“just a family doc”

This is a phrase that gets thrown around a lot. I have seen it used by non-medical folks and healthcare professionals alike. As a result, many seem to have internalized a belief that family medicine or GPs are lesser of a medical specialty, or worse, not a specialty at all.

Through the first few years of my medical training however, many specialists have been sufficiently frank with me to expose that they had considered doing family medicine but found it terrifying. A medical oncologist related to some classmates that she was quite happy to retreat into her very narrow specialty. There she could master it completely and further, she could comfortably keep up with all the new research that pertained to her. When she would see patients she could virtually always know the answer and what the numbers were to support her advice.

But not Family Medicine. This is a specialty of medicine with boundless scope. Not limited to the confines of an anatomical system, nor to the degree of acuity. A urologist may confidently head to the hospital knowing they are likely to see some urinary incontinence, perhaps a cervical CA and an ever-more-rare circumcision. The Family Doc though, will have no such expectation.

This expanse of scope is made all the more exaggerated when your practice is rural. I wanted to experience this specialty in this rawest of forms, and nothing presented itself so well as Haida Gwaii.

And so, a mere 18 hours of driving…

and adding on an eight hour boat ride over to the island from Prince Rupert….

I high-tailed it up to Masset, my home base, to get settled in before the first day. My airbnb was a room in a PMG(personal military quarters) building. These are VERY common in Masset and are a remnant of the military base that dominated this area since the early 40’s.

The benefit of this location though was that it was very close to the hospital and in addition there was a trail through the woods which made the route very nearly as-the-crow-flies.

I took the night before as an opportunity to sort out my route through the forest and see what the hospital looked like. The hospital sits along an oceanside road joining Masset to Old Masset (the reserve) and as a result benefits with a stunning view from many spaces in the hospital.

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The hospital has:

• one resuscitation bed
• four stretchers in emergency (two general, one casting area, one small procedures)
• 9 inpatient rooms
• a number of long term care beds
• a clinic with eight exam rooms including one for visiting specialists, a clinical nurse and spirometry
• speech language pathology
• a small physiotherapy space
• a small conference room with video conferencing equipment
• a lab with basics done in house
• x-ray in house

In addition, they’re one of the few I have come across where food is made in house.

Our week was composed of one day of clinic at Masset hospital, two days at clinic in Port Clements, which is a tiny community south of Masset as well as usually two days of 24 hour coverage of the ER. This was the first occasion I had to see GPs simultaneously switching between their morning clinic while taking calls from nursing/triage in the attached Emergency Department. So not only did we not know what to expect in the clinic, we also knew even less what to expect over in the ED.

It was difficult to switch gears from one to the other multiple times through the morning, and it was wonderful to see the ease with which these physicians were able to walk into the unknown every 15 minutes and handle it without breaking a sweat.

Finally with a day off I went to the surf shop to see about renting a bike for the month I was there. He told me it was end of season, so I can just keep it for $150. This was less than I expected to pay for renting, so I happily agreed. He threw in a lock and gave some advice about the local surf and how it is more fickle than people from off-island expect. Thanks to the bike, my relaxing commute was even shorter, now well under five minutes:

Of course, I had ulterior motive for wanting an elective on Haida Gwaii, and that motive was that it is absolutely beautiful. My partner agrees and joined me for the second half to explore a little.

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As with any rotation, I learned a lot of medicine here. But more than that, I got a direct view into how amazing our rural GPs are. They plunge into the unknown supporting people who they see regularly. They help with their medical needs, their social struggles, mental health worries and then regularly keep their phones on all night for when trauma and accidents strike.

More than this they do this in their unique geographical context. At 2 am, you need to medically support anyone who might end up in your ED. But you also need to consider that you are hours away from a Surgeon, or any other specialist. You need to decide if an expensive helicopter and the associated care team needs to be activated.

Transport unnecessarily and resources are wasted as well as families displaced hours away on the mainland, putting their lives on hold to be with their loved one.

Hold transport too long and it might be too late to get a crashing patient to the resources they need.

We elected to check off our bucket list item of taking the Inner Passage ferry to Vancouver Island for my next rotation in Duncan. As we passed the stunning scenery, multiple sightings of whales and took in the beauty of west coast BC, I thought about how much respect I had for those who just spent a month passing on their knowledge and spending their time with me.

I wondered if I might one day be as committed and competent as the teachers I just had the pleasure to share this month with and could confidently let people know I am “just a family doc”

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