July 28, 2016 • 0 Comments

• Written by Jonathan Koch

Twenty-five years ago, a healthcare administrator from Saskatoon named David Kay received some unfortunate news from his family physician, Dr. Rick Spooner.

 “[He] told me that he was going to be leaving, going to Edmonton to be responsible for this brand new exciting program called ‘RPAP’,” recounted Kay.

In Alberta, and across Canada, the attraction and retention of physicians for rural practice was a burning issue. Physicians weren’t necessarily where they were needed, and weren’t always performing the skills the community needed. As the ageing rural physician population moved on, there weren’t sufficient numbers of physicians interested in rural practice to replace them.

In need of an action plan to attract and retain rural physicians, a provincial working group formulated 16 initiatives to influence physicians’ decisions about moving to, and remaining in rural Alberta.

The implementation of these recommendations would become known as the Rural Physician Action Plan, or RPAP.

Although his first contact with RPAP may have seemed innocuous, within a few years, the New Brunswick native would also find himself in Edmonton, cheering for the Oilers, and in charge of the Rural Physician Action Plan.

“I would never have known that six or so years later I would be responsible for RPAP,” Kay added. “So that was quite a coincidence.”

Having moved to Edmonton in 1996 with wife, Dorothy, and children, Jennifer and Michael, to work for Capital Health, David was recruited for the role of RPAP Executive Director in 1998, and was presented with a miniscule budget, zero staff, and no office.

“When I started with RPAP it literally was a shoe box that I inherited. I had no clue what the initiatives were or really what it did other than help to recruit and retain physicians for the province.”

Working from home, he began venturing into rural Alberta as much as possible, shadowing physicians, working with mentors, and figuring what recruitment and retention of physicians for rural Alberta was all about.

Through the execution of the 16 initiatives, RPAP under Kay’s leadership would evolve into Canada’s only integrated and comprehensive health work force agency. Over time, as data and experience were gathered, initiatives have been added or modified: Distributed rural medical education, community engagement, and Continuous Professional Development for rural physicians are among the new components that comprise RPAP’s sequential series of initiatives.

The organization has grown from Kay’s basement years, and now supports a roster of staff and consultants to execute RPAP programming to recruit and retain healthcare workers and their families in rural Alberta. In recent years, he has moved the organization towards providing support for other healthcare professions, in the same evidence-based manner that RPAP has done for physicians and their trainees.

“By working with a lot of really good people who understood those moving pieces, we’re able to refine them, and over time grow RPAP from a quarter million dollar program that I ran from my home office, to what we see today as a very complex program of a lot of moving pieces,” says Kay.

After 18 years of service, Kay has moved across the hallway from RPAP, accepting the role of Assistant Registrar and Chief Operating Officer with the College of Physician & Surgeons of Alberta. He leaves behind an organization that is a trusted partner and collaborator within rural healthcare, and has done what needs to be done for the people of rural Alberta, without the bureaucracy or bottlenecks that challenge larger organizations.

 “We have done what we said we could do, not always by ourselves, but with partners, and that is grow the workforce, help distribute it to where it’s needed, and help retain those healthcare workers physicians and their families in rural Alberta,” Kay added. “I think we have done a good job.”

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