GREENE, Dr Treena
Canada - remote family doctor
photo: Treena Greene in front of her house this week (March 2014)
Can you tell us something about yourself and your work?
My name is Treena Greene and I am a family physician practicing in Canada’s arctic city of Iqaluit, Nunavut. I am from the small town of Port Saunders on Newfoundland’s Northern Peninsula. I completed medical school at Memorial University and my residency training through Dalhousie University. I came to Iqaluit in 2002 for a six month locum – a way to see a part of my country that I was curious about – and I grew to love the medicine, the Inuit people and their culture. I have now been in the north for 13 years.
What is the practice like in such a remote location?
The practice of medicine here is multi-faceted. What I do today has changed from when I first started practicing here. We practice out of the Qikiqtani General Hospital – the only hospital in the territory of Nunavut. My work involves clinic, obstetrical shifts, hospitalist, rapid access clinic, remote phone support for community health nurses, community visits to remote communities further north, air medical evacuations, tuberculosis clinic, home care coverage and palliative care. I have also completed a three month fellowship in colposcopy to assist the women of this region in getting more timely access to treatment following an abnormal cervical cancer screen, as well as helping the medical officer of health in developing new territorial cervical cancer screening guidelines. I no longer practice in the ER as the above activities keeps me busy.
The health system in the north has proven to be a challenge but a rewarding one at that. We have limited physical resources and human resources. We rely heavily on locums to help sustain the care which has led to a strain on the value of continuity of care. Many clients never ‘know’ a family doctor to call their own but we ensure the access points to care are covered. Primary care is continuing to evolve here where the Inuit and non-Inuit clients are remarkably adaptive. We have our challenges – high suicide rates, high smoking rates, teen pregnancy, alcohol abuse, domestic violence and we cannot forget cancer. My elder clients are unilingual Inuktitut speaking, so my practice could not function without interpreters. Even with these challenges the medicine is rewarding as the people are very appreciative of the help they receive and I do see my work making a difference.
What other professional activities are you involved in?
Since coming north, I have been involved in the teaching of both family medicine residents and pediatric residents. Our most recent venture is NunaFam – a federally funded partnership between Nunavut and Memorial University. This involves us offering the two month core obstetrical rotation to family medicine residents during their first year of training and a 4 month family medicine rotation during their second year. This work is constantly challenging yet very rewarding when I see their academic progression and, hopefully, a new found appreciation for my specialty of family medicine and the people of the north.
I am involved with MoreOB at our hospital – a safety first obstetrical course for which I am a core team member. I also talk in the schools regarding sexual health and assist with prenatal classes when possible. As we live in a rather remote place, I felt a need to help with the continuing professional development for the medical staff. I have been the on-site coordinator for problem based small group learning since 2003. I, personally, received my fellowship from the College of Family Physicians of Canada in November, 2012. I am the Nunavut representative on the Membership Advisory Committee with the CFPC and try to have a strong voice for us northern, remote physicians.
My focus at work in the last few years has become prenatal, intrapartum and postpartum care as well as women’s health. With that said, I still thoroughly enjoy the challenge still presented to us by tuberculosis infection/disease and striving to have equal access to care for my clients in such a unique part of the world.
And on a personal note?
I am supposed to tell you about hobbies – I am the proud mother of three daughters so I do not get much time for hobbies anymore. Molly (age 5), Lily (age 4) and Jesse (7 months) keep me very busy. I still try to find time to take them skating, snowmobiling, and hiking. I am a lover of music and love to sing which is one more thing to try and instill in my girls.
I could talk about so much more but I think I should end it here and thank you for giving me an opportunity to speak about a professional and a place that I love.
Qujannami (Inuktitut for thank you)