Originally, I am from Winnipeg, Manitoba. In my early teens, my family moved to Lions Bay, British Columbia in 1979. After completing my BSc in Cell Biology at UBC, I entered UBC medical school in 1988. After completing a rotating internship at St. Paul’s Hospital in Vancouver, I worked as a general practitioner in the Lower Mainland for one year. I started my residency in General Pathology at UBC in 1994. During residency, my wife and I travelled to the beautiful Cariboo region of the BC Interior and I fell in love with trout fishing. On the way home, we passed through Kamloops and I thought that this could be a nice place to live, work, and play given that it is considered one of the places on the planet for stillwater fly-fishing.

As luck would have it, I was offered a job as a general pathologist in the Department of Pathology at Royal Inland Hospital (RIH) in Kamloops. I seized the opportunity and have had no regrets. My wife and I raised our two children in this very family friendly city with diverse amenities and easy access to nature.

Tell us about your role as a Community Pathologist?

As a community general pathologist, I feel fortunate to have practiced almost all major disciplines of laboratory medicine over the past 24 years. For the first five years, I primarily practiced anatomical pathology (including surgical pathology, non-gyne cytopathology, and autopsy pathology). I would cover medical microbiology, infection control, and hematopathology (including transfusion medicine) during my colleagues’ absences. In 2002, I took over as the RIH medical lead of hematopathology and as Medical Director of Transfusion Services. I served in the latter role for 10 years.

The diversity of clinical cases as a general pathologist is fascinating, challenging, and is it not unusual for one to be involved in the care of a single patient from different lab discipline perspectives simultaneously. Many of us have direct patient contact by performing both bone marrow biopsy procedures and fine needle aspirations.

Administrative duties and committee work soon becomes part of the job of the community pathologist. In 2011, I became Head, RIH Department of Pathology and Medical Director of Labs, Thompson Cariboo Shuswap Health Service Area (TCS) in the Interior Health (IH) Lab system. Since then, my diagnostic practice has primarily focused on hematopathology, transfusion medicine, point of care testing, and medical biochemistry. Only recently, I stepped down from the above leadership positions after serving for more than a decade.

RIH is the major referral centre in TCS and as lab physicians we frequently develop positive close working relationships as lab consultants for our urban and rural clinical colleagues.

In TCS, many of our department members serve as medical directors for smaller labs. Regional site visits as one travels through spectacular landscapes is one of the benefits of overseeing a smaller lab. These types of medical oversight roles in a multi-centre lab system have been very valuable in appreciating the complexity of our provincial lab system.

Most challenging part of your job?

One of the most challenging parts of my job is managing finite resources in a world of seemingly infinite demands and constantly expanding regulatory requirements. Many times, the diagnostic lab is simply viewed by many as a black box with infinite capacity that generates timely, accurate data for clinical use. When resources are at their limit, there will usually be a knock at the pathologist’s office door. Resolving these situations is rarely simple or easy. Creative thinking and a deep understanding of potentially cascading consequences are essential in arriving at sustainable solutions.

Best part of your job?

I really enjoy interacting with the clinicians on a particularly challenging case where laboratory testing provides critical information that significantly alters patient management. These types of cases really highlight the value of a robust laboratory service and its importance in delivering high quality health care. I always use these opportunities to interact with my colleagues, clinicians, students, and our technologists as these types of cases usually result in a great learning opportunity.

Who inspires you and why?

From a professional point of view, the individuals who most inspired me were Dr. Shelley Naiman and Dr. Louis Wadsworth. Both were great instructor role models in my residency and both possessed the incredible ability to clearly explain, teach, and provide memorable case examples and analogies that I still remember years later.

Tell us about a project or endeavour that you’ve participated in that makes you proud?

My active fifteen year participation as Medical Lead of the IH Hematology Working Group (HWG) has been very fulfilling.

IH Labs consists of 50 collection sites affiliated with 26 laboratories of varying sizes covering a diverse geography the size of many European countries, two time zones, four distinct seasons, and serving over 700,000 people. The task of running a high quality, integrated lab system of this logistical complexity cannot be understated.

Formed in late 2005, the HWG’s mandate was to standardize four separate Meditech lab databases and it grew from there. Over the following years, the HWG was able to standardize the vast majority of hematology lab testing policies/processes/procedures, institute quality initiatives, standardize/implement region wide coagulation/hematology testing platforms, develop/troubleshoot lab information system reporting, and implement new methodologies such as autoimmune/malaria nucleic acid testing/digital image analysis.

Participation on the HWG also led to opportunities to collaborate on various projects with my provincial colleagues. The latter was very valuable to my professional development as British Columbia possesses a very high quality hematopathology network/community whose members have taught me a great deal.

Are there any tips you want to share with students on how to be successful in medical practice?

I suppose one could say “study harder, read more, and see lots”.

That stated, health care is a group effort so never underestimate the value that positive professional relationships will have with a group of people who are working together to optimize patient care. Our job is challenging enough and if you get along with those around you, the mutual support and team effort will allow the group to thrive. A highly functioning health care team leads to better patient outcomes as communication is free flowing and counterproductive distractions are contained.

With the above in mind, it is equally important to express a different opinion in a group if it is warranted and will be productive. An alternate view is best presented in a clear manner and after respectful consideration of all perspectives.

Favourite vacation spot in BC?

This is very difficult question to answer as British Columbia is a unique natural gem with such a diverse beautiful geography.

For me, though, I have a strong bias for any body of clear water in a beautiful setting where one can fish for salmon or trout.