News for — and about — members of the Thompson Region Division of Family Practice.

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Maternity event connects providers from across the BC Interior

Maternity care providers gather to share experiences and challenges

An unprecedented, physician-led, and in-person maternity care event drew 21 physicians and two midwives from ten communities throughout the BC Interior to share experiences across their sites.  Participants discussed the roles of providers, Divisions and other organizations in human resource planning, and explored how a regional network of maternity care could improve patient care.

“When we began to explore the concept, we discovered the interest to participate was palpable and the decision to proceed with a maternity care event was obvious,” said Melanie Todd, Senior Project Manager at the Thompson Region Division of Family Practice.

The group came together for an evening meet-and-greet and a full day of facilitated conversation in Kamloops where they shared information about their sites, challenges, successes, opportunities, and what motivates them to do the work they do.

“An event like this has never been done before,” said Dr. Shaun Davis, a family physician who works at Thompson Region Family Obstetrics and was the physician lead for the event. “There has been little opportunity for family physicians and midwives providing intrapartum care across the region to build relationships, share experiences, and learn from each other. This event gave us a valuable opportunity to put names to faces and empathize with our colleagues from other communities in the region who are facing similar situations.”

Key learnings included:

• The need for clear risk assessment guidelines for obstetrician transfer and consult.
• Enhancement of collaborative compensation models (FP/midwife).
• Allowing providers more transparency with patients.
• Increasing the number of maternity care providers.
• Experiences of residents and learners in current environments.
• Nursing shortages and training to support nursing staff.
• Differences in how obstetricians practice across the region (primary care vs. consult-only) require navigation support.

“Family physicians and midwives are a critical part of the system. They are the foundation of maternity care in BC, but they can only function when the whole system is working,” Dr. Davis said. “These conversations around maternity care are deeply impactful and let providers express their frustrations, build relationships and work towards a better future. We are not alone in this struggle of feeling pushed over-capacity. All parts of the system are feeling this pressure and the moral distress of having to turn away pregnant patients is difficult to manage.”

The group worked on a list of recommendations to break down barriers and enhance cohesiveness, including the creation of a regional maternity network to support information sharing, education, and the opportunity to amplify regional needs.

Regional strategies to improve patient care could include regional rounds to support collective decision-making concerning patient care and transport; the creation of a funded regional position for maternity care access and flow between referring and accepting sites; and the creation of a central list for maternity care locums.

“Maternity care providers across the BC Interior are struggling and require targeted ongoing funding and infrastructure to support a network that could help identify pain points and inform provincial stakeholders and eventually policy making.” said Katherine Brown, Executive Director, Thompson Region Division of Family Practice. “The challenges are multi-faceted and require ongoing quality improvement funding to support sustained maternity care improvements.”

Next steps include escalating key learnings and regional strategies to appropriate regional and provincial stakeholders, and bringing the group of providers together again.

 

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Collaboration improves supportive cancer care services

A message from the Chair of the Division

I have been working at the Kamloops Cancer Clinic since 2018 as a General Practitioner in Oncology. This work is rewarding and challenging.

Our cancer clinic is not a regional cancer centre like they have in larger cities like Kelowna, nor is the current plan for us to become a regional centre. We are a Community Oncology Network clinic, operated as part of a collaborative partnership between Interior Health and BC Cancer for the Southern Interior in Kelowna.

In this model, wraparound supportive care services have historically been lacking for our patients. This was part of the inspiration behind applying for Shared Care funding through the Thompson Region Division of Family Practice. One of the aims of this project work was to enhance cancer supportive care services for patients of the Thompson Region. 

This work has enabled us to collaborate with organizations that work tirelessly to achieve the same goal. The Kamloops Cancer Supportive Care Society, which is a grassroots non-profit society, and the Royal Inland Hospital Foundation have been instrumental in bringing InspireHealth LIFE Programs to Kamloops.  

These are amazing, free, two-day, in-person programs held in Kamloops for cancer patients and their families around supportive cancer care. These programs are being advertised through the Kamloops Cancer Clinic and have been very well-received. Many of our patients are also accessing on-line and telephone services through InspireHealth. Last year, more than 250 oncology patients accessed approximately 2,000 patient visits with physicians, dietitians, counselors, exercise therapists, and group programming.  

Information sessions on InspireHealth and their services have been offered to Kamloops Cancer Clinic staff, the Medical Office Assistants network, a Division lunch-and-learn webinar, and at a recent Timely Talks session at the Kamloops Library.

