Partnering to recruit and retain doctors in Bella Bella

A collaborative partnership focused on physician recruitment and retention is paying off in Bella Bella, where three part-time physicians and a full-time international medical graduate have been successfully hired to support patients in the community and hospital.

The ƛ̓uxválásu̓ilas Heiltsuk Hospital Medical Staff Association (MSA) and Bella Bella Chapter of the Rural and Remote Division of Family Practice, with funding support from Doctors of BC through the Joint Clinical Committees, are working together with Vancouver Coastal Health (VCH) to overcome the challenges of physician turnover shared by many communities across BC, through joint planning, projects, and resources.

Showcasing the community

Bella Bella is located on Campbell Island in the heart of the Great Bear Rainforest on the Central Coast of BC, about 200 kilometres north of Vancouver Island, and with year-round access by air and ferry. Fishing, tourism, and logging are its main industries, and Heiltusk First Nation members (on which the hospital rests) are heavily involved in cultural activities and traditional food gathering and preservation. 

Primary health services include VCH’s integrated ƛ̓uxválásu̓ilas Heiltsuk Hospital (kwil-valas-iwaylas) and the Heiltsuk Hailika’as Health Centre. The hospital provides acute, residential and emergency care, diagnostic imaging, lab, pharmacy, and visiting ultrasound services. The medical clinic provides primary care, public health, maternal/child health, chronic disease, home care, and patient travel services. Both facilities host robust outreach specialist clinics, linking with more than 25 providers from around the province.

Doctors in Bella Bella work in both hospital and community roles within a tightly-knit rural medical community.

“The broad scope of practice and sense of adventure available in rural medicine is particularly attractive to new grads, especially when that is combined with a welcoming community and supportive medical team.”
– Dr Greg Costello, Staff Physician, MSA President and ER / Credentialing & Recruitment Lead

Showcasing the benefits of working and living in the community is a key strategy for the partners, who have held more than 20 or lunch and dinner meetings with prospective, locum, and visiting physicians. Fostering these collegial and personal connections has been a key, positive step to support recruitment and retention.

A jointly-funded recruitment website provides an overview of health care services, local amenities and recreation, a video, and convenient VCH employment links. Physicians say this resource has been informative and helpful when considering and preparing to work in Bella Bella.

Streamlining the physician work experience

The community continues to actively court a large pool of locums to augment the physician workforce and as a potential source of future recruits. Great strides have been made to improve orientation and practice experiences for locums, as well as newly-hired and permanent physicians.

A secure, online "Bella Bella Physician Wiki" has modernized and streamlined the orientation experience for locums as well as regular physicians. Helpful 'how-to' information and instructions are readily available on the Wiki’s easily searchable platform. Notably, all locums have found the Wiki with its organized repository of resources to be helpful.

A secure Slack channel helps facilitate continuous engagement of physicians on hospital and community activities and important issues, while reducing e-mails and streamlining information – ultimately optimizing more time for patient care. 

Training and revitalized health promotion and community engagement efforts are supporting physicians to practice culturally safe patient care and strengthen connections with local residents.

“These resources help to maintain healthy interest among locums in our community and get ahead of future staffing crunches. One of our returning locums told me recently: “Every time I come back to Bella Bella, things just keep getting better and better!” – Dr Costello

Improving the clinical care environment 

To support physician retention, the MSA is working with the health authority’s local program manager, director of operations, and senior medical director to improve the experiences of doctors and nurses in their daily work to deliver safe, high-quality patient care.

VCH team members and clinical staff have reorganized and optimized the Emergency Department trauma and critical care bays, and modernized all clinical spaces in the hospital and clinic with state-of-the-art diagnostic wall sets for blood pressure cuffs, scopes, monitors, and other equipment. Similar changes are also being adopted in outpatient services.

Together, these efforts have not only led to the recruitment of four new doctors and improved the workplace for existing doctors, they are helping to make Bella Bella an attractive option for future physicians seeking medical training experiences.

The success of the collaboration goes a long way towards providing consistent and sustainable longitudinal care in the community and hospital, and to inject fresh energy into the community for further growth.

“By working together as a medical staff and coordinating efforts within the health authority and between divisions, we have a greater opportunity to make progress on issues that ultimately affect all parties. 

By having an official way to connect with the health authority, we can have formal communications around how to improve care for patients and recruitment/retention of staff for the site, and coordinate resources and projects to address issues. 

By connecting between different divisions, we can find common pain points and learn from each other on how to best advocate around issues like access, equipment, and more.”

– Dr Costello