The Practice: Family Practitioners
Overview
Yellowknife Health & Social Services Authority (YHSSA) is one of eight health authorities in the Northwest Territories and has 31 full-time positions for salaried family doctors. YHSSA provides all family medical services to the community of Yellowknife and to two smaller communities within the Authority. It also provides physician services to three communities within the Tli Cho Community Services Agency, a proximal health authority. Services are delivered at four health clinics, an outreach clinic, in the outlying communities and at STHA's hospital in the ER, OB, OR and hospitalist services.
The close relationship between STHA and YHSSA may seem confusing; all family physician contracts in Yellowknife are administered by YHSSA.
Clinic Practice
Physicians, nurse practitioners, nurses and a broad range of other staff deliver primary health care through two Yellowknife clinics:
Frame Lake Community Health Clinic
Yellowknife Primary Care Centre
Services include:
- Health promotion, including healthy lifestyle promotion, maternal health, reproductive and child care and community development.
- Health protection and preventative services, including screening, intervention disease control, prevention of injury, prevention of chronic diseases and addictions, hearing and vision, early intervention.
- Emergency, acute and diagnostic services, including crisis response.
- Continuing care, including palliative care and long-term care.
- Developmental rehabilitation and support services, including mental health and addictions.
- Obstetrics, emergency room coverage, inpatient care, surgical assists and GP anaesthesia at Stanton Territorial Hospital (STH).
- Medical direction to other agencies, such as Aven Manor, City of Yellowknife - Fire Department.
- Regular physician visits to communities in the region, to other communities in the NWT and to selected communities in the Nunavut Territory.
Community Visits
YHSSA has two smaller communities within its mandate. Yellowknife-based family doctors supply medical services to those communities plus the communities within Tli Cho Community Services Agency (another of the eight territorial health authorities). This affords physicians the exciting opportunity to develop meaningful connections with northern people by gaining access to areas otherwise not easily visited. Community visits are either by car or small airplane and are sometimes an overnight excursion.
Obstetrics
There is a FP obstetrics group that consists of approximately 10 doctors. These physicians provide complete antenatal care and manage all risk levels (e.g. VBAC, diabetes, hypertension, and post-dates pregnancy). There are 600 to 700 deliveries per year in the catchment area that includes Yellowknife, much of the NWT, and parts of Nunavut. The group is supported by friendly 24/7 Obs/gyne specialist back-up and consulting services.
Emergency Department
The Emergency Room at Stanton Territorial Health Authority ("Stanton Hospital") is staffed by YHSSA physicians. The department has a core group of five CCFP-EM practitioners. Other FPs with an interest in emergency medicine also contribute. There are approximately 18,000 visits per year and the department also provides remote telephone support to outlying communities in the Northwest Territories and Nunuvut. Acuity varies widely and includes serious trauma.
Family Practice Anesthesia
YHSSA has funding for four GP/A physicians. These physicians, along with a FRCPC Anesthetist, provide service to the Stanton Hospital. Two operating rooms run full time Monday to Friday, 0730 to 1530 with a third OR occasionally open for dental surgery or visiting urology. FP/A's spend an average of 2-3 days per week in the OR depending upon how many are in town and how many OR's are running. When not in the OR, the FP/A's work in the ED or in one of the medical clinics. Call is usually 1:4, but varies according to how many from the Anesthesia group are in town.
Hospitalist Services
Family physicians in Yellowknife have a system of shared call known as a hospitalist service. There are parallel systems; one is comprised of physicians who are part of the OB group and the other is family physicians who do not do OB as part of their practice. The former is known as the Green Team and the latter the Blue Team.
BLUE TEAM: Manages all patients who either belong to physicians of this team or orphaned patients. Patients may be on the medical, surgical or pediatric units. A typical day starts at 0700 when the EP calls to inform of any overnight admissions. That is followed by rounds etc between 0800 and 1700. Between 1700 and 2200 it is possible that the Hospitalist may be called back if there are new admissions. From 2200 to 0700 there home-based call that would only come from the wards (the EP acts as MRP for new admits overnight).
GREEN TEAM: Acts similarly to the Blue Team, however they cover OBS patients as well.
