The Rock not a hard place
When he quit practising in Kamloops last year, dermatologist Dr. Christopher Sladden said the reasons were very simple — it made no business sense to continue and he was not getting a positive reception to the idea of creating a clinic at Royal Inland Hospital.
Less than a year since he sent his letter to then-provincial health minister Michael de Jong, explaining his plans and reasons, Sladden has found what he was looking for on the other side of the country.
Working in Cornerbrook, N.L., Sladden spends two weeks every month or so on the East Coast in a clinic attached to a hospital doing what he said he chose medicine to do — “see tough patients that need to be seen and get to be paid appropriately.”
Sladden said he is near the emergency room for calls and, in that hospital, it’s not as difficult to locate a patient in the ward or find a nurse for help.
“It’s a shame, really, because that’s the way to do it.”
However, Dr. David Sanden, chief of staff at Royal Inland Hospital, said he doesn’t see the need for such a clinic at RIH, “because they tend to do a more efficient job in their office.”
There is a low volume of hospital need for a dermatologist immediately, he added, and, although RIH is not doing it now, some hospitals are opting for technological assistance, using cameras to take photos of rashes that are then sent to the specialists, along with a medical history and symptoms, for a diagnosis.
“You’ve either seen it or you haven’t,” Sanden said of the rashes that might be the subject of the examination.
“And it would be neat to have that here.”
At the time of his resignation, Sladden said he was encouraged by some to do more cosmetic dermatology, something he said he isn’t interested in doing.
He loves the clinical side of it, the diagnoses of the thousands of skin-related ailments that exist and being able to give patients proper care.
“I see challenging cases, which is what I want to see,” he said.
And, while he said he made as much in 20 weeks’ of work in Newfoundland as he did in two years in Kamloops, Sladden said it’s not about the money.
A specialized practice is expensive and, to continue in the River City, he said he was likely going to have to remortgage his house.
Among costs dermatologists can face in just setting up a business are required specialized lights that cost up to $30,000, the $200,000-plus it would cost to install a surgical suite, wages and benefits required for the staff to assist, office overhead and myriad other business costs.
Sladden said he made his case to several politicians, singling out Kamloops-South Thompson Liberal MLA Kevin Krueger as one who listened to him, but predicting de Jong won’t be in government after the May 14 provincial election.
He also met with officials at Royal Inland Hospital.
Sladden questioned the thoroughness of education doctors receive who are opting to do dermatology courses by distance learning, noting to specialize in the field requires many years of study, “a gruelling exam” and many more years of training.
“You can’t do that with distance classes.”
Sladden said he has spoken with colleagues in Kamloops who are unhappy and other doctors have contacted him, asking about coming to Kamloops — something he does not recommend.
However, while agreeing the fee guide for some specialists is an issue compared to that in other provinces, Sanden hasn’t found any reluctance by doctors to relocate to Kamloops.
“B.C. is still an attractive place to come,” Sanden said, noting about 30 doctors have moved to the city in the past year or so, while another five are being contacted.
Sanden said when he heard of Sladden’s discontent last year, he contacted him and they talked three times, but were unable to find a time that worked for them to both to meet.
“But, I’d still be happy to meet with him and talk about this,” Sanden said.
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