Through collaboration, more of the patients in the Thompson Region are accessing much-needed supportive cancer care services. 

— Dr. Meghan MacDonald, Chair

Resources:
- Read more about InspireHealth at inspirehealth.ca 
- Learn more about the Kamloops Cancer Supportive Care Society at kamcancersupport.com

 

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LTC Practice: Many ways, many reasons

Exploring the professional fulfillment and personal rewards of long-term care

Long-term care offers physicians a unique and rewarding opportunity to diversify their practices while making a significant impact on the lives of their patients. For some, long-term care (LTC) is integrated into their longitudinal family practices, with care provided to residents across one or two facilities. For others, LTC becomes the primary focus, with physicians taking on roles like Medical Director in one or more facilities.

We asked four LTC providers to share their personal experiences, and to describe the motivations that drive their practices, and the professional fulfillment that they find in this field.

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Dr. Kraig Montalbetti:

"I have followed my own patients from my longitudinal community practice into long-term care since assuming the practice of my own family physician upon his retirement in 2011. I have found it easy and rewarding to continue to care for these patients in long-term care facilities as I knew them when they were younger and healthier (both mentally and physically) and continue to look after their family members. I have found my connection with them as they have transitioned from community/acute to subacute/short-stay to long-term care helpful in knowing when and how to assist with adjusting their focus/goals of care as they progress through these settings.

“Logistically, I find attending long-term care facilities to be a nice way to add variety to my practice. You can drop in whenever there is a gap in your schedule, making rounding quite convenient. With the institution of the LFP payment model, we are now paid very well to do this work, including travel time when driving between facilities!”

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Dr. Jim Howie:

“I have been a family physician in Kamloops since 1983. During my career, I was a full-service family physician, doing a combination of Emergency work, hospital rounds, office practice, delivering babies, and long-term care on my practice patients who went into long-term care.

“Following my retirement from my office-based practice four years ago, I work exclusively in long-term care. I have found long-term care an important part of my practice. Working with nurses and care aides and other allied health workers has been a challenging and rewarding aspect of medicine for me as I have been a medical director of two Kamloops’ facilities over the past 20 years. I still have the drive to continue working in long-term care.”

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Dr. Phillip Sigalet:

“Caring for people in long-term care tends to go under the radar. It is a place where you practice narrative medicine in its purest form — with limited access to labs and no imaging, we rely on history and physical exams. It is team-based care: We rely on care aids, LPNs, dietitians, physiotherapists, recreation therapists, pharmacists, and families to develop plans and deliver care. We care for some of the most vulnerable people in our society who happen to be the builders of that very society.”

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Dr. Alina Cribb:

“I was drawn into significantly expanding my long-term care practice by a phone call from a retiring colleague. Basically, he suggested I consolidate my practice into one long-term care facility and suggested a regular day for visiting. I had recently moved to Kamloops, and in my previous family practices, we had shared our long-term care practice. When it was your weekend on call, you zoomed around to all the long-term care facilities to put out fires.

“Currently, the practice standards for long-term care that have been developed over the last 10 years encourage a more proactive type of care, with regular preventative visits to clients living in facilities.

“In any case, I was wooed to take on his 10 patients, and so my journey to markedly increased involvement in long-term care began. Those 10 patients in The Hamlets bloomed to between 80-85 patients over the years. Naturally, with that many people, a regular day of rounding is useful. If you are interested in teamwork, long-term care offers the opportunity to work with nurses, care aides, recreation directors, physiotherapists, or occupational therapists, social workers, dieticians, and families. 

“I enjoy the time I spend in LTC. The skills needed are both different, and the same, than what are needed in office-based practice. There are plenty of opportunities to practice your clinical exam skills and truly explore conversations with patients and families about what matters to them in their care. You may end up looking after a multitude of different debilitating diseases, in all age groups, from young adults to frail 100-year-olds. You will definitely be expanding your scope of practice if you've found yourself stagnating in the office.  

“I would recommend joining a call group so you can keep some balance in life. Overall, I would say I'm glad a colleague called me and lured me into taking on a Long-Term Care practice. There was a learning curve, and some growing pains, but I enjoy the outing from the clinic, the teamwork, the variety, the challenges of some creative problem solving, and the wide range of clients.”

