Local lack of doctors and walk-ins gets worse with View Royal clinic closure

View Royal’s Eagle Creek Medical walk-in announced it will be closing its doors on April 15, due to the departure of family doctors George Zabakolas and Chelsie Velikovsky.

While the clinic says it has put out job postings for the vacant positions, they don’t expect them to be filled in time for the April 15 closure date, when roughly 3,000 people will be left without a family doctor.

In a statement to their patients, Zabakolas and Velikovsky said they will be ending their practices in Victoria and will no longer be the family doctor for any of their existing patients. They will still be living in Victoria but working remotely to provide care for US patients. The husband and wife duo told Global News that the strain of looking after 1,500 patients each while raising their 2 children was too much to handle.

Zabakolas told CHEK the current pay-for-service model is unsustainable. On average, he’s paid $30 per visit while having to also factor in rent and staffing. Zabakolas says many doctors take on more patients than they can handle just to pay the bills.

Eagle Creek says costs to lease space have grown substantially over the last several years and that the high cost of living in Greater Victoria has forced a rise in staffing costs. This is in addition to supply chain issues driving up the cost of supplies. Eagle Creek says that the rate of pay for physicians has not kept pace with these rising costs.

Eagle Creek was able to expand their clinic by over 2,000 square feet in 2020 and bring on 2 new family doctors as well as 2 new nurse practitioners. The new physicians are still bringing on new patients as part of the PCN Expansion Project, however, the waitlist has long since closed to new sign-ups.

The closure of Eagle Creek exacerbates the longstanding primary-physician shortage in Greater Victoria. BC’s Ministry of Health says that to address the provincewide shortage it has committed to creating 85 primary care networks, 40 urgent and primary care centres, and up to 15 Indigenous primary care centres. Currently there are 6 primary care centres in Greater Victoria, as well as 2 community health centres. In 2021, 2 new UPCCs and a PCN opened locally, but wait lists for primary doctors are still long due to closures and staff leaving the James Bay UPCC.


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Bereavement Survey – BC Centre for Palliative Care – Survey runs until March 25 2022

New research study seeking participants for a survey study looking at bereavement experiences in British Columbia 

We are conducting a study looking at bereavement experiences and supports in British Columbia. The findings of the study will inform the development of priority actions and strategies to make effective supports accessible to more British Columbians with bereavement experiences. We have recently completed interviews with the bereaved and now have developed a survey to capture more experiences. Additionally, we have expanded the participation criteria.  

We are looking for British Columbians who experienced a death of someone that was important to them since March 1, 2020. 

The survey should take approximately 15minutes. It asks about: 

• The experience of grief following the death or deaths 

• Whether and how it was affected by the pandemic  

• What resources and grief supports (formal and informal) were used 

• What changes would they like to see to grief support services in BC 

If you know anybody who might be interested in participating in the survey, please send them the survey link or attached poster.  

This is the link to the online survey https://ubc.ca1.qualtrics.com/jfe/form/SV_bBphBxDPL0pPwyy 

The deadline to participate is March 25, 2022

Please do not hesitate to reach out to us at jblack@bc-cpc.ca or 604-553-4866 ext. 230 should you have any questions or concerns.  

Who are we? 

The BC Centre for Palliative Care (BCCPC) (www.bc-cpc.ca) is a non-profit organization that works with partners in the health system and community to help British Columbians affected by serious illness have the best possible quality of life.  As part of this mission, we provide tools and resources to support community organizations who are helping their community members with grief, bereavement and other related activities. 

Study Title: A provincial evidence-informed approach to supporting people experiencing bereavement in British Columbia.

Principal Investigator: Dr. Eman Hassan (ehassan@bc-cpc.ca, 604-553-4866). Ethics ID: H21-01672. 


Joshua Black, PhD(He/Him)
Research Manager, BC Centre for Palliative Care 
Tel: 604-553-4866 Ext. 230
Email: jblack@bc-cpc.ca   
Web: www.bc-cpc.ca | www.ihsts.ca

Journal of Rural and Community Development – COVID-19 and Rural Canada

Vol. 16 No. 4 (2021): COVID-19 and Rural Canada: Rural Impacts and Resilience

The COVID-19 Vulnerability Landscape: Susceptibility to COVID-19 Across Rural Versus Urban Health Regions of Canada

Rural communities are often portrayed in the research literature and popular media as being disadvantaged and ‘vulnerable’. This paper examines the extent to which rural health regions in Canada are more vulnerable than other health regions in terms of contracting COVID-19 and developing serious illness from this virus that leads to death. Data include published numbers of cases of and deaths from COVID-19 in each health region across Canada. Other data from Statistics Canada’s Canadian Community Health Survey (CCHS) documents the higher rates of ‘vulnerability’ in rural health regions, according to (a) their socio-demographic conditions (income, education, age), and (b) the rates of ‘underlying health conditions’ which would make individuals more susceptible to serious illness from COVID-19. Despite these vulnerabilities, which are consistent with other research on rural areas in Canada, COVID-19 rates are found to be higher in metropolitan areas—although there is some variation in this pattern by province. In no provinces is the rate of death per case of COVID-19 highest in rural areas. Overall, in Canada, deaths per case from COVID-19 are higher in metropolitan than in rural health regions, challenging the notion of rural areas being only and always disadvantaged.

