Skip to main content

Tag: Gavin Parker

Torsos of three medical staff with crossed arms. One in a white coat and two in blue scrubs.

Alberta’s health-care future front and centre at engagement sessions

The Alberta government is looking at changing the province’s health care, a system many describe as broken.

A series of in-person engagements began last week, hearing from health-care providers and community members on what the government called some of the challenges Albertans are facing.

Two of those gatherings were held Jan. 24 in Crowsnest Pass and Pincher Creek. Unlike a packed town hall meeting in August 2023 at Pincher Creek Community Hall, last week’s sessions can be best described as roundtable discussions.

“I think any time that there’s change there’s an opportunity, and with opportunity a chance for folks to participate, to contribute,” said Sarah Murrant, speaking on behalf of the province.

“What I understand, and why we’re running this entire process, is not every answer is there.”

Discussion during the two-hour event centred around topics including experiences and outcomes, but also on a proposed unified health-care system the current government says will enhance local decision-making and lead to early detection and intervention. Just what that might look like is yet to be determined.

Chelsae Petrovic, MLA for Livingstone-Macleod, feels any conversation must include patient care outside of the larger centres.

“It’s extremely important that we look at rural health. That we start to see the unique challenges and some of the unique solutions that, maybe, can be brought forward,” she said.

 

 

A former nurse with 13 years in the field, Petrovic knows all too well about the challenges.

“I think it’s great to meet with front-liners, coming from that experience and understanding where they’re coming from. Being able to, I guess, sympathize,” she said. “And it was only seven months ago that I was in those same positions, so I really do understand.”

Some health-care providers at the Pincher Creek event, who didn’t wish to go on record, felt the agenda items lacked details and “weren’t sure what they were signing up for” in any future plan.

Dr. Gavin Parker, a local physician, agreed engagement is important, however.

“I think we have a system that has long failed Albertans, in particular the lack of investment in primary care and rural services. But if these conversations lead towards improving that, then it was time well spent,” he said.

One of the talking points zeroed in on Alberta’s burgeoning population and the added stress it’s putting on the health-care system.

Parker acknowledged there’s more at play.

“I think what you’ve seen in the last few years is not only an exodus of family physicians in the province or people going into early retirement, but also changing the scope of their practice.”

 

 

He said the end result is less focus on primary comprehensive care and more doctors working toward a niche practice.

“Until we train, pay and support rural family physicians better, the situation won’t change,” he said. “The problem is we’re running into a dearth of physicians who are trained as rural comprehensive physicians, and when they are trained they aren’t compensated adequately.”

Parker also noted a drop in specialty practices, like maternity, declining to less than 50 per cent in the south zone compared to when he started his training.

“So, these young doctors that want to provide comprehensive rural care, including maternity, feel utterly unsupported to do that right now because of the current situation,” he said.

The sessions in Crowsnest Pass and Pincher Creek were the second and third of more than 40 visits scheduled to communities across Alberta.

Although there aren’t further meetings scheduled for the southwest region, a complete list of the remaining sessions can be found online and you can have your say here.

 

Ad for Aurora Eggert Coaching in Beaver Mines

 

Ad requesting memorabilia from CNP music festival

Heading for My Little Corner and editorial by Shannon Peace

‘It’s crumbling around us as we speak’

Should there be public consultation when changes affecting health care are proposed? Should there be an opportunity to ask questions? Should we be concerned when budget cuts could drastically affect our community?

I asked these questions in a March 2020 article after Pincher Creek physicians voiced concerns about budget changes at a community town hall.

A key point, one I hadn’t considered before, was that rural family medicine practices are small businesses with fixed costs. And when cost outweighs income, changes must be made for a practice to remain viable.

Financial costs aren’t the only consideration. At the time, Dr. Jared Van Bussel referred specifically to potential changes to maternity care and the cost of losing it. His concerns have not changed.

He also noted that disruptions to maternity care and individual health services impact the viability of the community.

A month later, Associate Clinic physicians announced a planned withdrawal of hospital-based services to come in 90 days. The move was prompted by a continuing lack of trust between doctors and Alberta Health, and ongoing uncertainty for the future. The uncertainty was not just for the physicians themselves but for their staff, patients and community.

