From the Mayor’s Desk, Ron Toyota speaks on our local health-care system. (Photo by Brian Lawrence)

From the Mayor’s Desk, Ron Toyota speaks on our local health-care system. (Photo by Brian Lawrence)

From the Mayor’s Desk: The Many Challenges of Rural Medicine

The challenges of rural medicine is shared amongst all the physicians practicing in Creston

By Ron Toyota, Mayor – Town of Creston

The Creston Valley Health Working Group (CVHWG) was developed in 2006 as a strategic community-based plan to support recruitment of physicians for the citizens of the Creston Valley.

The CVHWG is a collaborative group, comprised of representation from Town council, Regional District of Central Kootenay (RDCK) Directors from Areas B & C, Town of Creston staff, local physicians, Interior Health administration, and current health professions recruiter Marilin States, who has been active in the position since 2011. The program is funded through RDCK Service 108 via the Town of Creston.

The CVHWG’s commitment to our community is to recruit physicians with the advanced skills required so that our citizens have the services provided by skilled family physicians, not only in a clinical setting, but also to serve our fully functional Hospital with a 24/7 emergency department. Many small communities in our province lack this important community service. In order to have a fully functional hospital, we require family physicians who have the advanced maintained skills to provide emergency department coverage, management of admitted patients, clinical office hours, and care for patients in extended/long term care facilities.

This means Creston requires full-service family physicians to keep our hospital operational. Most physicians would admit that while there are many rewards to practicing in Creston, there are also some personal and professional challenges. These challenges include the responsibilities of being an emergency physician in a geographically isolated community, and providing after hours/weekend/holiday coverage for both emergencies and in-patients.

Fortunately, in Creston, this challenging aspect of rural medicine is shared amongst all the physicians practicing here. The fact that all our doctors work in our hospital creates an equity amongst our physicians. They “share the load”, for which we are all grateful. Walk-in clinics may seem like an attractive option or easy solution to increase access to physician care, as we know they work in larger centres. However, walk-in clinics in our community would create a work imbalance between physicians that would not equally share hospital and emergency responsibilities. The natural consequence of that inequity is the likelihood local physicians would gradually leave full-service practice for office/daytime work only. This would leave us without coverage for our much needed emergency department and hospital in-patients.

Our emergency department is, by default, our “walk-in” option for those citizens without a family physician, or those with an emergency. As with any emergency department, patients are seen in priority of need. While everyone agrees that there is a hardship with an indefinite wait, it remains our most viable option to maintain hospital care in the Creston Valley.

The security of keeping our hospital here is maintained by recruiting those full-service physicians. The CVHWG’s continued service to the community, through our physician recruiter, is improving our supply of family doctors. Since 2011, Creston has successfully recruited 16 physicians. Of those, 11 are currently here in practice. Various family commitments and other decisions have resulted in relocation for three of these physicians and two were known to be here in a temporary (two to five years) capacity. In addition, our physician recruiter has successfully recruited and assisted numerous locum doctors, who offer coverage for our permanent physicians to take much deserved breaks, yet offering consistency for the care of their patients during their absences.

As new family physicians are recruited to Creston, past practice has been that the clinic that the physician will be based out of will publish a notice in the Creston Valley Advance newspaper and the physician recruiter will ensure that this notice is concurrently published on the Town of Creston website – – with the details on the intake process.

I trust this provides further insight into the work that has been and continues to be done by our physician recruitment specialist on behalf of the CVHWG. It is with the support of all our local physicians, local government, Interior Health, and the community at large that we have enjoyed our many successes… and more to come!

On behalf of the CVHWG, please join us in welcoming a new permanent Family Practice Physician & his family, relocating to Creston. Dr. Bryndel Fell, a graduate of UBC medical school, is a current resident of Prince George, B.C. He and his family will be relocating to Creston this July. We look forward to their arrival and settling into and enjoying their home here in the Creston Valley!

Future information regarding Dr. Fell’s intake process will be posted on the Town of Creston website – – where we encourage you to sign up for the “News Flash” to be notified when this information is posted to the Town of Creston newsfeed. The information will also be posted on our Town of Creston Facebook page (@TownofCrestonBC) and/or Instagram (@townofcreston). Updates, as they become available with specific information, will be posted simultaneously on the above platforms.

Don’t hesitate to contact me by visiting me at my office in Town Hall, emailing at or calling 250-428-2214 (ext. 111).

ColumnCreston Valley