Port aux Basques doc­tor re­ceives ru­ral ser­vice award

Award win­ning doc­tor en­cour­ages other physi­cians to help re­form the health care sys­tem

The Gulf News (Port aux Basques) - - Front Page - BY MAR­TINE BLUE

It’s all in a day’s work for Dr. Wendy Gra­ham.

The Port aux Basques fam­ily doc­tor re­cently re­ceived a Ru­ral Ser­vice Award from the So­ci­ety of Ru­ral Physi­cians of Canada.

“It’s a nice recog­ni­tion,” Gra­ham said. “For those of us who prac­tice in ru­ral com­mu­ni­ties, that’s ex­actly what we do as fam­ily doc­tors.

“It’s a ca­reer of ser­vice. We’re try­ing to help pa­tients. We’re ul­ti­mately pa­tient cen­tered. We have re­la­tion­ships with peo­ple and we serve our com­mu­ni­ties and we try to pro­vide ser­vices for peo­ple as close to home as pos­si­ble and we take a holis­tic view of them.”

Gra­ham says that’s why the award is spe­cial.

“It rec­og­nizes that you’re do­ing good work for the ci­ti­zens of the com­mu­nity, your neigh­bours, the peo­ple you care about and that you’ve been do­ing it well and you’ve been do­ing it a long time,” she said. “It’s an honour of priv­i­lege to be a fam­ily physi­cian, the award rec­og­nizes that you are do­ing some good on a com­mu­nity level.”

Gra­ham spe­cial­izes in Fam­ily Medicine. She is trained to care for pa­tients through­out their whole lives, from birth to se­nior age. The Rose Blanch na­tive was drawn to this dis­ci­pline for the va­ri­ety of care she is trained to pro­vide to pa­tients.

“I wanted to go to a very broad-based prac­tice where I prac­tice gen­er­al­ism,” Gra­ham ex­plained. “Where I could prac­tice fam­ily medicine in a host of set­tings.”

Gra­ham has worked in Port aux Basques for 18 years.

“I have a pri­vate prac­tice, I work at the emer­gency room, I look af­ter pa­tients in long term care, acute care, pal­li­ate peo­ple in their homes, I do house vis­its, I do che­mother­apy care at the hospi­tal, I do mi­nor sur­gi­cal pro­ce­dures in the morn­ings. I have a very di­verse prac­tice in the com­mu­nity,” she said.

Be­sides her busy prac­tice, Gra­ham also works full-time as an as­so­ciate pro­fes­sor of Fam­ily Medicine at Memo­rial Univer­sity; she does some work for the New­found­land and Labrador Med­i­cal As­so­ci­a­tion; and is co-chair of an ini­tia­tive called the Fam­ily Prac­tice Re­newal Pro­gram.

Ru­ral medicine

Dr. Gra­ham ad­mits that work­ing in ru­ral medicine has its chal­lenges.

“The sys­tem works in var­i­ous si­los and has var­i­ous poli­cies that con­flict with each other of­ten,” she ex­plained. “Some­times I see a fam­ily that strug­gling with a child in the school sys­tem, or I see a frail el­derly per­son who has lots of ill­nesses, and there’s this pro­gram and that pro­gram and an­other pro­gram that has th­ese all th­ese ser­vices, but my pa­tient who needs help doesn’t fit all the check­boxes to the cri­te­ria of that pro­gram.

“We talk about pro­grams and ser­vices be­ing pa­tient cen­tered, but some­times they are lost in a sea of poli­cies and bu­reau­cra­cies that con­flict with one an­other,” she con­tin­ued. “We’re of­ten try­ing to get help for our pa­tients to be told, ‘I’m sorry, we re­al­ize this pa­tient has a need but we can’t help your pa­tient be­cause your pa­tient doesn’t fit our cri­te­ria.’”

Gra­ham said that’s the big­gest chal­lenge, a lack of strat­egy.

“We talk about pa­tient-cen­tered care and we talk about in­ter­dis­ci­plinary care, but there’s re­ally no strat­egy to bring th­ese things to­gether,” she said. “We’re re­ally work­ing hard, one on one, case-by-case ad­vo­cat­ing for pa­tients. I love ad­vo­cat­ing for pa­tients, but it shouldn’t be as dif­fi­cult as it is.”

Gra­ham cred­its her com­mu­nity of fel­low care­givers, col­leagues in so­cial work, nurs­ing, phar­macy, phys­io­ther­apy, oc­cu­pa­tional ther­apy and many oth­ers, for pro­vid­ing some of the great­est ben­e­fits to prac­tic­ing ru­rally.

“We know one an­other very well as a team when we work ru­rally to­gether,” Gra­ham said. “You don’t have to won­der who saw your pa­tient, who might see your pa­tient, be­cause there’s only one of them.

“So I like to think of our com­mu­nity as right sized. We’re large enough to have the main in­ter­dis­ci­plinary pro­fes­sion­als, but we’re small enough to know one an­other and trust and re­spect one an­other.”

Gra­ham said, “our sys­tem is a sys­tem of pri­mary care”.

“At the hospi­tal, all the doc­tors who work at the hospi­tal are fam­ily doc­tors,” she said. “We know pa­tients are best cared for when they re­ceive care close to home. Peo­ple have their fam­ily mem­bers close by, the physi­cians and nurses know the pa­tient.

“And it’s re­ally those re­la­tion­ships with pa­tients and the con­ti­nu­ity of care that’s re­ally spe­cial and helps the per­son get bet­ter. I can see the pa­tient in my of­fice, I can see the pa­tient in the emer­gency room, on a home visit, if that pa­tient is ad­mit­ted to a per­sonal care home or a long-term care home, I can fol­low that pa­tient. They’re not see­ing dif­fer­ent doc­tors.”

Gra­ham said it’s chal­leng­ing to co-or­di­nate all th­ese as­pects, but that it is very re­ward­ing to see the pa­tient in dif­fer­ent set­tings and to see the pa­tient and his/her fam­ily. “There’s just such an op­por­tu­nity to work with the big­ger com­mu­nity at large,” she said.

Health care re­form

Health care re­form is an area of par­tic­u­lar im­por­tance to Gra­ham. She hopes more doc­tors will seek out roles to help shape and de­fine the fun­da­men­tal pol­icy guid­ing the health care sys­tem.

“I re­ally en­cour­age physi­cians to be in­volved with their com­mu­ni­ties in terms of serv­ing their com­mu­ni­ties be­yond their clin­i­cal prac­tices,” Gra­ham said. “I’ve been in­volved with hel­met use, with schools to de­velop ana­phy­laxis pol­icy in school, fam­ily medicine re­form.

“When we get in­volved with health pol­icy, work that pa­tients don’t al­ways un­der­stand be­cause it takes you out of the of­fice some­times, when you get in­volved with that type of work, it makes more of a dif­fer­ence for more peo­ple. Some­times we have to spend time at some­thing else out­side of the clinic but it’s re­ally for the bet­ter­ment of the com­mu­ni­ties.”

“We’re of­ten try­ing to get help for our pa­tients to be told, ‘I’m sorry, we re­al­ize this pa­tient has a need, but we can’t help your pa­tient be­cause your pa­tient doesn’t fit our cri­te­ria.’”

Dr. Wendy Gra­ham

SUB­MIT­TED

Dr. Wendy Gra­ham won a Ru­ral Ser­vice Award April 13.

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