Taking the roundabout route: Dr. Clayton Reynolds’ entry into rural specialist practice

ReynoldsWhen Dr. Clayton Reynolds of Victoria, BC boarded his Vancouver-bound flight in February 2014, he didn’t realize his endocrinology practice was about to take an unforeseen turn.

During this February flight, Reynolds sat next to Laura Soles, coordinator of the Rural Emergency Continuum of Care (RECC) , RCCbc’s annual rural medical conference. While they chatted, Soles discovered that Reynolds was looking for a way to meet and network with BC’s rural physicians. He was already travelling to several rural communities to provide endocrinology consultations, but wanted to extend his services further afield. What he lacked was an easy, centralized way to approach rural physicians about setting up endocrinology clinics.

Before the flight landed, Soles had secured Reynolds contact information and asked him whether he’d be interested in presenting at 2014 RECC. Within a few short weeks, Reynolds proposals for two presentations were accepted, and he flew to Penticton, BC at the end of May, ready to meet rural physicians from across British Columbia.

While he was at RECC, his practice took yet another unforeseen turn: Reynolds attended Dr. John Pawlovich’s presentation on telehealth in rural and remote First Nations communities. After the session ended, Reynolds introduced himself to Pawlovich. Five days later, he was in Abbotsford, “shadowing” Pawlovich through a typical day in the latter’s home-based telehealth practice.

Reynolds was familiar with telehealth – in November 2013, he started providing diabetic, thyroid, adrenal, and pituitary videoconference consultations to patients in Masset and Queen Charlotte City. However, those visits were accomplished using health authority and/or hospital-based videoconferencing systems and were scheduled by the community well ahead of time. Pawlovich’s practice – where he may be consulted between 8:00 am – 5:00 pm by any of the five communities he serves[1], either from his home office or from his iPad – was a very different style of practice, and that held great appeal for Reynolds.

Shortly after his visit to Abbotsford, Reynolds reached an agreement with Carrier Sekani Family Services (CSFS), a First Nations health services provider, to provide telehealth services as a consultant. Like other CSFS physicians such as Pawlovich, Reynolds will provide videoconference consults, and then supplement that care with in-person visits to specific communities served by CSFS.

While serving First Nations communities in this capacity will be a new experience for Reynolds, providing fly-in specialist consults to rural patients has been a regular part of his practice for the last 10 years. Reynolds initial foray into rural care was yet another unplanned (but fortuitous) occurrence. His original intention in 2004 was to move to Victoria, practice for three or four years, and then retire from practice; however, he didn’t land the position he’d hoped to get. Undaunted, Reynolds spoke with Dr. Hector Baillie of Nanaimo, who confirmed that several Island physicians would be happy to refer their endocrinology patients to Reynolds. With that assurance, Reynolds and his wife pulled up stakes from Lancaster, California, and moved north, where he quickly set up specialist clinics in Nanaimo, Ladysmith, Mill Bay, and Victoria.

Two years after Reynolds’ move to BC, he had an illuminating conversation with one of his northern BC patients. When Reynolds told the patient about his aspirations for providing service to rural BC, the patient replied “why don’t you come up to Masset and do some clinics?” Inspired, Reynolds called providers in Masset, who noted that Queen Charlotte City needed a physician with his skills. Shortly thereafter, Reynolds found himself flying to Haida Gwaii.

Similarly, a chance meeting with Dr. Mike Kenyon of Nanaimo, BC at a retirement party led Reynolds to practice in Terrace, BC. Once Reynolds had secured a date for a visit to Terrace, he took out a map of BC to discover what other communities near Terrace he might visit and practice in. “I figured that since I was already in Terrace, I should see if anybody in the other communities wanted my help. Kitimat and Prince Rupert are all within a day’s drive from Terrace, so I called the physicians in those communities, introduced myself, and then flew up, and spent a week travelling between all three communities.”

In addition to the communities already mentioned, Reynolds also regularly visits Port Hardy, Alert Bay, Port McNeill, Smithers, and Fort Rupert (a First Nations community). He averages about 28-30 rural community visits per year, and plans to provide telehealth support to patients in these communities on a regular basis.

In September 2014, Reynolds will be celebrating his tenth year of medical practice in BC. When asked about his former retirement plans, he laughed and admitted that he loves his work and isn’t ready to relinquish it yet. “I want to be helpful to a wider community and extend my reach,” says Reynolds enthusiastically.

To contact Dr. Reynolds about providing endocrinology clinics in your BC rural community, in person or by telehealth, please email him using this link.

 

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[1] Pawlovich also provides 24/7 on-call services for the emergency room in Takla Landing

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