Canada’s North might be cold most of the year, but visiting doctors receive the warmest welcomes.
It’s potluck at the Fort Smith Health Centre – and I’m not talking about food. As with other communities in the Northwest Territories outside of Yellowknife, the town of Fort Smith relies on locums to help fill a chronic shortage of doctors. Talk about relying on the kindness of strangers. These physicians come from the south to fill in from two weeks to a few months at a time. We’re happy to have them, but each medical visit brings a fresh new face.
Some locums come once or twice, but British Columbia physician Dr. Carl Gill is a repeat customer. This gentle giant of a man hadn’t heard of Fort Smith when someone from our health centre phoned in January 2007 asking him to come to our community. Dr. Gill had retired from his busy practice in November 2006 and welcomed the opportunity to keep practicing medicine while enjoying the perks of retirement.
He now visits Fort Smith every six to eight weeks for a couple of weeks at a time. “It’s an easier practice, much less paperwork than I would have to do down south and fewer patients,” he says sitting in an exam room.
“When I’m gone, I have no responsibility. Once I’m out of here, I don’t have ongoing things I have to follow up with.” He also enjoys working in a remote setting. During his off-hours, he grabs his camera and heads off in search of wildlife to photograph.
According to the territorial government’s Department of Health and Social Services, locums are generally young physicians who are looking for experience before settling into a practice in Canada, or empty nesters aged 45-59 who have been working in a very fast-paced clinic where they see as many as 30-40 people a day.
Specialists take turns cruising through the community every few months. They’re hired by the Stanton Territorial Health Authority in Yellowknife, and travel to communities across the N.W.T. and western Nunavut.
With no blood bank or trauma unit here to speak of, surgeries are done in Yellowknife. More complex medical tests are carried out in a better-equipped Edmonton hospital and medevacs (medical evacuations) end up either at Stanton Territorial Hospital in Yellowknife or an Edmonton hospital.
Being paid a daily rate in the North, rather than on a fee-for-service basis, lets locums know what they’re going to earn. It doesn’t depend on how many patients they’re going to see. That can also translate into better patient care and, well, more patient doctors.
“Take your time,” a physician tells me as I try desperately to hustle off the person who called me on my cellphone moments before the doctor stepped into the waiting room to call my name. I’m embarrassed to make the doctor wait, particularly since I appreciate his presence. As I finish my call and step into the examining room, I silently wonder if the doctor is operating on Northern time.
I approach my medical appointments with a mix of curiosity at who will turn up to examine me and a bit of apprehension about the quality of the care I will receive. Continuity of care is virtually non-existent. If you want to meet men in this town, book a doctor’s appointment. You’re almost guaranteed to never see the same one twice. A few women do come to care for us, but it’s mostly men.
One of them is Dr. Schumann, a locum I see for an earache. He’s apologetic for making me wait; he’s overbooked and running an hour behind schedule. “That’s OK,” I say. “We appreciate that you’re here.”
He’s from Toronto and this is his first time in the community. “Please tell your friends to come, too!” I say, hopefully. “I will,” he laughs. You can never miss an opportunity to do a bit of recruiting when you have to rely on the kindness of strangers. Then we get down to medical business.
“Yellowknife, NWT” SteveS_2004 @ Flickr.com. Creative Commons. Some Rights Reserved.
“Dr. Gill” © Hélèna Katz
“Fort Smith Health Centre” © Hélèna Katz