Reflections on medical care in the Kootenays

Last week I had the pleasure of being on tour and meeting and talking with members in several communities in the Kootenays: Fernie, Cranbrook, Creston, Trail, and Nelson. The landscapes were stunningly beautiful – as only the Kootenays can be.  But, at other times of the year, these same landscapes pose huge barriers resulting in many communities becoming completely isolated for extended periods of time. While driving the area I quickly learned that the apparent distance as shown on the map between communities has NOTHING to do with how difficult it is to travel between them.

I heard concerns from each community about the lack of Health Authority consultation with local doctors in the allocation of regional resources and their subsequent frustration. They feel doctor involvement in these kinds of decisions would improve patient care and also improve efficiencies and reduce costs.  This lack of engagement is a common theme.  The Board of Directors identified this issue as a priority to be addressed in the current round of negotiations with government.

I was also surprised to learn of an issue that hadn’t been on my radar before, but is a significant one in rural and remote communities – the problems with accessing medevac services.  Eastern BC has access to STARS from Alberta, but the BC Ambulance Service doesn’t operate rotary-wing aircraft – only fixed-wing.  The inability to get fixed-wing aircraft in and out of communities, the organizational difficulties in being shunted from one person to another in the middle of a crisis – these are issues I will take back to our organization to see what we can do.

Lastly the Provincial Privileging Project remains an issue of great concern.  While my colleagues acknowledge a need to remain competent and current, until now the project has indicated the intent to use a minimum number of services to prove competency.  Doing this would completely destabilize many communities, especially our rural and remotes ones.  Imagine the domino effect of a local anaesthetist who doesn’t get a minimum number of certain procedures which leads to consequences such as a lack of OR access and a loss of local obstetrical and surgical services!  Fortunately, recent meetings between the Ministry of Health, Doctors of BC, and our representatives from the Rural Coordination Centre of BC and the Joint Standing Committee on Rural Issues have articulated these problems, and we are all working on alternative processes that are both supportive and practical.  Stay posted on this as it is a vital issue!

My tour continued last week as I traveled throughout the Okanagan, and as my grandmother used to say. “No rest for the wicked and less for the righteous”.  Never could figure out where I stood in that!

Dr Bill Cavers

President, 2014-2015