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Yukon doctor shortage solution could be homegrown

In a territory where the value of doctors is appreciating faster than gold, Alisa Kelly is platinum.Mayo-born, the 30-year-old represents much more…

In a territory where the value of doctors is appreciating faster than gold, Alisa Kelly is platinum.

Mayo-born, the 30-year-old represents much more than academic achievement against odds and the pride of the Vuntut Gwitchin, her First Nation.

When Kelly graduates from McMaster University medical school in May, 2009, she will affirm Yukon is capable of nursing its own doctor shortage with a home remedy.

A nervous giggle betrays her awareness of how much is wagered on her success, but it is quickly overcome by a bold, perhaps more recently-adopted confidence that matches her striking features and strong, tall frame.

“As an aboriginal kid, nobody ever said to you, ‘You can be a doctor or you can be a lawyer; you should go do this,’” recalls Kelly, who, at the age of eight, moved with her parents to Campbell River, British Columbia.

“That was never suggested as an option for me, so it took me a long time to figure out that I could actually apply and I could actually get in, and it is something that I could do.

It took me a long time to wrap my head around that.”

The daughter of a Vuntut Gwitchin nurse and a New Zealand man who had come to Yukon to mine at Elsa, Kelly began her post-secondary education at the University of Victoria, where she eventually received a degree in anthropology.

But medicine continued to call Kelly, who has always been intrigued by wellness and healing.

“For a long time, I tried to find different ways how I could incorporate that in my life,” says Kelly, whose friends encouraged her by way of introducing her to doctors and professors from medical school.

“The more physicians that I met and the more I saw what they were doing with their lives, and how they were practising medicine, I began to be more interested.”

While living in Vancouver for five years following her first degree, Kelly explored her interest in medicine through working on a series of unique aboriginal health projects funded by the federal government’s Greater Urban Aboriginal Strategy.

The funding paid the way to publish a magazine targeted at HIV/AIDS, to establish the Vancouver Native Health Centre and an early childhood development centre for First Nations, and a dozen other related projects.

The experience, as well as the study of Native health care in other countries, gave Kelly a view how important it is to make First Nations patients feel comfortable with and trust their doctors.

“Cultural sensitivity: it’s making health care environments more accessible to the indigenous people,” she says.

Originally deterred from medicine by images of white coats, stethoscopes and big hospital settings, Kelly now hopes to devote a significant amount of her practice to working directly in the communities and on projects outside the hospital.

“I think it’s finding that balance,” she says.

“How you communicate with your patients, how you involve yourself in the community, how you practise medicine.”

Although as yet undecided about her specialization, Kelly finds herself drawn to pediatrics.

It will be the up to the likes of Whitehorse family doctor Ken Quong, under whom Kelly is training for the next few weeks, to sell her on general practice in Yukon.

A past president of the Yukon Medical Association, Quong meets several new doctors per year from across the country at his Klondyke Medical Clinic in downtown Whitehorse.

Through a territorial government program designed to attract more doctors, Klondyke is now an official teaching centre for the Rural Alberta North Family Practice Program of the University of Alberta in Edmonton.

“They can get some really good experience, and they can see how fun it is to practice medicine here,” says Quong of the students.

“GPs can do so much more here. You can do as much here as you’re comfortable with.

“That is not every general practitioner’s dream, but it makes your job really challenging and interesting, and every day you’re seeing something new, right?”

If Quong and other physicians at Whitehorse General Hospital, which prides itself on a staff of doctors who provide “full spectrum care,” can show Kelly how satisfying, challenging and rewarding it is to doctor in Yukon, she will come back to stay, he says.

And it would not take many more like her to greatly ease the need for physicians, for now at least.

But the next five years will mark the beginning of a serious shortage, as up to a third of boomers like Quong are lured to retirement.

Although she is two years from writing her licensing exam, Kelly plans to return home to practice.

“It’s been great,” she says of her practical training so far.

“I’d like to come back to the Yukon.”

It was an easy sell for Quong, a born and raised in Yukoner and father of two.

He spends a significant amount of time every year hunting, fishing, and photographing birds and, in partnership with several others, has recently acquired a trapline.

“I told Kathleen that I wanted to die on a trapline on the Pelly River,” he smiles.

“She said, ‘Well, I’ll come and visit you periodically.’”

There is a deeper sense of trust given to doctors who have been raised locally, because of their familiarity, and their culture, says the Chinese Canadian, who graduated from medical school in 1987.

“When I worked in Baffin, most couldn’t distinguish me from the Inuit people,” he says. “They always wanted to see the ‘Inuit’ doctor over my wife (anesthetist Kathleen Dalinghaus), who’s white.

“She’s a lot smarter than I am, but they wanted to see me, because I’m the same skin colour. It’s like you sort of have some common ground, common assumptions, common attitudes before you even start the interaction.

“I think that practising medicine, the fundamental value for all of us is that it’s a privilege. It’s a privilege to be trusted to care for people and their lives and their families.

“It’s a huge privilege. It goes beyond what most any other person in society is given. But it’s even a bigger privilege when you can come to the community that you grew up in, that you were born and raised in, and be given that trust.

That’s the common thing that Alisa and I have. She has a connection here, I have a connection here, and we both have this huge privilege.”

But both doctors also embody a higher standard for recruitment and retention, in the face of fierce ethical debate over the practice of poaching health care professionals from abroad.

Delegates from the filthy-rich province of Alberta, in a single, recent and typically myopic shopping trip to South Africa, wore out their welcome for good when they returned with 55 of the nation’s doctors.

“The next time they tried to go there, they were banned from the country, because they were seen as coming in and stealing the doctors,” says Quong. “Shifting doctors around the globe isn’t really the answer.”

The practice is unsavoury not only for the most apparent reason, that it plunders an impoverished, disease-ravaged country of its health practitioners.

It also casts a glaring light on the notion that perhaps a country as wealthy as Canada does not pour sufficient financial and educational effort into the nurturance of its own talent.

Despite assistance she receives from First Nations and territorial government programs, should she pursue her ambition of pediatrics to fruition, Kelly will begin her career with a minimum $150,000 debt, predicts Quong.

“By doing this, I would like to say to other kids ‘you can do whatever you want to do. Just because it seems like there are all these roadblocks in the way, it doesn’t mean that they can stop you,’” says Kelly.

“So, I don’t know if I’m necessarily a role model, but hopefully it encourages people to let go of that hesitation, to encourage other kids to do the same thing.”

Barb McLeod is a Whitehorse-based writer.