[Excerpt]  While  acknowledging  the  importance  of  rural  variety,  if  we  adopt  a  broad  rural development  perspective  on  the  conditions  in  rural  communities  and  regions  in Canada, several specific challenges and assets emerge, relative to pandemic impacts. Challenges include ageing population levels; lower overall health outcomes; limited health care capacity; distance to services; variable internet, broadband access;lower levels  of  education;  lower  income  levels;  and  a  high  level  of  essential  service designations associated with rural employment, particularly in the resource and food production  sectors. 

Rural communities and regions are, however, endowed with considerable assets that have  proven  important  in  responding  to  the  pandemic  crisis.  Most  notably,  high levels of  social  capital commonly  noted in  rural  areas  have spurred innovative support responses. The strong presence and role  of the  voluntary sector have also clearly  risen  to  the  challenge  of  dynamic,  flexible,  and  tailored interventions in communities. Aside from the immediate impacts, it is also clear—although not yet fully  understood—that  the  comparative  affordability  of  rural  housing(when compared  with  urban  metropolitan  regions),  combined  with high quality  of  life dynamics, have  spurred  an  in-migration  of  urban  residents  into select rural communities(although not all rural regions, as evidence to support the importance of not assuming a homogenous interpretation of rural). 

The COVID-19 Vulnerability Landscape: Susceptibility to COVID-19 Across Rural Versus Urban Health Regions of Canada
E. Dianne Looker
To access, click on:  pdf

Two-Eyed Seeing: Current approaches, and discussion of medical applications

Issue: BCMJ, vol. 63 , No. 8 , October 2021 By: Tristan Jeffery, BScDonna L.M. Kurtz, RN, PhDCharlotte Ann Jones, PhD, MD, FRCPC

ABSTRACT: Two-Eyed Seeing is an approach of inquiry and solutions in which people come together to view the world through an Indigenous lens with one eye (perspective), while the other eye sees through a Western lens. It has been used in a variety of Indigenous-partnered research projects, but little information exists about Two-Eyed Seeing approaches in medical research. A focused narrative review of peer-reviewed Western literature was conducted to identify principles of Two-Eyed Seeing applications. Medline, Web of Science, and CAB Direct were searched and papers that described Two-Eyed Seeing approaches in Indigenous-partnered research projects were selected for review. Relationship building, community control, collaborative data analysis, and results that fostered change were recognized as common principles for successful application of Two-Eyed Seeing. Medical researchers must be aware of relational and community-involved processes while conducting research with Indigenous communities.

A review of which Indigenous health care themes are present in Western medical literature.


Indigenous knowledge is shaped by the environment and land. Emotional, spiritual, and physical relationships with the natural world influence traditions and customs.[1] Ties to the natural world also influence perspectives on research. There are multiple Indigenous perspectives on research, often relational, being inclusive of people’s experiences, spirituality, and culture. Western perspectives about research focus on interpretation of concrete facts and understanding the world, with little attention to emotional or spiritual realms.[1]

Two-Eyed Seeing developed from the teachings of Chief Charles Labrador of Acadia First Nation, but Mi’kmaw Elder Albert Marshall of the Eskasoni First Nation was the first to apply the concept of Two-Eyed Seeing in a Western setting.[2] Specifically, Two-Eyed Seeing “refers to learning to see from one eye with the strengths of Indigenous knowledges and ways of knowing, and from the other eye with the strengths of Western knowledges and ways of knowing, and to use both of these eyes together for the benefit of all.”[2] Elder Albert Marshall emphasizes that Two-Eyed Seeing requires groups to weave between each respective way of knowing, as Indigenous knowledge may be more applicable than Western in certain situations and vice versa.[2] It brings together two ways of knowing to allow a diverse group of people to use all understandings to improve the world.

Originally developed as a grassroots program to encourage Mi’kmaq postsecondary students to pursue science education,[2] Two-Eyed Seeing has since been used in research projects with Indigenous people across a variety of disciplines, but applications vary between groups. Further, there is little information about Two-Eyed Seeing approaches in medical research. The aim of this article is to discover and review which Indigenous health care themes are present in Western medical literature.

Eight themes were identified from the literature:

  • The need to declare author positionality.
  • Communication of group interpretations and guiding principles.
  • Relationship building.
  • Inclusion of Indigenous advisory committees and Knowledge Holders.
  • Continued community guidance.
  • Use of traditional knowledge gathering techniques.
  • Collaborative community-involved data analysis and interpretation.
  • Making meaningful and lasting relationships.

