SOMBA K'E/YELLOWKNIFE
The Stanton Territorial Health Authority is in the rare situation of having no permanent general internal doctors after losing three practitioners over the past year.
Bing Guthrie, medical director, manages medical affairs at Stanton and part of his role is to ensure there are enough doctors and that they are happy in their work environment.
One of his objectives over the coming year will be to replace three permanent internists who resigned in 2015 – Dr. Terry Wuerz, Dr. Jacquelyn Dirks, and Dr. Amy Hendricks. Wuertz and Dirks, who came as a couple in 2012, moved to Winnipeg to practice in March, while Hendricks resigned in August.
"At the beginning of the year we had three permanent doctors and now we are down to none," Guthrie said. "We are actively recruiting for three permanent full-time internal physicians."
General internal doctors are a key component of the delivery of care in the North, especially when it comes to diagnosing certain illnesses and co-ordinating how patients should receive treatment, Guthrie explained.
Often this means that the physician has a sub-specialty or a general understanding of internal body parts. In the North, this can mean that internists are more heavily relied upon for jobs that sub-specialists would do in urban centres, such as checking pacemakers or insulin pumps.
According to Guthrie, the hole left by the outgoing doctors is being filled by locums.
Locums, or temporary doctors, fly in and out of various communities when needed and in the case of Stanton are paid for by the GNWT.
This is not only costly, since locums work on a daily rate rather than on a paid salary, but it is also seen as inconvenient to patients who don't have a familiar face to regularly consult with, said Wuerz.
Yellowknifer sought to learn the cost difference between locums and permanent-resident doctors through the Department of Health and Social Services but was referred to a medical recruitment website where no figures appeared to be available.
"I think it is a serious matter that there are no permanent internists in Yellowknife," Wuerz said. "The major detriment to the patient is just the lack of continuity of care. Stanton recruits a large number of excellent locum general internists, however there is certainly something lost every time you go back to your specialist doctor for follow-up and it is a different face. In a sense you end up revisiting some of the same problems because the person is not as familiar with you."
Hendricks was featured in Yellowknifer recently for having been recognized with an award by her national professional organization.
Part of her recognition was for advocating for revisions to university programming for internal medicine that would take into consideration how internal physicians can better meet the needs of Northern and rural centres.
Wuerz said in an interview from Winnipeg this week that he left on very favourable circumstances, but wanted to move to the Manitoba city because he has relatives living there and it was easier for him personally with small children.
He said the role of his job is complex but can be understood as being like "a pediatrician for adults."
"It is a very broad specialty," he said, adding it's most common for them to treat cardiac disease.
