Four doctors to exit Tulattavik Health Centre

The Tulattavik Health Centre, which provides health care to Nunavimmiut in Kuujjuaq and communities along the Ungava Bay, will soon lose at least four of its long-time resident doctors.

“But we won’t have any breaks in the service,” assured Dr. Normand Tremblay.

Tremblay, a doctor with more than 30 years experience in Nunavik, assists the Nunavik Regional Board of Health and Social Services with its recruitment of new doctors.

“I’m not going to panic because it’s the kind of situation we’ve seen before. You have to expect that and prepare yourself mentally for this,” he said.

In July, Carl Bromwich, a doctor who has spent 11 years with Tulattavik, will make his final visit as a family physician to Kangiqsualujjuaq.

“I feel really bad. It’s going to be a very sad day for me,” he said. “But now is the right time to go. There’s no question I’m leaving. I have no doubts about my decision.”

Bromwich has three young children. Their mother, Danielle Mercier, a part-time doctor in Kuujjuaq, will also head south this summer.

Bromwich said the decision is not connected with the departure of two other doctors. Rather, he feels his children would always be at a disadvantage if they were to stay in Nunavik.

“This will never be their home in the sense that it would be for an Inuk. I can’t show them the land. The best parts about this place, they won’t have access to. They will have access to some of the bad things. People here get it all, and get to make a decision about it,” Bromwich said.

“It’s one of the unfortunate things that we have here in Nunavik that we don’t have any doctors who have been born and bred here.”

To replace the departing veteran doctors, Tremblay is encouraging recent graduates of medical schools in southern Quebec to practise in Nunavik.

“We went to the career days for doctors who are finishing their medical studies. We met several people, prepared lists and now we’re intending to meet them again,” Tremblay said. “We’ll take those who are interested out to supper.”

Schmoozing with new medical graduates is not the board’s only recruitment strategy. Tremblay said recruiting experienced foreign doctors, who have received their training in other countries, is another possibility.

“There’s a certain openness now at the [provincial] health department to look at this,” he said. “We would have to sponsor them. The institution would then agree to take charge of them and bring them through all the steps so they could be licensed to work in Quebec.”

Tremblay said these doctors would be attached to Tulattavik for a set number of years. This new stock of doctors would presumably stay in the region for a longer period than is sometimes now the case.

“Those who get a grant from the government – it gives a year of study in return for a year of service – often these people will just stay the minimum length of time necessary to reimburse their grant. After that, they don’t have to stay. So, it’s more or less an incentive,” Tremblay said.

Every doctor who works in Nunavik receives a $25,000 annual bonus as an encouragement to practise in the North. But doctors can work anywhere in the province and expect a good salary, so money isn’t really an issue when they decide to leave.

“People may not spend their whole lives here, but the longer we can keep them the better,” Tremblay said.

In an effort to make Nunavik more attractive, in the long term, to potential doctors, there needs to be more and better housing. This, said Tremblay, will change the idea that Nunavik is more than just a place to spend a couple of years.

“It’s really time … for suitable housing. We aren’t living 20 years ago. If we want to keep them, we have to have good housing. We want to the North to stop being a marginal place to practise and become a place where people can live and get up housekeeping and have a normal life,” Tremblay said.

If the health board’s efforts to find more permanent doctors fail, a backup plan will be put into action. This could involve twinning with another health centre that would send doctors to Kuujjuaq on rotation.

“Senior doctors will serve as coordinators. The others will be replacements,” Tremblay said. “In the past, I remember we were just two and we just did the supervision of the other doctors and provided the continuity … they did the medical work.”

At the Inuulitsivik Health Centre in Puvirnituq, where several doctors left at the same time a few years ago, the physician roster is now stable, but several of them job-share and spend only limited periods in Puvirnituq and the other Hudson Bay communities.

“It’s the lesser of two evils,” Tremblay said. “It makes a break in the continuity in the service and it doesn’t help the doctors get attached to the milieu. But it’s a way in the North to keep people for a longer time. When we can keep them, it’s very valuable.”