As he settles into his fourth week at the Steelhead Medical Centre, Dr. Chris Chandler says he is struck by how many health services Houston has to draw on.
In that respect, it's a world apart from Île-à-la-Crosse, the aboriginal community in northwest Saskatchewan where Dr. Chandler practiced family and emergency medicine for the last 15 years.
"Especially compared to B.C., you realize northern Saskatchewan is very poor," he said. "But the enjoyable thing about that practice is the way that people made up for the lack of resources there."
On a map, Île-à-la-Crosse looks like a neatly arranged village of 1600 people, all collected onto the tip of a peninsula that juts out 18 km into a huge lake.
The village has a large hospital, but it serves 12,000 people scattered across northwest Saskatchewan and the nearest specialist of any kind is 500 km away in Saskatoon. Just one physiotherapist—his wife—was practicing in the entire region.
Dr. Chandler said the doctors, nurses, home care and other health care workers in Île-à-la-Crosse make it work by adopting a "team health" approach. They manage patients collectively, relying on one other to fill in any gaps.
"That's a big part of my practice and my background, so I'm eager to be involved with any sort of health teams here," he said.
In fact, Dr. Chandler said that B.C. is better organized for collectively managed care. His biggest challenge starting here will just be getting to know everyone.
"I've been practicing for 15 years now, and medicine isn't the hard part—the hard part is logistical stuff," he said. "You realize pretty quickly that you're not that helpful to people unless you know how to tap into the other health players. Physicians on their own aren't much help to anyone."
At the Steelhead Medical Centre on 9th Street, Dr. Chandler will work alongside Dr. Woodstra and Dr. Merkel, taking on some of the patients who had been with Dr. Morrie before he retired last winter.
"That basically doubled their workload, or more," he said. "I think that bringing an extra physician has taken some of the stress off that. I don't think it was sustainable for those guys to be managing that many patients for too long."
Waiting lists at the clinic are already down to a day or two, Dr. Chandler said, adding that the three family physicians will work to keep it as low as possible.
Born and raised in Saskatchewan, Dr. Chandler also trained there—first in family practice, then in emergency medicine. Before moving to Île-à-la-Crosse, he worked in the emergency room in a Saskatoon hospital.
He enjoyed the quick-thinking needed there, but he found himself drawn back to family medicine.
"I find it a lot more fulfilling to know your patients, to have a relationship with them," he said. "At the end of the day, that's what kind of keeps you going."
That kind of relationship also benefits patients, he said.
"That physician knows a little bit more about your history, the family structure that you come from, what your specific issues are," he said.
That continuity of care will be the key to Dr. Chandler's other new role here in town—looking after all the Houston patients who are admitted to the Smithers hospital with serious conditions.
Previously, patients from Houston would be managed by whatever doctor happened to be working in Bulkley Valley hospital. Now, Dr. Chandler will be there to admit them, and to follow-up with patients when they leave.
That's a huge benefit, he said, "because a lot of medical problems aren't solved in one visit. They're solved over time, and a hospital stay is just one piece of that."
When he is not practicing medicine, Dr. Chandler said he and his wife will enjoy raising their two young daughters here.
"I'd always sort of felt—since I was a university student travelling around the country—that the Bulkley Valley was an area that's about the right size," he said.
"I'm definitely not a big-city person," he added, but the area has just enough opportunities for a family with children at 6 and 3 years old.
"That was the main reason for our move," he said. :It was time for them to have more opportunities school-wise, and in extra-curricular activities too."
But as he gets his bearings on, among other things, the great skiing here, Dr. Chandler said he's also on the lookout for community activities he himself can join.
"The single most important thing for a family doctor is that you can't be a benefit until you understand something about a community," he said. "So I'm keen to be involved in any community things that are happening."
"People can let me know," he added, laughing. "The more I can get involved in the community, the better."