 

Ad for Sara Hawthorn, Pincher Creek and Crowsnest Pass realtor

 

The point hit home, and Pincher Creek rallied around its doctors. Letters were sent to government officials and a drive-by rally was held in June.

At the same time, Covid-19 was moving in, stretching local, provincial, national and global medical care to its limit.

Negotiating a master plan between the Alberta Medical Association and the provincial government piled even more pressure on Alberta’s medical professionals.

In October, local physicians chose to continue working in the emergency room and hospital rather than withdrawing those services. The community gave a collective sigh of relief, but problems remained unsolved.

By April 2021, a tentative master plan from Alberta Health had been brought forward and voted down by AMA members. Tyler Shandro, then minister of health, had also been to Pincher Creek to meet with Associate Clinic doctors, who were cautiously optimistic that agreement could be found.

It was September 2022 before a new funding contract was agreed to between AMA and the province.

The number of doctors at the clinic began to decline. Some retired while others chose to pursue careers elsewhere.

Finding replacements continues to be a challenge. Meanwhile, the cost of operating the clinic remains.

As we have all seen the cost of living rise dramatically, the cost of running any kind of business has increased as well.

To put this in perspective, as with any business, the financial burden on each partner increases substantially when the number of partners declines.

Speaking from personal experience, the stress and workload also increase significantly when staffing changes occur.

 

 

Let’s take stock of what we have in Pincher Creek.

We have a clinic and hospital providing continuity of care under one roof, personal relationships with physicians, an anesthetist and a surgeon, and even a CT scanner. Most importantly, we have a team of family doctors providing comprehensive care.

We also have our medical community working in difficult circumstances and likely losing hope for positive change. The emergency department was closed overnight twice in July due to a shortage of physician coverage.

About 800,000 Albertans do not have a family doctor, a situation especially dire in rural areas.

Our community has amazing medical resources, which are easy to take for granted, but a lack of stability under the very foundation of our health care system leaves it in danger of caving in.

“It’s crumbling around us as we speak.”

Dr. Paul Parks, president of the Alberta Medical Association, spoke those words Tuesday morning while sharing the results of a family and rural generalist physician survey conducted last week.

Asked to put the current state of affairs into medical terms, he likened it to a mass casualty that is bleeding out. The bleeding needs to be stopped and the patient stabilized.

Only then, once the chaos has passed, can treatment proceed.

 

Ad for Blinds and More in Pincher Creek and Crowsnest Pass

 

About 30 per cent of Alberta doctors participated in the AMA survey. Most have been practising for 11 or more years and 43 per cent are dealing with 1,000 or more patients.

Of respondents, 21 per cent feel their finances can sustain their practices for up to a year, while 20 per cent say they are unlikely to be viable beyond six months and eight per cent say only three months.

While $100 million of federal assistance earmarked for stabilization was announced in December, Parks says “not one cent has flowed to family physicians yet.”

He also noted that financial assistance is available immediately when there are wildfires and other emergencies. The health-care crisis, which physicians and their association have been red-flagging for over a decade, has yet to trigger the same response.

The old model needs to evolve because physicians are leaving Alberta for greener pastures where governments are responding to the crisis. Actions must match promises so health-care workers and all of us can look forward with hope.

If we sit quietly and say nothing, the system will continue to crumble, with disastrous consequences.

At a town hall last May, Dr. Gavin Parker said, “If you want to find someone who can fix this, find a mirror.”

On its website, Alberta Health says, “The future of health care is in your hands.”

Alberta Health is holding public engagement sessions in Crowsnest Pass at 10 a.m. today and in Pincher Creek at 5 p.m. Registration is required.

TODAY!

This long backstory leads to a strong call to action.

If you are concerned about a crumbling health-care system, please register for a session.

Have your say — your life may depend on it.

 

 

Table setting of wedding venue — the Cowley Lions Campground Stockade near Pincher Creek in southwestern Alberta.

