On November 15, 2016, the Joint Standing Committee on Rural Issues (JSC), along with its partners, UBC and the Rural Coordination Centre of BC (RCCbc), announced a $5M endowment for the Rural Doctors’ UBC Chair for Rural Health. The monies for the chair were generously provided through the Joint Standing Committee on Rural Affairs (JSC) to help provide academic leadership in rural affairs and establish relevant rural research.
The announcement took place in Prince George and featured comments from: Dr. Terry Lake, Hon. Minister of Health, BC Government; Dr. Alan Ruddiman, President, Doctors of BC and Co-Chair of the JSC; Dr. Dermot Kelleher, Dean, UBC Faculty of Medicine; Dr. Granger Avery, President, Canadian Medical Association and Chair, Rural Issues Committee, Doctors of BC; and Dr. David Snadden, the Rural Doctors’ Founding Chair in Rural Health. Videos of the announcement are available online.
In addition to the $5M endowment, the JSC committed to providing $350,000 of funding per year over a period of five years to support operational costs, the development of a Dean’s Advisory Committee on Rural and Remote Health and a distributed provincial rural research presence. Working together with the UBC Chair in Rural Health and in collaboration with partners and a broad range of stakeholders, the advisory committee and rural research network will focus on activities, including strategic directions, policy needs and research/innovation, on issues relevant to the health of BC’s rural and remote citizens. This tripartite initiative is expected to address issues such as access to care, recruitment and retention of health professionals, generalism, enhanced skills training, research and evaluation essential to health human resource planning, health systems and policy research and other issues as appropriate.
Several rural physicians have already clearly sent a message to Snadden that they view the Founding UBC Chair in Rural Health primarily as an advocate who will ensure that rural issues are high on the agenda within different institutions and hospitals. “A Chair in the academic sense is someone who focuses on research,” says Snadden. “In this case, research can mean many different things: it can be the research of discovery, the research of interpretation, the research of education, the research of healthcare policy and system improvement.” Snadden commented that notable innovations are already taking place in rural BC, citing telehealth, chronic disease networks, and GP Oncologist managed care for cancer treatment as three examples of successful initiatives that bring care ‘closer-to-home’ for rural patients. “There are many, many opportunities for BC’s rural physicians to ask ‘what else do we have to tell each other or the world?’” says Snadden. He remarked that shepherding an idea through a formal research process to publication takes a lot of time. “It’s nice to have someone walking that with you who’s done it before, for whom it’s relatively straightforward.”
In addition to supporting BC’s aspiring rural researchers, Snadden is also looking at ways to build capacity for rural physician research in the context of busy practices, and remote distances from UBC’s Faculty of Medicine. Snadden encourages BC’s rural physicians to share their thoughts and ideas with him about their ideas for innovation, research, advocacy, and building community capacity for all of these important activities.
“A rural chair is independent,” says Snadden, “so when people are fighting against the system, those of us in the academic sector are neither on one side nor the other – we bring a more impartial voice, which is a strength.” He welcomes the input of rural physicians regarding what topics to research, noting that when he listens to many people, common issues or themes come up. “The real research questions are those that rural physicians who are working in rural BC are going to tell us about, not what I’m going to dream up.”
Although Snadden will not be driving the research agenda of the UBC Chair in Rural Health, he is an experienced researcher who recently completed data collection for a qualitative project exploring how rural practitioners and the rural practice environment are changing and interacting. During his study, he spoke with over 40 rural physicians and healthcare providers throughout northern BC and Yukon.
“It’s not really clear in my own mind what the data is telling me,” he says. “I see the system adapting towards what I see as a generational change, for a whole variety of reasons. Young doctors are working just as hard as their predecessors, but the environment they are working with has changed a lot, and the expectations have changed.” When Snadden completes his data analysis, he will try to determine how to use this information to positively impact rural healthcare recruitment and retention.
“Clinical work is different – there’s more complexity now than there was 20-30 years ago. Expectations of what you’ll do as a physician and how you’ll do it has also changed.” Snadden views these changes as creating certain challenges, but observes that “in rural areas, working with limited resources, you can never determine with certainty what the outcome’s going to be, because of weather, transport and other factors.” Snadden is calling for BC’s rural physicians to support students and residents in learning to be comfortable with the uncertainties of generalist practice as one of the first steps in encouraging new graduates to consider the excitement of careers in rural practice..
If you would like to contact Dr. David Snadden with a suggestion or to learn more about how you can become involved in rural research, you many email him at firstname.lastname@example.org.