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Learn more about working in Long-term Care.
Contact Ania Zubrowska, Long-term Care Initiative Project Manager.
Email: azubrowska@thompsondivision.ca

 

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Stories from a life in family medicine

The Odd Couple

They were quite the odd couple. She sashayed in like the queen, her hair freshly coiffed and wrapped in a floral scarf. She was dramatic, full of vim and vigor. He shuffled in like a country bumpkin, a perpetual grin plastered on his joyful face. She led. He followed.

At first, I thought they were husband and wife. Nope. Brother and sister? Nope.

They were childhood friends from way back when Kamloops was a three-street town. Their family farms were adjacent. They played together, met at the pond, wasted many afternoons skipping rocks across the water until the sun went down. He was simple and content. She was grandiose and loved all things American.

They grew up. She met an American man and was whisked off, her floral scarf holding down coiffed hair as she rode in a convertible all the way down to Alabama where she raised a family and built up a real estate company.

He stayed in Kamloops, took care of his parents and never married. In the midst of these two completely different lifestyles, they stayed in touch through letters and the occasional long-distance phone call at 24 cents a minute.

Time marched on. Her kids grew up. Her husband left. She was divorced, empty-nested and wealthy. His parents passed away. He sold the family farm to pay off debts and became homeless. She learned of this, packed up her life in Alabama, bought a house on West Battle Street, and moved the two of them into it.

This is how I met them. An odd couple in their 70s, fighting like married spouses and cohabiting like brother and sister, held together by the bond of childhood friendship. 

Eventually, with advancing time and age, they began to accrue three-letter diseases: HTN, TIA, CVA, CHF, CKD, MCI and NCD. One day, I brought her in to discuss care planning and she informed me that her daughters would be moving her into a posh nursing home in the Californian desert.

She made a two-stage plan to move him into an apartment for seniors while they waited for a spot in a local nursing home. We didn’t talk much about her care plan. She was here to ensure that I knew what to do after she was whisked off to California, which, by the way, she would be travelling to in a convertible, her hair wrapped in a floral scarf.

Many years later, I was at that nursing home and saw him sitting in the lounge. He did not recognize me. As I was leaving, I turned to wave goodbye, but his eyes were distant, that perpetual grin plastered on his peaceful face. I knew he was at the edge of the pond, skipping rocks with a little girl who wore a floral scarf.

This odd couple taught me that love comes in different shapes and sizes. Love just shows up. When space and time robbed them of their bodies and minds, love showed up and remained.

— Dr. Allison Chung

 

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Building a resilient MAiD network for the Thompson Region

 

Demand for the program continues to grow

The Medical Assistance in Dying program (MAiD) for end-of-life care is experiencing a growing demand in the BC Interior.

To maintain the program's resiliency, the Thompson Region MAiD physician group has been instrumental in encouraging greater involvement from local physicians and nurse practitioners.

The group has:

• Engaged in 1:1 recruitment.
• Hosted a fall MAiD meet-and-greet event for 11 interested primary care providers.
• Offered mentoring and shadowing opportunities.
• Built a foundation for a strong MAiD network.

The efforts have been successful: Three physicians new to the program have recently completed their MAiD certification to perform provisions in the Thompson Region.

The Division would like to acknowledge the local team for their recruitment and retention efforts, and extend a warm welcome to the newly MAiD-certified physicians.

The work doesn’t stop there because the program still needs more support. If you are interested in becoming a MAiD provider or assessor, then please send me a note and we can have a discussion.

— Melanie Todd, Senior Project Manager.
Email: mtodd@thompsondivision.ca

 

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MOAs: A vital link in building the Thompson Region PCN

The transformative world of Primary Care Networks (PCN) in BC has finally touched down in the Thompson Region

Designed to streamline primary health services through team-based care, PCNs aim to provide comprehensive, patient-centered care by fostering collaboration among various primary health care providers.

The goal is to evolve into a system where patients’ health care experiences are seamless, efficient, and supportive. By integrating Medical Office Assistants (MOAs) into the core of this system, PCNs will enhance the coordination of care, ensuring that every patient receives timely and appropriate services.

Imagine networks of primary care providers, such as family doctors and nurse practitioners, working alongside allied health professionals, like physiotherapists and dietitians, all dedicated to meeting the diverse health needs in our communities.

“Medical office assistants will be a vital thread in the fabric of the Primary Care Networks, supporting the coordination between patients, primary care, and allied health providers,” says Sarah Graham, Thompson Region PCN Manager. “The expertise and engagement of MOAs will be crucial in helping to deliver team-based care throughout our region."

Marcy Matthew is a new Project Lead with the Division, and she is the new liaison with the MOA Network.

