Preceptor Dr. Elizabeth Watters works with residency student Dr. Travis Thompson at the Fairview Medical Clinic. Mark Brett/Western News

The changing faces of rural doctors

The new doctors residency program in the South Okanagan

The face of the kindly, old country doctor standing at your door with the well-worn leather medical bag in hand is changing.

Enter the new generation, physicians like Dr. Travis Thompson, 27, and while the appearance may not be the same the dedication and commitment to be a really great small town doc is.

For Thompson and others of his genre it’s not the appeal of the bright city lights, but rather a commitment to work in a wide range of medical disciplines and ultimately deliver the best care they can for their patients in a familiar setting.

To help these young physicians along their chosen path and ultimately bolster the medical ranks of rural doctors in B.C., there is the new UBC Family Practice Residency Program in the South Okanagan.

Thompson and three other doctors recently completed the inaugural 12 months of the two-year curriculum and four more new physicians were just added at the start of the second semester.

This marks the first time those doctors can complete their entire residency in this region, which hopefully will lead them to put down roots.

“I’m from Oliver originally so I like the small town feel and Penticton is a good size too and I just like the Okanagan, I grew up here and it’s home,” said Thompson who enjoys his cycling, hiking and being with family and friends in his downtime. “The other thing is thing is in your last year of medical school you become pretty nomadic, I was in a different city every four weeks so I got to see a lot of B.C. and Alberta.

“I feel like I’ve lived in enough places, either long-term or short-term, to know that the Okanagan’s probably where I want to end up.”

For Thompson, like many other people who move away from where they grew up, there’s something special about coming home to stay.

“When you come from a small town you have the unique understanding of the needs felt by a community,” said Thompson, who alternates his week between hospitals and medical clinics. “I’m really passionate about doing my part to help under-serviced communities, and I think being a smaller centre, the training site in the South Okanagan will help me to become a very competent rural doctor.”

The under servicing became apparent locally in June with the overnight closure of the emergency ward at Thompson’s home town South Okanagan General Hospital, due to “limited physician availability.”

Two other scheduled closures at the same hospital were narrowly avoided earlier that month.

A big part of Thompson wanting to become involved in medicine happened when he was just a youngster in the small community where he grew up.

“I remember when my grandmother was sick, the entire medical community rallied around her — it was in that moment I decided I wanted to be part of a tight-knit medical community and provide quality healthcare to others down the road,” he said, although he initially planned to become a pharmacist.

According to Summerland’s Dr. Margie Krabbe, site director for the UBC program, with new physicians, there is a changing trend in the medical guard of the past.

“The old, solo practitioner working on their own just isn’t out there anymore so we’re trying to find new solutions,” said Krabbe who works with a number of other doctors at a clinic in Summerland. “These young physicians that are coming into practices are no longer willing to work 80 or 90 hours a week and have no personal life.

“That’s where doctors are saying: ‘No I don’t want to be on call 24 hours a day 365 days a year.’

“The whole part of the mandate with the training program, it’s, ‘well we used to do things that way but that doesn’t mean that’s the way we should keep doing them.’ It’s an interesting time.

“The struggle a little bit with the program is they can’t mandate that people stay where they train but hopefully it will make it appealing and get their families established.”

Being a physician in a small community can also mean a greater variety of medical tasks for the doctor.

“Lots of city doctors now don’t do in-patient hospital care and mostly do clinic-based care where rural doctors might do obstetrics, hospital care, ER (emergency room) and sometimes even a little bit of ICU (intensive care)” said Krabbe. “They have to deal with more problems on their own without as much support, so the breadth of practice is much deeper so potentially you have even more responsibility and accountability than a city doctor.”

Learning those skills and enhancing the existing ones is something Thompson particularly enjoyed in his first year of the program.

“No one is ever on the same rotation at the same time, be it internal medicine, obstetrics, psychiatry so you’re always the only resident learner on the rotation,” he said. “So with the staff physician you’re the one that they’re teaching. For the most part it’s one-on-one teaching. And with that comes development of relationships with the different specialists and other family doctors in town.”

One of those doctors he is working with now in Penticton is Dr. Elizabeth Watters at the Fairview Medical Clinic.

“I believe it is essential for the future of the provision of family practice for our community to have the learners entrenched in that environment from the beginning, so Travis is an example of the success of that and he’s an excellent person to work with,” said Watters who has been in the medical business for over 30 years. “Also the personal rewards (of working with new doctors) for me were unexpected, I did not realize it would increase my appreciation for my work. It’s fun to share stories and successes and very rewarding to see others contribute to the care of people you have known for 20 years, just a very rewarding experience personally and professionally.

“I think Travis is committed to being a small town doc, he shows that in the way he interacts with patients both in the office and in the hospital.”

And while the rural doctor’s image may be changing, Thompson plans to continue the tradition of making house calls.

Strictly confidential

Living and working as a small-town physician comes with its own set of challenges, one which can be doctor-patient relationships.

“Obviously, living in a rural environment you’re more of a figure in your community so having anonymity is not easy,” said Dr. Margie Krabbe who has worked in Summerland for nearly a decade. “I think it’s a mix and it depends on your personality, being in a rural community or small town you are more accountable because people know you more.”

Dr. Elizabeth Watters, who has worked in Penticton for the last 19 years and who headed for the hills after her first year of practice in Toronto, agreed.

“I think because you could run into them (patients) in the grocery store you really do have a different sense of where they’re living and where you’re living, so you share similar experiences,” she said. “So I think you do treat your patients differently in a small town, there’s a lot of connectivity. You might live next door to their cousins.”

But for her, that connectivity is important for her patients’ care, which made her gravitate to a general physician-based facility like Penticton Regional Hospital.

“There’s more openness and I think being able to see them when they’re in the hospital allows them to see and appreciate that we know how sick they’ve been,” said Watters.

And while there are challenges in getting to know your patients that well, according to Dr. Krabbe there can be benefits too.

 

Eight-year-old Ambrose Colbeck reverses roles with Dr. Travis Thompson in the exam room at the Fairview Medical Clinic where Thompson is doing part of his UBC Family Practice Residency program. Mark Brett/Western News

Dr. Travis Thompson during a shift at Penticton Regional Hospital as part of the UBC Family Practice Residency Program in the South Okanagan. The goal of the program is to keep more doctors in smaller communities. Mark Brett/Western News