 

 

Funeral announcement for Rick Brasnett

Richard (Rick) Sterling Brasnett

It is with great sorrow that we announce the passing of Richard (Rick) Sterling Brasnett on July 14th, 2023, at the age of 73.  Rick passed peacefully at his home, surrounded by his family, after a courageous battle with cancer. He was born on February 9th, 1950, in Middleton, Nova Scotia, to Fred and Mary Brasnett.

His presence will be greatly missed by his best friend and eternal companion, Lynn Brasnett; his children Christina Brasnett, Charlotte (Greg) Stene, Kacey (Jay) Brasnett-Lilburn, Sariah (Tyson) Hendernett, Dustin (Jody) Brasnett-Shields, Nikara (Derek) Wood, and Sammy (Travis) Shyback; as well as his 23 grandchildren and five great-grandchildren; his sister Sandra Freeman; and many others who called him family or friend.

Rick is having a joyous reunion with those he was predeceased by — his parents Fred and Mary Brasnett, his daughter Lacey Mary Elizabeth Brasnett and several friends that he also considered family.

Rick spent the majority of his life in oilfield construction, where he made numerous friends over the years and mentored many. He enjoyed spending time black-powder shooting and riding his Harley, holding close all of the people he met along the way through these hobbies.

A funeral service will be held on July 22, 2023, at the LDS Church, 1240 Wentworth Ave. in Pincher Creek, Alta.  Meet the family at noon, funeral service at 1 p.m. with lunch reception to follow. Interment will follow at 4 p.m., at the Fairview Cemetery.

The family would like to extend their gratitude for all the care Rick received from the Pincher Creek hospital and staff, Pincher Creek Emergency Services and Jack Ady Cancer Centre Staff. A special thank you to Dr. Gavin Parker for his kindness and care!

In lieu of flowers, please consider donating to Pincher Creek Emergency Services.

Dr. Akarakiri, a young black man with short hair, moustache and trimmed beard, outside Pincher Creek's Associate Clinic

New doctor joins staff at Pincher Creek hospital, clinic

Pincher Creek has a new doctor, and he plans to stay for years to come. 

Dr. Kunmi Akarakiri, a Nigerian expat with over 10 years’ experience in rural medicine, is a welcome addition to Pincher Creek Health Centre’s ER and neighbouring Associate Clinic, where a handful of GPs have held the fort for years. 

His arrival in mid May brought the number of full-time docs at the centre and clinic from five to six, according to the clinic’s executive director, Jeff Brockmann. 

Another doctor had joined both rosters in the new year, but is no longer practising at the clinic. 

“The adaptation for me has been very easy,” Akarakiri told Shootin’ the Breeze.

It took him a little over a year after landing in Canada in December 2020 to clear most of the regulatory hurdles set by Alberta’s College of Physicians & Surgeons. 

“I was lucky,” he said, noting that the process can take two to three years for many foreign-trained GPs. 

He’d never seen snow before passing his first winter in Kamloops, B.C. 

“When I got there, I thought to myself, ‘The snow is bad. But it’s not that bad.’ Then I moved to Calgary,” he said with a laugh.

If the white stuff was bad west of the Rockies, it wasn’t long before he suffered a minor case of frostbite in Cowtown.

 

 

When he toured Pincher Creek with ER chief Dr. Gavin Parker last August, the only concern he left with had to do with the town’s notorious chinooks. 

“I was told that, sometimes, the wind can blow against you,” he told the Breeze in what has to be the understatement of the year. 

It remains for him to wrap up the college’s supervised practical experience, which Brockman explained will be monitored by a doctor from outside the community, in order to avoid any conflict of interest. 

Akarakiri said he then hopes to sign a five-year contract with Alberta Health Services. 

In the meantime, he plans to settle into his new rental — a rare find in a small town that’s up against a housing crunch — and then welcome his wife, Hephzibah, and their young daughter, Megan. 

“It’s a nice community,” he said, complimenting Canadians’ friendliness and easy-going nature. 

Akarakiri graduated medical school in Nigeria in 2012. He practised rural medicine for seven years in the southwestern town of Ile-Ife before moving to Canada, he told the Breeze. 

