Thursday, 1 February 2018

Dr. Mike Spooner and Family Medicine in Saskatchewan.

   Mike Spooner, an old colleague and friend, died last week.  When Mike came back to Regina circa 1965 with his recently gained master's degree in education, it was with the intent of developing a postgraduate program in Family Medicine in the province of Saskatchewan.  A new family medicine department already existed in Saskatoon, the site of the medical school.      Until then, the one year rotating internship was all that was required for licensure and this was very much 'in-hospital' care. There was a growing recognition that this did not adequately prepare students for general practice, where most of the patients were ambulatory and often carrying on with life as best they could.  many mothers knew a good deal more about common pediatric conditions than their newly qualified doctor.  Developing a family medicine residency training program was essential. City Hospital in Saskatoon traded most of their rotating internship positions for Family Medicine training positions in the early seventies. 
   Mike was determined to develop a residency training program in Family Medicine in Saskatchewan when he started back into family practice in the Medical Arts Clinic and that was when I met him and we became friends.  He quickly developed a general practice within the clinic where his enthusiasm and restlessness to  improve the training of Family Physicians was apparent.
   I left the Medical Arts Clinic after about two years to join a smaller group in Regina and was settling well into that group where I thought I was going to live out my professional career, but as Rabbi Burns said," The best laid schemes o' mice an' men//gang aft a-gley".
    I got a call from Mike, one day.
   "Hi Stan, I've got a proposition  for you," he said.  
   "What sort of proposition, Mike?" I asked.
   " You know the new hospital that is being built on  the North side of the city, by the  by-pass?"
    "Well, there is going  to  be a department of  Family Medicine, with the mission of training family doctors for the  province," he said, "I'd like to take you out to lunch and tell you about it and show you the plans of the new Family Medicine Teaching Unit."
     "Sounds very interesting Mike, but I'm quite happy where I am now and not considering any sort of a move in the near future."
     " Just come and have a look at the plans of the new unit," he said, "you've been teaching students in your office practice for a few years, I'd just like to share our plans with you and see if you are interested in being involved."
      "Okay, Mike, as long as you realize I'm not contemplating any moves.  I don't want to waste your time."
      "Lunch at Gulf's, Wednesday at one, if that suits you."
      "That will be fine." I answered.

   So, on the following Wednesday I skipped out of the office a little early to meet Mike for lunch.  I am always early for my  appointments, a habit I have  never been able to  get out of, so I was nicely settled at my table when Mike breezed in, looking very business-like with a roll of blue-prints under his arm.
   After the usual niceties were exchanged, I asked Mike what the rolls of blue-prints he had placed to the side of the table were.
   "They are the plans of the new Family Medicine Unit that is going to be in a new hospital that is under construction,"  he said enthusiastically. "This hospital is cutting edge, it's going to  be the 'jewel in the crown' of the health care system.  It's to be called 'The Plains Health Centre' and we are just in the process of  planning the layout of the Family Medicine Unit which will be the training unit for future generations of  Family Physicians.  It's not good enough to  throw new graduates into a rotating internship when all they have been trained in is hospital medicine. 
   It wasn't long before Mike had the blueprints spread all over the table and was enthusiastically pointing out all the nooks and crannies of the new department.
"Here there's  going to be a well equipped in- department operating room for the sort of minor surgery that family doctors traditionally did in their offices, here," he added, "there will a lab, and around the periphery are the consulting rooms and examining rooms." He went on animated.

    "Really interesting, Mike.but why are you going into all this detail with me?" I asked, knowing full well why.
   " Stan, I've developed a plan for a Residency Training Program for family doctors, I have a group of exceptional new graduates interested in practicing in the province and I can't think of a better role model than you to be the residency training director.  You've been taking interested students into your office to "puppy dog" around after you and see what medicine is like outside of the Teaching Hospital environment.  I'd really like to get you involved.  We need someone to be the Residency Training Director and I thought you might be interested."  
   I knew I was a competent general practitioner but I  certainly wasn't an educator.   I had accepted medical students into my practice to expose them to medical care outside the hospital environment.  Anything I had to teach was not academic, it was 'real world' stuff that a student could get a glimpse of by watching what I was doing and asking relevant questions as to how and why.
   "Mike, this sounds like good stuff.  I spent a couple of years around hospitals after I got my degree that certainly didn't prepare me for general practice.  In fact, as you pointed out, that only prepared me for more hospital care practice.  I support the concept of a training program that emphasizes looking after what you call the 'walking wounded'.  I'm not an educator, I'm a grunt, a GP looking after patients.  You need to find a someone with an academic teaching  background."
    " I'm not asking you for a decision right now.  Just don't say no.  Think about it for a while and maybe we can get together  in a couple of weeks and I can show you the building in general and the Family Medicine Unit in detail.  And I'd like to talk to you about involving community physicians because I know we'll have to involve them in a major way."
   " Okay, Mike, but I don't want to leave you with the impression that I'm thinking of moving.  I'm in a good group, with good partners and I think this is where I'm going to stay until I retire!"
   "I'm not asking you for any decisions just don't say no for now and let me discuss some of the plans I'm developing with you."
   "Okay, but I'm not making any commitment."
   "Fine," he said, "why don't we meet for lunch next week and then I'll take you over and show you the building."
Watch this space for episode 2. 

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