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Clinic closure leaves patients searching for answers

Selkirk Family Medicine will be shutting its doors Dec. 11, medical community planning for future.
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Trail’s Margie Crawford and Kay Oliphant are without a medical clinic come December. The pair are advocating for a resolution to a doctor shortage.

Trail’s Margie Crawford and Kay Oliphant may need to see a doctor to deal with a bout of anxiety after finding out their medical clinic in closing.

The Trail sisters were among about 1,500 to receive a letter from Selkirk Family Medicine Friday that regretfully informed patients that the longtime facility would be shutting its doors Dec. 11.

After 41 years of service, Dr. Trudi Toews was in the process of retiring but has to close her practice promptly due to medical reasons. The other medical professionals at the clinic are parting ways, some offering continued service to outgoing Selkirk patients.

The sisters are counted in the upwards of 1,000 people who do not have a plan, yet. They are not sitting tight, however, and are on a mission to generate a serious conversation on the doctor shortage in the area.

Crawford has made contact with Trail Mayor Mike Martin, MLA Katrine Conroy, MP Alex Atamanenko as well as other movers and shakers in the medical community. She is a known advocate in the community, if her phone ringing off the hook is any indication.

“I feel shock, panic and overwhelming fear because Kay is on Warfarin (blood thinner) and needs to be monitored,” said Crawford, 70.

Oliphant, 84, has Atrial fibrillation, an abnormal heart rhythm characterized by rapid and irregular beating.

“If I don’t have a doctor, then I don’t know what dose to take and it could become very dangerous,” added Oliphant.

The Kootenay Boundary Division of Family Practice (Divisions) has been working closely with the clinic during the few months leading up to the closure notice. Divisions represents all the doctors across the 14 communities in the Kootenay Boundary region.

Clinical Lead Julius Halaschek-Wiener assures that the medical community is set to meet to figure out a short-term and long-term plan that sees to continuity of care.

“Until Dec. 11, it’s business as usual and it’s 100 per cent commitment to care for them,” he explained. “In the meantime, we’re working on a short-term immediate response and a longer-term plan to how we can mitigate this situation.”

Divisions will be meeting with Interior Health Sept. 25, while all general practitioners intend to get together Sept. 28. The conversation will continue with community leaders at the beginning of next month. The medical community would like to invite patients into the discussion but will know more about how people can add their voice after they meet.

“It’s certainly challenging and there’s no simple solution to mitigate the closure of the clinic but we believe that if all stakeholders come together that we can find a solution to this,” he said. “And we think that not one group can solve this on its own, it’s only as a collaborative that we can fully address this.”

Discussions are expected to centre around creative ways of expanding patient lists at existing facilities, could touch on encouraging part-time physicians to make the leap to full time work and the need of working through the patient list with priority given to the vulnerable and more complex files.

Recruitment has been on the agenda for some time and continues to be the driving solution to staffing shortages. There are at least two job postings in the Trail area and potential for more with retirement set for ageing staff.

Statistics suggest that Trail, Fruitvale and Rossland will have to recruit about seven general practitioners over the next year, according to Dr. Cheryl Hume, who adds all together the region will need 25 new professionals.

She’s the director of the new Kootenay Boundary Rural Family Practice Residency Program that just welcomed its first crew of rural family practice residents this summer.

The program trains physicians who will enter into rural family practice and provide essential primary care in rural areas. The four rural family practice residents are joined by three medical students from the Integrated Clinical Clerkship (ICC) program here for hands-on training.

Though these programs could see to some improvements further down the road, there is a gap in time from now until then when shortages are becoming very real.

Finding the right balance between the number of professionals and patients can be a challenge and the same could be said about securing someone who wants to run a private clinic, said Crawford.

“Some of the young doctors today choose to not get into a practice,  they choose to work more at the hospital or in some other context,” she added. “But what they’re not realizing is they’re missing one of the most beautiful aspects of medicine . . . ands that’s the long-term building of relationships and seeing what you’ve done to help someone, to see them restored to good health.”

The sisters began seeing Dr. Toews back in 1994 when their former clinic closed. The “good fit” was further suggested when the two started with Dr. Gwen Campbell, who they began to build what they thought would be a lasting relationship.

Campbell is set to move to Grand Forks, where she’s found a clinic that can accommodate her while she completes her full Canadian license. Her colleagues have plans of their own, too.

Dr. Miles Smith is relocating to Medical Association in Rossland, Dr. Katherine Forman will be concentrating on hospital work as well as fill in opportunities in other clinics throughout the province and U.S., and Chelsea VanVliet, a nurse practitioner, will continue to work in the area.

The letter states that Smith will take his patients up to his new clinic and that Salmo and Fruitvale residents are welcomed into the Salmo Clinic and Beaver Valley Clinic, but doesn’t give any real resolution for Trail area patients.

The notice makes note of two walk-in clinics in NelsonKootenay Lake Walk-In Clinic in Chahko-Mika Mall and Ancron Medical Centre on Baker Street. Patients who are registered and being seen by Trail Mental Health can see the nurse practitioner at Kiro Wellness Centre. And lastly, in case of medical emergency, there’s always the emergency department at Kootenay Boundary Regional Hospital.

Whether this closure will bump up ER visits is only speculative at this time.

“While IH doesn’t oversee private practice physicians, the nurse practitioner at this clinic is an Interior Health employee and will continue to support primary care in the region,” confirmed Cheryl Whittleton, the health authority’s community integrated health services administrator. “We are currently looking at options to support our nurse practitioner in providing primary care to area residents.”

While possibilities are tossed around, Selkirk wraps up business.

Patients are asked to visit their doctor to create a medical plan during this time of transition.

The clinic will be sending its medical records to Docudavit Solutions for the storage and management of all patient medical records for those who have yet to find a doctor after the facility closes.

But this service isn’t free. Individual patients will fork out $80 while a family of four is expected to pay $160 and $50 for each additional member (plus taxes and shipping).

The expense could be an added stress for some but the real loss is some well respected doctors, who’ve made an impact on many lives.

“Dr. Toews is well loved,” said Crawford. “People are grieving quite heavily over her retirement and now her health because she was so much a part of their lives.”