Life on Gabriola Island can be idyllic, providing residents with a tight-knit sense of community and a feeling of peace and seclusion from the outside world. However, until recently, that seclusion was impacting residents’ ability to access health care—residents had no access to care between 10 p.m. and 6 a.m. due to ferry schedules and a lack of emergency care facilities on the island.
A shortage of office space had also impacted the availability of care. Two local physicians—Drs Francois Bosman and Tracey Thorne—were practising out of a converted storefront with no room to accommodate potential new physician recruits. To address their need for more space, the two doctors became part of the community effort to build the Gabriola Community Health Centre.
“Prior to [the centre being built] my colleague and I were working out of a converted liquor store,” explained Dr Thorne in an interview with the Bowen Island Health Centre Foundation. “We each had one tiny clinical space, we had no room to expand and no room to really add another physician because there was no space for them.”
Understanding the need for a dedicated clinical space for physicians and other care providers to see patients, the community banded together to raise funds for a new health care centre. The facility was built largely through volunteer efforts—islanders of all ages built the structure with their own hands. Once the centre was complete, Drs Thorne and Bosman soon recruited a new physician to join them.
“When this building went up,” says Dr Thorne, “it became a space that was legitimately appropriate to show people and say ‘there is room for you here, please join us.’ We were fairly quickly able to recruit a third physician. We built the building knowing that the physical services would follow if there was a space for them, and its borne fruit.”
The centre has improved Gabriola residents’ access to health care dramatically. Patients now receive care from a team that includes a home care nurse who takes care of wound dressings and palliative care, a community health nurse, a social worker, and a mental health nurse who shares duties with the social worker to cover mental health emergencies five days per week. “All of us working in the same space is a real collaborative care model,” explains Dr Thorne. “If I have an issue with a patient that I’m worried about, I can immediately speak to the home care nurse, the mental health nurse, or my social worker and say ‘can we problem solve this and how can we get it done?’ and things happen fairly quickly.”
While Dr Thorne and her colleagues appreciate the additional space at the new clinic, things sometimes get crowded—in a good way, she clarifies—when specialists visit. “We have a visiting general surgeon, plastic surgeon, and psychiatrist. We have public health coming in to do immunizations for the kids on the island, and some days we’re so full we think ‘wow, we’ve got to build a bigger building!’ But we’ve been able to find space for everybody,” says Dr Thorne. Having visiting specialists on site improves efficiency in patient care significantly, she explains. “I had one day when I was seeing a patient, and the visiting psychiatrist happened to be in the building, so I just popped around and spoke to him and he was able to see my patient then for a first consult rather than waiting 12 weeks to get in. When things are acute with mental health, immediacy is important.”
While the centre was built prior to the formation of the Gabriola Island Chapter of the Rural and Remote Division of Family Practice, the division and chapter have been instrumental in initiating a part-time social worker, telehealth videoconferencing equipment and support, development of the Health and Wellness Collaborative and the Palliative Care Working Group, and more. Island Health and other local health care stakeholders support the centre as well.
The centre now functions as a patient medical home, giving people access to the health care they need in a consistent fashion, and recently winning the Rural Community Award at BC’s Rural Health Conference. “The sense of ownership in the building is important” says Dr Thorne. “People are very proud of it, and they have a sense of belonging because of it—it’s not like the doctors own the building and the community comes, it’s the community owns the building, and we work out of it.”