Spring 2020 (Volume 30, Number 1)

Regional News

Update from the Yukon

By B. Daniel McLeod, MD, FRCPC

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Rheumatology consulting services in the Yukon are provided by a visiting consultant allotted eight weeks of clinic time and reimbursement. The Territory provides clinic space in the Whitehorse General Hospital. A part-time clinic nurse is provided, and the current nurse Simone Cox deserves recognition for her dedication and efficiency. She provides excellent continuity of care and organization to the clinic. She carries out patient education, particularly for biologic use. The medical office assistants working for the clinic provide additional organizational back up. Lately there has been some changeover in this role.

We have access to standard imaging, MRI and CT. There is no nuclear medicine or bone densitometry. There is limited ultrasound access and interventional radiology. There are two full-time orthopedic surgeons. There is a visiting hand surgeon. There are visiting physiatry and neurology services, including electrophysiological testing. There is an excellent variety of clinical cases to see.

B. Daniel McLeod, MD, FRCPC
Rheumatologist,
Kelowna, British Columbia

Update from the Northwest Territories

By Martha Decker, MD, FRCPC

Healthcare delivery in rheumatology is evolving in Canada, and the North is no exception. The Northwest Territories (NWT) and Nunavut have seen several transitions in rheumatology care over the course of the last year.

In spring 2019, the new Stanton Territorial Hospital was opened in Yellowknife. The rheumatology clinic has transitioned to the expanded Ambulatory Care Centre in the new hospital. We continue to be well supported by a team, including nurses and administrators, who assist with coordinating the outreach clinics.

A major transition for Northern patients has occurred with Dr. Dalton Sholter retiring from the NWT portion of his practice. Dr. Sholter continues to maintain his rheumatology practice in Edmonton, Alberta. Dr. Sholter first went up to Yellowknife in July 1997, having just finished his rheumatology fellowship several weeks prior. He had taken over the practice from Dr. Sharon Le Clercq, who had been doing outreach clinics in the area for 10 years, and asked Dr. Sholter if he was willing to take on the challenge. Dr. Sholter says “She told me that I would see great pathology and function as a "true consultant." It seemed really cool and I was keen to go. I went for four days with the clinic booked exactly as she had done it before, 30 minutes for new patients and 15 minutes for follow ups, except they were all new to me. Plus, I had no idea how to navigate the system, but Dr. Le Clercq kept meticulous records and had the neatest handwriting (no computers were used back then). She took very good care of her patients so I felt like I had big shoes to fill.”

Dr. Sholter provided consistent, high-quality rheumatology care to patients in the NWT and Nunavut for 22 years, holding clinics every three months without fail until his last clinic on July 15, 2019. I am in my first year of practice in rheumatology and completed my fellowship at the University of Alberta in June 2019. I held my first clinic in Yellowknife several weeks after finishing my fellowship, and have held clinics every three months since. There is a high burden of advanced rheumatic disease among Northern patients, who often live in resource-limited settings. Like Dr. Sholter, I have found it to be a challenging but highly rewarding experience. Dr. Sholter’s patients are very well cared for and it’s clear that the next generation of rheumatology trainees also have “big shoes to fill.” I look forward to working with the Territorial Health Authority to expand the clinic, so that we can continue to provide timely and high-quality rheumatology care to patients in the North.

The new Stanton Territorial Hospital in January 2020.

Part of the team in the Stanton Ambulatory Care Centre. From left to right, Dr. Dalton Sholter, Tina Drew (Nursing, Urology), Pauline Sundberg (Clinic supervisor, retired), Tammy Connors (Administration, specialty clinics), Patricia (Nursing, ENT), Dr. Omar Ahmad (General Internal Medicine), Darlene Funk (ENT physician assistant).

Martha Decker, MD, FRCPC
Rheumatologist,
Lethbridge, Alberta