Learn more about Dr. Akarakiri in this episode of The Innovative Practitioner.

 

 

Woman with shoulder-length dark brown curly hair speaks into a microphone as one other woman and two men look on

Pincher Creek health-care forum draws large audience

Alberta’s rural health-care system needs more public funding, more efficiency and much more local autonomy, residents and esteemed panellists said at Pincher Creek’s health-care forum in late April.

Upwards of 150 people came for a one-hour discussion that saw residents, politicians and one riding candidate engage local doctors and public health policy researchers from the University of Calgary.

Between panellists who said the status quo isn’t holding and residents who said they felt ignored by the province, the conversation registered an uneasy mix of frustration and hope for the future. 

‘If you want to find someone who can fix this, find a mirror’

Drs. Gavin Parker and Kristy Penner, both of whom practise family and emergency medicine in Pincher Creek and neighbouring Crowsnest Pass, repeatedly called for more community involvement. 

“If anybody can help solve this, or at least start to work on this, it’s the people in this room,” Parker started off. 

“I do think there is hope,” he continued, qualifying in the next breath that “Clearly, what I’m doing and what we’re doing isn’t working.”

Penner’s prognosis was no less sparing.

“If we keep doing the same thing, we’re only going to be waiting longer” for routine medical services, she told the packed forum, painting graver implications for women and the elderly. 

“You’re going to have to leave [home] to have a baby — you won’t be able to get surgery in Pincher Creek or Crowsnest Pass. You won’t be able to get home care or long-term care in your community. And as a senior, you’ll have to move out of your community to access long-term geriatric care.”

The College of Physicians and Surgeons of Alberta is working to fast-track foreign-trained doctors’ credentials, while licensed practical nurses are picking up the slack at Pincher Creek’s medical clinic, according to Parker.

But the system can’t build capacity when there aren’t enough doctors to train med school graduates, much less foreign doctors. 

“Our voice is stronger when it’s collective,” Parker said, acknowledging the residents on Pincher Creek’s Attraction and Retention Committee, the citizen/council body that helps settle incoming doctors within the community, among other functions.

Parker also noted that Albertans who work outside of medicine make up a significant proportion of the CPSA’s board of directors.  

“So, if you want to find someone who can fix this, find a mirror. That’s who,” he said. 

It’s Friday night: Do you know where your MLA is?

Audience speakers questioned how civic participation could reverse the Government of Alberta’s concentration of authority in a sclerotic Alberta Health Services, the provincial health authority that executes government policy. 

“I’ll vote for any party that starts taking that system apart and returning power to the community so that we can make a difference with some of the things you’re asking us to make a difference on,” one speaker said. 

Another speaker noted that United Conservative MLA Roger Reid, who represents Livingstone-Macleod, was conspicuously absent. 

“Where’s our MLA?” the speaker asked, drawing groans from the crowd.  

“Is anybody from the Alberta government here?” another speaker asked. “Maybe that’s part of the problem,” the speaker suggested, drawing thunderous applause.

In the crowd were town Coun. Sahra Nodge, MD Coun. Dave Cox and Reeve Rick Lemire, and a host of doctors and nurses from Pincher Creek Health Centre. 

The NDP’s Kevin Van Tighem, the only riding candidate to show, suggested that Pincher Creek has the talent and the grit to restore the health centre to a model of rural health care. 

“Do we have to change ourselves? Or can we change medicine so it fits into our community without the community changing?” he asked from the mic. 

The UCP’s 2023 provincial budget funds public health care to the tune of $24.5 billion, a roughly four per cent annual increase. This year’s budget includes $105 million for capital projects under the UCP’s Rural Health Facilities Revitalization Program. 

Don’t expect a quick fix 

Funding and educational programs need to deliver a robust, “team-based” rural health-care model that empowers Indigenous and rural learners to practise medicine, Dr. Penner explained. 

More immediately, Penner said, doctors-in-training have complained about a lack of affordable housing and limited child-care options in Crowsnest Pass.