“I'm excited to step into this new role overseeing MOA Network engagement,” Marcy says. “It’s important to me to continue the great work established by my predecessor, and supporting MOAs through the implementation of PCN will be an exciting addition to this role. I look forward to building on these strong foundations and working together in the coming year.”

Marcy is coming off her first engagement session, a holiday-themed MOA appreciation event in November.

“I met a lot of new faces,” she says. “It was great to celebrate our past year's successes and provide an opportunity to strengthen our partnership, share valuable educational resources for Primary Care Networks, and listen to feedback.”

 

 

Makenzi Irwin, the Division’s Attachment Coordinator, is no stranger to the day-to-day clinic experiences of MOAs.

“MOAs balance compassion and efficiency to ensure quality care, they are the vital connection between patients and the health care system,” Makenzi says. “My own career path from being a Medical Office Assistant to an Attachment Coordinator has ignited my passion to improve local access for unattached patients and enhance team-based care. MOAs will help shape patient experiences as we get further into our regional Primary Care Networks.”

Chelsey McKinney, also a former MOA, is now a Practice Improvement Coach, Engagement and Quality Improvement, with Doctors of BC.

“As a previous MOA, I have always held such a soft spot for the profession and know that they are often underappreciated,” Chelsey says. “In the shift toward Primary Care Networks, the role of Medical Office Assistants remains extremely vital. MOAs are not only the first point of contact but also the steady pillars ensuring that patient care remains coordinated, accessible, and efficient while still supporting the integration of teams and ensuring smooth operations.”

Connie Walker, an MOA and the producer of the quarterly MOA Newsletter, says that she looks to the Division to play a vital and supportive role in empowering Medical Office Assistants. The Division offers educational resources and professional development, bringing essential tools to help streamline the operations of family practice clinics.

“These resources enable MOAs to manage practices more efficiently, handle medical billing, and support complex services,” Connie says. “MOAs are crucial in ensuring smooth clinic operations, and the implementation of the PCN should be no different as the Division enhances our capabilities, helping us ensure that family physicians and our teams can provide high-quality care with efficiency and expertise.”

Sarah says that Primary Care Networks are essentially about creating a health care environment where every patient feels valued, and every caregiver is empowered to provide the best possible care.

“PCN is an exciting development, and MOAs will be a connective tissue that binds the PCN framework, ensuring every patient encounter reflects the values of collaboration and care at the heart of this initiative,” she says.

 

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Kudos to our Medical Office Assistants

I've walked in your shoes, and now I'm excited to walk alongside you

When I think about where I began my journey in health care, it always leads me back to my days as a Medical Office Assistant, both at a physician’s office and at the Aberdeen Ultrasound and X-Ray CIC (Community Imaging Clinic) in Kamloops.

Those years weren’t just about managing schedules or answering phones — they were about connecting with patients during some of their most vulnerable moments. MOAs wear many hats at any given time, balancing compassion with efficiency to keep everything running smoothly, and ensuring the care of each patient.

As an MOA, I learned that we are often the first touchpoint in the health care system — the bridge between patients and care — and our work lays the foundation for trust and quality care. Whether it was reassuring a patient before their imaging procedure or troubleshooting an IT problem, I came to deeply understand how essential MOAs are to primary care.

But as I grew in my career and gained experience, I also became aware of the gaps in our health care system — patients who couldn’t find a primary care provider or those who felt lost navigating the system. It was a problem I encountered again and again, and it ignited a passion in me. I wanted to be part of the solution. That desire led me here, to the Division, as an Attachment Coordinator. In this role, I get to work at the system level, collaborating with clinics, care teams, and implementation of enhancements within the system.

It’s a role that allows me to draw on my experiences as an MOA while working to improve access for unattached patients across our region. What ties my journey together is the recognition of the importance of team-based care, which is at the heart of Primary Care Networks (PCN). MOAs are critical players in this team. They’re not only administrative support: They’re the glue that holds everything together.

As we move forward in building a strong Thompson Region PCN and improving patient attachment through tools like the Health Connect Registry and the Provincial Attachment System, the work MOAs do is more important than ever. MOAs, you’re not just supporting clinics, you’re shaping patients’ experiences and ensuring that our health care system works for everyone. So, I want to say Thank You. Thank you for your dedication, your resilience, and your commitment to care. It's an honour to have walked in your shoes, and now to walk alongside you, striving for the same goal — to create a health care system where every patient feels connected, supported, and cared for.

— Makenzi Irwin, Attachment Coordinator