Chilliwack doctor’s mission to bridge gaps between community and hospital care

By Mari-Len De Guzman

For a system as massive and complex as British Columbia’s health-care network, it is typical for people working within the system to spot where the bottlenecks are, while standing on the sidelines waiting for things to change.

For Chilliwack physician Dr. Perry Tompkins, however, there is another choice: “put your skin in the game and try to work on those problems.”

Tompkins has taken on the leadership role in Chilliwack’s Community Family Physicians In-patient Care (CFPIC) program, which aims to address the daily gaps in coordination that can happen when care is split between the clinic and the hospital. He views himself as an advocate for the doctors who, like him, keep one foot in both worlds to ensure their patients don’t get lost in the transition.

This hands-on approach is a hallmark of the local medical community. At Chilliwack General Hospital (CGH) and Fraser Canyon Hospital in Hope, B.C., family physicians still care for their own admitted patients alongside hospitalists and specialists.

Led by the Chilliwack Division of Family Practice, CFPIC is designed to bridge the gaps between community and hospital patient care and help ensure every patient in Chilliwack experiences a seamless health-care journey.

“I think patients always appreciate having that continuity of care, with the doctor knowing them, knowing their background, and shepherding them through the (hospital) admission process. There’s a sense of security that patients get by having that process,” Tompkins said.

Seat at the table

Even in a well-connected hospital such as CGH, siloed systems can and still do exist as different departments may operate independently, Tompkins noted. For family doctors who balance a private practice with hospital rounds, this fragmentation can create significant hurdles.

Effectively on call from 8:00 am to 6:00 pm every weekday for their hospitalized patients, family physicians often find themselves “living in two worlds simultaneously,” managed by different sets of rules and communication channels, he explained.

The CFPIC program addresses these challenges by providing a dedicated lead who can represent these dual-role physicians. By essentially having a seat at the table with surgery, internal medicine and psychiatry, for example, Tompkins can advocate for the unique needs of family doctors, ensuring they aren’t just bystanders in the hospital setting.

“It was felt that it would be helpful to have someone who speaks for, represents and advocates for those physicians who are having one foot in the hospital and one foot in the community simultaneously, because they have unique challenges.”

Six months into his role, Tompkins is recognizing the benefits of the CFPIC program not just for physicians and patients but also in systems efficiency.

For one thing, family physicians following their patients when they are admitted to the hospital means there is already existing knowledge about patient history as soon as they enter the high-acuity environment of the hospital.

“There tends to be less duplication of work,” Tompkins explained. “If I know that this particular patient has this particular history, I may be less likely to order tests that a doctor unfamiliar with them might. So, it saves patients from being poked for blood, for example, or for imaging.”

From a systemic level, this means saving the health-care system the cost of unnecessary tests and imaging that would have been ordered if the attending hospital physician has no knowledge of the patient’s history.

On a personal level, Tompkins said caring for patients through their hospital journey until they are discharged offers a sense of professional satisfaction.

“Knowing that you’re going to have to see that person and care for them after they leave the hospital, you want to make sure certain things are done to make sure the landing is smooth. So, it kind of makes you more accountable to the patient, in a way,” he said.

“At the end of the day, when you get good results and the patient feels like they’ve been looked after, you get a sense of satisfaction from that.”

A personal investment

Tompkins’ motivation to help improve the local health-care landscape is fueled by a deep personal connection to the Chilliwack community. Originally from Lethbridge, Alberta, he worked as a community pharmacist after graduating from the University of British Columbia, before deciding to pursue medicine at the University of Calgary.

When it came time for his residency, Chilliwack was at the top of his list — not just for its reputation of having a great residency program, but also due to personal ties. His wife is originally from Chilliwack, and her family still calls the community home.

“We knew Chilliwack,” Tompkins said, noting that even among Calgary’s medical scene, Chilliwack is known for producing high-calibre physicians. “It sounded like a good residency program.”

Now, nearly five years into his practice as an attending physician, Tompkins views his leadership role as his contribution to ensuring the community his family has come to call home has a sustainable medical workforce for the future.

As Chilliwack’s population continues to grow, he believes investing in a versatile workforce of family physicians is essential.

“I don’t envision us leaving the community anytime soon, so I’m going to be involved with the hospital for quite a while,” he said. “Knowing that, and knowing the challenges we face on a recurring, enduring basis, I would say, it’s one thing to complain about things, it’s another thing to pick up a shovel and start doing something about it,” Tompkins said.

Supporting Tompkins and other Division members’ professional growth through leadership opportunities is a key pillar of Chilliwack Division’s strategic priorities, toward its vision of a thriving community of family physicians and primary care providers delivering excellent patient services.