Melissa Fredette, a registered nurse at the health centre, vice-chair of the town’s Attraction and Retention Committee and mother of three, implored the community to promote Pincher Creek as a career destination for young health-care providers. But Fredette and her colleagues need more local support.  

“We’ve just come out of a pandemic. We’re tired in health care,” she said. “We would love to have more help from the people here.”

Once it’s gone, it may never come back

Aaron Johnston, associate dean of rural medicine at the U of C, warned after the forum that many rural health-care teams are on the verge of collapse. 

An under-resourced team “works until it doesn’t work — until there’s the loss of that last one person,” he said. “Lose a rural anesthetist and say goodbye to that town’s surgical team. Lose a team, and good luck restoring the services it was designed to provide.”

“Imagine how difficult it is to recruit 10 highly-trained medical staff at the exact same time,” he suggested, “because that’s what it takes to reboot these services once they’re gone.” 

Male with short, dark hair and woman with dark dark hair and cap, stand in front of an ambulance. Both are dressed in navy blue uniforms. Pat Neumann is the Pincher Creek fire chief and Sariah Brasnett is deputy-chief.

Wait times at urban hospitals tying up Pincher Creek ambulances

Increasing wait times at urban hospitals are delaying treatments for patients transferred by Pincher Creek Emergency Services’ ambulance crews and tying up paramedics, PCES Chief Pat Neumann told Shootin’ the Breeze.

Neumann said PCES crews have long experienced these delays at Calgary hospitals, especially at Foothills Medical Centre, which Neumann said handles most of the cardiac emergencies, advanced heart treatments and diagnostics, and complex traumas within Alberta Health Services’ south zone.

But similar bottlenecks have hit the Chinook Regional Hospital in Lethbridge, which also takes routine and emergency patients from Pincher Creek and surrounding areas, and where Neumann said PCES crews have consistently reported emergency room delays since last summer. 

“Lethbridge is terrible now” for wait times, Neumann said.

“It’s to a point where, unless they actually are admitting the patient to the ER right away, (PCES crews) are typically waiting every time they go now.”

 

 

A return trip to Calgary will tie up a PCES ambulance crew for at least five hours, with crews spending at least three hours on trips to and from Lethbridge, the chief explained.

The department has two ambulances. When one has to travel to and from Calgary or Lethbridge, “That only leaves one ambulance in this community to do any other urgent transfers going out of this area, or to respond to any other emergency call,” Neumann said. 

Longer waits are the norm when urban hospitals increasingly provide routine treatment and diagnostics for rural patients. At the same time, Neumann said his crews now attend calls from town residents struggling to access primary care.

“We’re picking people up that are going to the (Pincher Creek) Health Centre because they don’t have a doctor. They don’t know what else to do to get the services they need.” 

 

 

 

Patients are showing up at the health centre sicker than they might have been if they’d had regular care from a family doctor, and the problem “compounds itself” as the hospital’s doctors and nurses scramble to fill the gap, Neumann explained. 

Six doctors now work at the health centre and its attached medical clinic, down from 11 several years ago, according to the clinic’s executive director, Jeff Brockmann. (Dr. Gavin Parker manages the health centre’s ER.)

Local ambulance calls have more than doubled since Neumann started at PCES roughly 20 years ago, with hospital transfers up by a similar margin. Crews that responded to just under 750 calls in 2005 were handling over 1,500 in 2018. Transfers meanwhile climbed from around 350 to just over 600 in the same period, according to PCES statistics. 

 

Ad for Dragons Heart Quilt Shop in Pincher Creek

 

The town’s population held at around 3,700 for much of that time, but shrank to around 3,400 by 2021, according to the Government of Alberta’s online regional dashboard. 

Just over 25 per cent of residents are 65 or older — a slight proportional increase over 2016, according to Statistics Canada’s 2021 census. As Neumann suggested, the town isn’t getting bigger — it’s getting older.

In response, Health Minister Jason Copping said the Alberta government is investing in rural health care. 

Copping said at a media roundtable Monday that the province had put up $1 million to explore options to train doctors at the University of Lethbridge and nearby Northwestern Polytechnic. 