To read more, click on: Two-Eyed Seeing: Current approaches, and discussion of medical applications

Four Ways to Fix Canada’s Long-Term Care System


From cohousing to dementia villages, here’s how we can put humanity back at the centre of senior care.

Sarah Tranum January 23| The Conversation

Sarah Tranum is an associate professor of social innovation design in the faculty of design at OCAD University.

Canada’s LTC can become a seamless, human-centered system that helps senior citizens get the care they need. (Shutterstock)

[Excerpt] COVID-19 has amplified existing cracks in the long-term care system in Canada. We need socially innovative solutions to help seniors age safely and with dignity.

From cohousing to community paramedicine programs, from home-based primary care to publicly funded dementia villages, there is hope on the horizon.

As a social innovation designer, I study complex challenges with the aim to find the common approaches needed to solve these issues and not just manage the symptoms.

To better understand the challenges of the long-term care system in Canada, I interviewed stakeholders involved in approaches attuned to individuals’ needs at different stages of aging — all of which are socially innovative.

Here are some solutions that can help when it comes to redesigning the long-term care system.

Senior cohousing

One of the goals outlined in the National Institute on Ageing’s National Seniors Strategy is to help seniors stay active, engaged and maintain their independence. But many seniors struggle to find suitable housing — especially affordable housing.

While retirement homes exist, for many the costs are out of reach — so some are choosing cohousing.

Louise Bardswich is a retired college dean and co-owns a home in Port Perry, Ontario. She and three other women pooled their resources to build a shared home.

Their home features design elements that will allow them to age in place — like wheelchair accessible bathrooms, a spacious kitchen and a guest room that can be used for a live-in caretaker. The housemates pool their resources to cover costs; Bardswich estimates her monthly costs at $1,100.

While $1,100 is not affordable for everyone, its considerably cheaper than a long-term-care facility in Ontario — the long-stay semi-private option is $2,280 per month.

Community paramedicine programs

An integral part of supporting older adults to continue living safely in their homes is ensuring that they have access to the services they need. One innovative example is community paramedicine programs. These programs use existing trained emergency medical personnel to provide primary health care to people who may have a difficult time leaving the home to see a doctor.

J.C. Gilbert is the deputy chief in charge of operations at the County of Simcoe Paramedic Services. In the five years since the launch of its community paramedicine programs, Gilbert says there’s been a positive impact on patient’s overall well-being and fewer emergency calls. “We’re seeing people able to cope with their illness much better at home.”

Home-based primary care

House Calls is a primary health care practice for home-bound seniors living in Toronto, led by Dr. Mark Nowaczynski and SPRINT Senior Care.

Nowaczynski explains that seeing people at home gives health practitioners the ability to gain a holistic understanding of a patient’s health and well-being that is not possible during an office visit. The level of care he and his team provide can prevent hospitalizations and admissions to nursing homes.

According to Nowaczynski, House Calls serves 450 seniors with an average age of 89. “We make it possible for our patients to live out their days at home and die at home,” he says.

Dementia villages

Dementia villages are communities of care designed to give their residents freedom and choice within a safe and supporting environment.

The first dementia village in the world opened in 2009 in the Netherlands. The Hogeweyk is an intentionally designed village with 23 houses for 152 seniors living with dementia. The village has a bar, restaurant, theatre, grocery store, streets and gardens for residents to use and enjoy. It is publicly funded and runs on a budget comparable to conventional nursing homes.

Providence Living, in partnership with Island Health, will open Canada’s first publicly funded dementia village care model in Comox, B.C. With construction starting this year, it will feature smaller households that support freedom of movement, access to nature and connection with the community.

Candace Chartier, CEO of Providence Living, explains that this village concept is not just about the physical design but encompasses a shift in the model of care in which residents, staff and family members work together to create a home environment where residents can thrive.

These examples show potential for the future of long-term care in Canada. The challenge is to make them the new standard of care instead of a patchwork of services that result in waitlists, drive up health-care costs and create confusion for seniors and their caregivers.

Canada’s long-term care can become a human-centred system that helps seniors get the care they need. But first we need to make humane, dignified care for seniors a top priority. 

Four Ways to Fix Canada’s Long-Term Care System


Planning Resilient Communities…Responding to climate change and eco system disruption

Rural Health Services Research Network of BCCentre for Rural Health Research

Kim, DianeRogan, SilaKarve, UrveeTran, EvonneCherian, ArlinGrzybowski, StefanTsang, ElyseLiu, KyaraFischer, Jordie A. J.de Waal, AnnaBland, Alexandra

Evidence from current climate science research suggests that anthropogenic activity will cause drastic changes to our environment, including global warming of over 1.5oC in the next 10-30 years, extreme weather patterns, and rising sea levels—some of these changes have already been observed in British Columbia. These environmental impacts have consequences for human health, with natural hazards disproportionately impacting rural populations. The purpose of this paper is to explore current evidence and identify gaps in the current literature around climate change and adaption, as well as identify innovative ways research can contribute to supporting adaptation strategies for rural health services and healthy communities in response to a changing environment.