When it comes to rural medicine, it can take a lot of convincing to get a doctor away from the city.
But for Dr. Geoff Appleton, he says it was an easy decision dedicating 44 years to the Northwest with his medical work.
“I’ve always had a yen for medicine and for helping people. When you go into it, you hope that you’re going to do some good and that it will be fulfilling,” he says. “My favourite part is that when you’ve been in practice in a spot for this many years, you certainly get to know everyone really well.”
Working in Terrace as a general practitioner, he says he’s had to often extend his reach to serve and advocate for the people here as there isn’t a vast network of medical support like there is in urban centres.
“Medicine itself can be extremely stressful if you’re stuck in a rural community and looking after someone that should be in intensive care,” he says. “Some physicians don’t feel competent working in those kinds of situations.”
Originally from Lancashire, U.K., Appleton graduated from Edinburgh Medical School and then spent a year in a pediatric residency at the Vancouver General Hospital. He accepted a one-year temporary position as a general practitioner in Terrace, where he says he was taken aback with the nature of the region and how welcoming everybody was.
Although he returned home to begin his work there, it only took him six months to realize he wanted to be in Terrace. He took over a local practice in 1974 and has since let the years zoom by.
“I couldn’t stand the attitude of senior physicians then [in the U.K.] to junior physicians,” he says. “ And to live in this kind of area with this outdoor life, compared to Britain, was unreal.”
He says the biggest struggle as a local physician was diagnosing patients who needed specialized attention that could only be offered elsewhere. He knew that for many, it would be difficult for them to get there because of costs and distance.
“There’s been times that I’ve had a patient injured or ill flown to Vancouver, but a few days later they phone me that they can’t afford to get back,” Appleton says. “When you see that kind of thing, where people aren’t getting the same kind of care that they could get in an urban area, it’s kind of depressing. Personally, I think genuine travel for medical services should be subsidized.”
When asked how he’s managed to work so long remotely, he says that being a part of several medical boards have kept him sane. Being able to travel out of Terrace for meetings and having another platform to dedicate his expertise to, reminded him of the importance of rural work and how his experiences could be taken into consideration to make things better.
He served as the medical director for the Northern Health Authority from 2009 to 2016. Prior to that, he was an active board member of the Doctors of BC Board, where he took on the presidency for a term.
“Part of my interest in rural health is that you can be at the table with provincial government and health authorites to argue with them,” Appleton says. “You can certainly advocate for patient care when you see it failing.”
He says that a lot of medical professionals in cities aren’t informed about the realities that a remote community faces and the support that it needs from the province. On the boards, he was able to implement changes such as introducing new policies that enable more conversation between the government and the medical world.
Throughout his career, he was involved in scouting out more doctors to come up to the Northwest. Oftentimes, it was hard to entice professionals to move away from more-established medical settings. Despite better salary and other work incentives, the ones who did decide to come would only stay for a short period of time.
“Younger physicians won’t take on that full workload, they want to see less patients and have more time off which is fine, but the problem is that you need more people to replace the ones that have retired,” he says. “Now, you need two doctors on average to replace the one doctor.”
Appleton recently retired as a general practitioner, but he’s still involved with some board member duties. He currently sits with the Dr. REM Lee Hospital Foundation and the Coast Mountain College Foundation.
“Fortunately, [retirement] has been gradual. I don’t know what I would do if I just quit and have been doing nothing,” Appleton says.
He adds that he still wants to help in whatever ways that he can. But with more time on his hands, he’s happy to be spending more time outdoors and even having the chance to travel.
Appleton says he’s also been surprised with the gratitude and recent recognition of his work. For his contribution to medicine in the Northwest and for improving the welfare of residents, the Doctors of BC have awarded a Silver Medal to Appleton. He was also awarded a Lifetime Achievement Award by the Rural Coordination Centre of BC.
“I have got as much out of this personally as what I’ve given, so it’s nice to get a reward,” he says. “I’ve really benefited a lot from doing this.”