 

 

“We recognize that we need to train and hire locally, and by getting those seats out in rural Alberta, the more likely that (graduating doctors) are going to stay,” he said.

Copping stressed that Alberta’s United Conservative Party provided many more millions in budget 2022, including the UCP’s new collective agreement with Alberta’s doctors. 

The province further hopes to attract foreign doctors by “leveraging immigration.” Seventeen doctors from outside Canada have agreed to work in Lethbridge, with some already working there. 

“I can tell you more is coming.… So, stay tuned,” Copping said. 

 

 

Alberta Health Minister Jason Copping giving bill 4 announcement from a podium in front of a background of provincial and Canadian flags.

Bill 4 announcement met with skepticism at Pincher Creek hospital

 

Pincher Creek’s chief doctor remains skeptical about prospects for an enduring partnership between Alberta doctors and the provincial government after Bill 4 announcement.

Dr. Gavin Parker, community medical director at Pincher Creek Health Centre, spoke with Shootin’ the Breeze Dec. 5, shortly after Health Minister Jason Copping vowed to repeal the province’s authority to unilaterally scrap its funding commitments to the Alberta Medical Association, which represents roughly 1,600 practising physicians across the province.

Copping said the Alberta Health Care Insurance Amendment Act, 2022 (Bill 4) heralds “a collaborative environment founded on mutual respect and trust” more than two years after the United Conservatives, under then-premier Jason Kenney, ended the AMA’s contract and imposed a new one.

The amendment, which Copping endorsed alongside AMA president Dr. Fredrykka Rinaldi, underscores a deal that the two sides brokered over the summer and which was ratified in September by 70 per cent of doctors, Copping said.

The UCP government will undo section 40.2 of the original act, used by former health minister Tyler Shandro in February 2020 to terminate the AMA’s last contract. In return, the AMA will drop its pending lawsuit against the government.

The proposed legislation comes roughly a week after Edmonton removed a cap on the number of daily patient visits that doctors can charge to Alberta Health Services.

 

 

The amendment pledges $750 million to “stabilize the health-care system” over the next four years, delivering a more than five per cent pay bump for family doctors. It also holds out “the potential” for binding arbitration should future contract negotiations break down, according to Copping.

Rinaldi thanked Copping for making a show of good faith, but stopped short of a glowing prognosis.

“It’s a step in the right direction, but it’s not a panacea,” she told reporters. 

Over at Pincher Creek Health Centre, Dr. Parker was less optimistic. Most of Bill 4’s substance had been hammered out months earlier, he said. Meanwhile, the medical community is perhaps less willing to trust the UCP than Copping let on.

“That’s great that they’ve said they’d take (section 40.2) off the books. But, I don’t think we can safely assume this kind of legislation will never come back,” Parker said. 

The health centre and attached medical clinic now have five full-time doctors, less than half of the 11 docs that were on-staff when Shandro tore up their contract.

 

Ace of spades card on ad for Chase the Ace at the Pincher Creek Legion

 

“It was pretty disastrous at the time,” Parker remembered.

Two doctors left the health centre to practise in urban centres in Alberta. One left the province altogether, highlighting the AMA’s aborted contract in their resignation letter. Others left to retrain in other medical specializations, while another doctor retired, according to Parker.

The health centre has recently brought on extra staff and “Alberta is still a great place to practise medicine,” Parker said, noting that doctors are paid well.

Surgeries are still performed at the health centre. “We’re one of a few places that still provide obstetric care,” while there’s none to be had in neighbouring Fort Macleod or Cardston, Parker said.

And the clinic has held on to its patients, despite the shortage of doctors.

“But, it’s been really tough,” Parker said, “because we haven’t been able to provide the same level of service and efficiency that people have come to expect.”

 

 

Emergency room patients with routine health concerns can wait up to eight hours to see a doctor if that doctor is busy performing a cesarean section, he said.

The health director also praised former health minister Shandro for his role in bringing a new CT scanner to the health centre.

“I’m glad to see the province’s finances are better now than when we were looking at contract negotiations a few years ago,” Parker said.

Watch news conference