Hello there, and welcome! I’m a social science researcher working within the broader health (care) sciences in Canada with a fascination for the intricate, messy, and often invisible dynamics that shape our health care systems. Rooted in the fields of medical sociology, organizations, and pharmaceutical sciences, my work pulls back the curtain on the daily rhythms, technologies, and human interactions that define how care is delivered—and experienced— within an organizational structure.
This Substack is where I unravel one of health care’s most persistent puzzles: polypharmacy. On the surface, it’s the use of multiple medications, but dig deeper, and you’ll find a web of routines, decisions, and systemic forces that reveal the true complexity of the issue. My goal? To make the invisible visible—to shine a light on the everyday practices, organizational norms, and human stories that keep this phenomenon alive.
Some of the questions I explore here include:
• What does the current landscape of polypharmacy look like? What does it reveal, and why does it matter?
• In what ways is polypharmacy considered a ‘wicked problem’ - deeply embedded in institutional routines, structures, and material practices, making it resistant to simple solutions.
• How do medicine and pharmacy study (or fail to study) polypharmacy? What methods work? What questions should we be asking?
• What are healthcare professionals, patients, advocacy groups, regulators, and governments saying and doing about polypharmacy?
• And how can we begin to theorize polypharmacy as a practice rather than just a problem to solve?
Drawing on my empirical ethnographic research in long-term care facilities, I map out the realities of polypharmacy on the ground—the forms, routines, policies, technologies, and relationships that make it a living, breathing part of health care systems.
I write a bit more about the contours of this substack here.
My Work
As a qualitative researcher and methodologist, I’m passionate about working with teams and individuals to design and carry out studies that illuminate the real-world complexities of health care systems. Whether through real-world research such as observations (ethnography), interviews, focus groups, or mixed methods, my aim is to craft research that’s not only methodologically robust but also insightful and transformative. My focus is on how to innovate patient centred care within complex adaptive systems. By drawing on diverse theoretical frameworks—such as practice theory or actor-network theory, I ensure that my work captures the nuanced interplay of people, systems, and objects that shape the delivery and experience of care.
Over the years, I’ve been lucky to explore a wide range of topics, including:
• Burnout in intensive care units (ICUs)
• Access to care for patients with inflammatory bowel disease (IBD)
• Patient safety and antimicrobial stewardship
• Deprescribing and tackling polypharmacy
• Patient-centered clinical trials in Nova Scotia
• Themes of death and dying in undergraduate medical education
• The experiences of underrepresented students in medical schools
• Authorship in collaborative research teams
• Various projects with The Canadian Longitudinal Study on Aging (CLSA)
You can find my academic work on Google Scholar, but what I share here is a bit different—stories, insights, and reflections on the realities of health care that often go unnoticed.
Research Funding
I’ve been involved as a co-investigator or PI on ~20 funded grants from CIHR, SSHRC, Nova Scotia Health Research Foundation, Faculty of Medicine (Dalhousie), IWK Children’s Hospital, Canadian Frailty Network, Dalhousie Pharmacy Endowment Fund, and Translating Research into Care (QEII Health Sciences Centre Foundation).
Where It All Started
Before diving into research, I spent years in health policy in Toronto, working at the Ontario Ministry of Health (10 year review of the Regulated Health Professions Act - RHPA) and the College of Physicians and Surgeons of Ontario (various government bills and working on domains such as patient safety). Those experiences—working with regulations, navigating governance, and witnessing the health care systems policy world up close—left a significant mark on how I approach health care as a researcher. I also did work for a variety of organizations such as the Canadian Cancer Society, and Canadian Strategy for Cancer Control.
As for my academic path, I received my PhD in Pharmaceutical Sciences at the Leslie Dan Faculty of Pharmacy (University of Toronto), an MA in Sociology at Queen’s University, and a BA(H) in Sociology and Anthropology at Hood College in Maryland.
I was born and raised in The Netherlands, lived in the United States for 6 years, more than a decade in Ontario and currently living in Nova Scotia.
Thank you for visiting. I hope this space sparks curiosity, reflection, and maybe even a new way of seeing the hidden worlds of medicine and health care.
The views and opinions expressed on this Substack are my own and do not reflect those of my employer or any affiliated organizations.
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