launched last year

Pegasus began as a pilot program in February 2025, beginning as a partnership with the hospital system’s nephrology and respirology departments.

It became available to all St. Joe’s patients with life-threatening illness last summer, and has now served between 40 and 50 patients, estimates Mitri, who is the head of service for palliative medicine at St. Joe’s.

The team also stresses that palliative care isn’t just about end-of-life care, but about improving function and quality of life for patients.

Mitri explained that despite a common understanding of palliative care that involves the relief of suffering at the very end of someone’s life, there are many ways palliative care experts can help people who are much earlier in their journey with life-threatening disease.

“We’re providing whole-person support that helps patients manage symptoms, plan ahead and live well on their own terms,” he said.

Palliative-care physicians are experts in drugs that can help patients feel better and live more fully, and also in having conversations with patients about how their values align with the treatments being offered, he said.

His team has helped patients with kidney disease talk through the pros and cons of going on dialysis, or ending dialysis, for example.

“Sometimes the angle we offer is asking very specific questions about values and priorities,” said Mitri. “Palliative care is making sure they are being true to themselves the whole way, and making sure they know their options the whole way.”

Dr. Joshua Wald, a respirologist who has been part of the Pegasus program from the start, says it has been “incredibly valuable” for his patients to have direct access to palliative care through Pegasus.

“Many patients with advanced lung disease don’t know about or have access to palliative care resources,” he said in an emailed statement. “The Pegasus program has [provided] them with access to a team specializing in managing symptoms and discussing options for people near the end of life.”

Dr. Meera Joseph, nephrologist at St. Joseph’s, says the Pegasus team has helped her patients with kidney disease “better manage symptoms and improve patients’ quality of life at every stage of their illness — not just at the end of life.”

‘All of us have a stake in the game’

The philosophy of taking a palliative approach to medicine is gaining traction, and is also promoted by Dr. Samantha Winemaker with McMaster University.

She’s the co-writer of a book called Hope for the Best, Plan for the Rest: 7 Keys for Navigating a Life-Changing Diagnosis, alongside researcher Hsien Seow, the Canada research chair in Palliative Care and Health System Innovation.

The pair, who also host a podcast, are urging Canadians to seek palliative care much earlier if facing a progressive illness, to ensure they have as much information and choice as possible. 

In an interview with CBC Radio’s White Coat, Black Art, Winemaker said that after caring for thousands of people, she’s found that “having less information” leads to families making choices that are “very reactive and crisis-driven.”

They’re also teaching family physicians and other healthcare workers how to incorporate palliative care approaches into their own practices. 

“I think every cardiologist, virologist, nephrologist, hepatologist, neurologist, oncologist, family practice [physician], all of us have a stake in the game and all of us need to be providing a palliative approach,” said Winemaker, who provides in-home palliative care services. 

“In the future, personally, I hope no one needs us because we’ve done such a good job integrating a palliative philosophy of care into all care providers competence that we don’t have to label it palliative care. It just becomes very amazing, person-centered care delivered by everyone.”