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鈥檚 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.
鈥淚鈥檓 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鈥檚 home,鈥� said Thompson who enjoys his cycling, hiking and being with family and friends in his downtime. 鈥淭he 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.
鈥淚 feel like I鈥檝e lived in enough places, either long-term or short-term, to know that the Okanagan鈥檚 probably where I want to end up.鈥�
For Thompson, like many other people who move away from where they grew up, there鈥檚 something special about coming home to stay.
鈥淲hen you come from a small town you have the unique understanding of the needs felt by a community,鈥� said Thompson, who alternates his week between hospitals and medical clinics. 鈥淚鈥檓 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.鈥�
The under servicing became apparent locally in June with the overnight closure of the emergency ward at Thompson鈥檚 home town South Okanagan General Hospital, due to 鈥渓imited physician availability.鈥�
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.
鈥淚 remember when my grandmother was sick, the entire medical community rallied around her 鈥� 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,鈥� he said, although he initially planned to become a pharmacist.
According to Summerland鈥檚 Dr. Margie Krabbe, site director for the UBC program, with new physicians, there is a changing trend in the medical guard of the past.
鈥淭he old, solo practitioner working on their own just isn鈥檛 out there anymore so we鈥檙e trying to find new solutions,鈥� said Krabbe who works with a number of other doctors at a clinic in Summerland. 鈥淭hese young physicians that are coming into practices are no longer willing to work 80 or 90 hours a week and have no personal life.
鈥淭hat鈥檚 where doctors are saying: 鈥楴o I don鈥檛 want to be on call 24 hours a day 365 days a year.鈥�
鈥淭he whole part of the mandate with the training program, it鈥檚, 鈥榳ell we used to do things that way but that doesn鈥檛 mean that鈥檚 the way we should keep doing them.鈥� It鈥檚 an interesting time.
鈥淭he struggle a little bit with the program is they can鈥檛 mandate that people stay where they train but hopefully it will make it appealing and get their families established.鈥�
Being a physician in a small community can also mean a greater variety of medical tasks for the doctor.
鈥淟ots of city doctors now don鈥檛 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)鈥� said Krabbe. 鈥淭hey 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.鈥�
Learning those skills and enhancing the existing ones is something Thompson particularly enjoyed in his first year of the program.
鈥淣o one is ever on the same rotation at the same time, be it internal medicine, obstetrics, psychiatry so you鈥檙e always the only resident learner on the rotation,鈥� he said. 鈥淪o with the staff physician you鈥檙e the one that they鈥檙e teaching. For the most part it鈥檚 one-on-one teaching. And with that comes development of relationships with the different specialists and other family doctors in town.鈥�
One of those doctors he is working with now in Penticton is Dr. Elizabeth Watters at the Fairview Medical Clinic.
鈥淚 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鈥檚 an excellent person to work with,鈥� said Watters who has been in the medical business for over 30 years. 鈥淎lso 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鈥檚 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.
鈥淚 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.鈥�
And while the rural doctor鈥檚 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.
鈥淥bviously, living in a rural environment you鈥檙e more of a figure in your community so having anonymity is not easy,鈥� said Dr. Margie Krabbe who has worked in Summerland for nearly a decade. 鈥淚 think it鈥檚 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.鈥�
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.
鈥淚 think because you could run into them (patients) in the grocery store you really do have a different sense of where they鈥檙e living and where you鈥檙e living, so you share similar experiences,鈥� she said. 鈥淪o I think you do treat your patients differently in a small town, there鈥檚 a lot of connectivity. You might live next door to their cousins.鈥�
But for her, that connectivity is important for her patients鈥� care, which made her gravitate to a general physician-based facility like Penticton Regional Hospital.
鈥淭here鈥檚 more openness and I think being able to see them when they鈥檙e in the hospital allows them to see and appreciate that we know how sick they鈥檝e been,鈥� said Watters.
And while there are challenges in getting to know your patients that well, according to Dr. Krabbe there can be benefits too.
