As he prepares for a new chapter in his life, well-known Hope area physician Dr. Joshua Greggain reflected on more than a decade of his life dedicated to improving rural medicine.
In a letter to his patients dated Oct. 30, 2020, Greggain said he will be leaving Hope and the Fraser Valley in March, moving to Victoria to support his wife’s career. At this time, he said he does not have immediate plans to open a practice or joining with a hospital in Victoria.
“I”m leaving lots of room for uncertainty and evolution over the next several months as life goes back to some semblance of normal in the world,” Greggain said.
Greggain’s wife, golf pro and former women’s amateur and Young Pro coach Jennifer Greggain, accepted a new coaching position coaching the national junior teams with head coach Robert Ratliffe. She will be based at Bear Mountain in Victoria.
“We’ve been married 20 years, and I’ve been through medical school, residency and [beyond], and so she stood with me and together for quite some time, and so now is my opportunity to honour her and the opportunity for her to potentially coach at the Olympics or the PAN-AM Games,” he said.
Dr. Jeff Shulz will take over for Greggain at the Hope Medical Centre; he has been part of the practice since 2018. Dr. Richard Darby will join the team in February or March.
Greggain’s rural residency began in 2004; he opened a full-time practice three years later. During his tenure in the area, Greggain served as the medical director at the Hope Medial Centre and the Fraser Canyon Clinic, site director at Fraser Canyon Hospital and chair of the Chilliwack Division of Family Practice, covering primary care practices from Chilliwack to Boston Bar, which specifically recognized his advocacy for broadening 24/7 emergency care access to the rural communities.
He aided in recruiting and retaining doctors in the community after three medical clinics shut down and the Hope area was declared to be in crisis; although the Hope local health area only accounts for about 0.5 per cent of Fraser Health’s population, that population is spread out over 40 per cent of Fraser Health’s physical territory.
Greggain called advocating for rural medicine in his area a challenging but rewarding uphill battle.
“Often times, as decisions are made about health care in the larger centres like Surrey or Abbotsford, some of the small population gets overlooked,” Greggain said. “What we’ve been able to do in the community in the last few years is raise it to the forefront of health care in the Health Authority when decisions are made and give people access.”
His dedication to rural medicine was recognized in major ways in recent years. Last year, he received the rural service award, one of 13 to receive such honours from the Society of Rural Physicians of Canada. In 2016, he was recognized as Health Care Hero for Fraser Health.
“It brought Hope to the limelight along with some of the work we are doing collectively,” Greggain said. “It’s always a bit funny being recognized individually when it’s really a team effort.”
Greggain has been honoured and blanketed by the Boston Bar and Seabird Island First Nations.
“That’s a real honour and a significant impression on my life to have been welcomed into those communities for the work that we’ve done,” he said.
While he is regarded as a leader in the local medical community, Greggain is quick to shift credit to local doctors who went before him and who banded together to strengthen access to care in the midst of not only doctor shortages but this year during the COVID-19 pandemic.
“Over the last 15 years, my role has never been to replace those people,” Greggain said. “Several [doctors] have a long-standing history and several of them still live in the community. My role and the evolution of health care has been around the consolidation of services, bringing people together. And when you bring people together, you can move forward.”
As of the end of 2020, there are 12 physicians and four nurse practitioners in the Hope area.
He added the work of organizations outside the medical industry such as the Hope and Area Transition Society and Care Transit can’t be understated.
“Trying to have a more [synchronized] strategy together about how we do care has been the biggest difference, I think,” Greggain said.
Greggain said there are still some challenges for accessing care in some of the more rural communities, but with COVID switching so much of life to the virtual world, area doctors learned of the potential of virtual outreach and care.
“Over the past year, we’ve learned that we can combine not all care but a fair bit of care over the phone or on video conference,” he said. “That suddenly doesn’t give you access to just the physicians and nurse practitioners that are in the community but it also starts to open up provincial or regional resources we’ve never had before.”
Greggain expects video conferences and phone calls to continue to be a resource tapped by rural health areas like Hope. Currently, about 60 per cent of doctor visits in the Hope area are held virtually; Greggain thinks that number might drop to some degree as the preferred face-to-face visits can’t be totally replaced.
“There is opportunity to [provide care] differently, which gives more people different access while not taking away from the population that still wants to see [doctors] in person,” Greggain said.
Greggain said virtual medicine has been particularly helpful to local First Nations communities that have closed themselves off to visitors to protect their people during COVID-19.
While there will continue to be challenges in rural medicine, with milestones like the opening of a clinic in Manning park, the rise of tele-medicine and the 10th anniversary of the Anderson Creek Medical Clinic in Boston Bar, those challenges are being met.
“I’m really privileged to have been able to help lead where we have gone and have no doubt there will be much more to come,” Greggain said. “I believe I’ve helped facilitate a culture of collaboration and a culture of ‘let me help you.’”
Greggain said the most stand-out factor in the success of Hope area medicine, care and COVID-19 management is the sense of community.
“We really do look after each other well,” Greggain said. “We really did this together, even though it was really hard. We are adaptable and we are resilient, and even though we may struggle with a whole slew of things and people continue to have illnesses, generally, people are resilient and willing to help out and struggle together more so than I’ve ever seen.”
It’s that sense of togetherness the Hope area brings that will forever hold a special place in Greggain’s heart.
Since notifying his patients that he was leaving, they have said they were thankful even when Greggain had to deliver difficult news.
“The depth of those relationships are for sure what I will miss the most,” he said. “I really, really have felt privileged to build a team of physicians, nurse practitioners and staff that are really, really dedicated to what they’re doing.”