No two days are ever quite the same for a family physician, and rural doc Noel DaCunha can attest to that. Dr. DaCunha’s practice consists of multi-generational families, which means his scope of work extends from, “delivering their babies, looking after their great grandparents and everything in between.” It is this comprehensive, patient and family-centred care that inspired Dr. DaCunha to pursue Family Medicine, a specialization where he could engage with patients that he knew well and be involved in all aspects of their healthcare.
A day in the life for Dr. DaCunha, consists of 8 a.m. hospital rounds with his R2 family medicine resident and 3rd year medical student – a role which blends both his passion of teaching and mentoring, followed up with clinic hours at Westlock’s Associated Medical Clinic. And when the weather is warm and the days are long, Dr. DaCunha can be found squeezing in a quick 9 holes of golf before the day begins!
The community Dr. DaCunha serves is not only important to him, but also to his family. 29 years ago, Dr. DaCunha and his family moved from the United Kingdom to the town of Westlock, Alberta and over the years, both Dr. DaCunha and his wife have invested back into their community by working with several local charities and sitting on boards of directors, in fact, Dr. DaCunha currently sits on the ACFP Board of Directors. “It is important to engage with colleagues and the community outside the work environment,” and for Dr. DaCunha these volunteer positions reinforce just that.
In the progression of his practice, Dr. DaCunha has taken on the role of Administrative Head for the Westlock Associated Medical Clinic. Responsibilities for negotiating lease and practice agreements, monitoring clinic finances, and organizing clinic meetings, all tasks Dr. DaCunha is only to happy to perform to alleviate stress off new physicians who are less familiar with the business aspects of a practice. With over 30 years of experience, when it comes to pursuing everyday excellence, Dr. DaCunha suggests, actively listening and honouring the time spent with each patient (even when it’s in short supply) goes a long way in building a life-long, trusted rapport.
Q1. Why did you choose Family Medicine?
Answer: I was drawn to the concept of comprehensive patient and family centered care, where I could engage with patients that I knew well and be involved in all aspects of their healthcare.
Q2. What is your favourite part of being a family physician?
Answer: Living in a small community where I have multi-generational extended families as patients – delivering their babies, looking after their great grandparents and everything in between.
Q3. What does a typical day look like in your practice? What is your routine?
Answer: I wake up early and check lab results, new hospital admissions, etc. online. In the summer, I usually get nine holes of golf in and then head to the hospital at 8 a.m. to round on my inpatients with my R2 family medicine resident and 3rd year medical student. We then go to our family medicine clinic from 9 a.m. to 5 p.m. This routine is often adjusted to deal with maternities in labor and emergencies at the hospital. After hours are generally work free although they can be interrupted by maternities, in-patient crises, and long-term care/palliative care visits.
Q4. What role do you play in the management of your clinic/practice?
Answer: I am currently the Administrative Head of our nine-doctor clinic. Fortunately, we have great staff and I do not get too involved in micro-management. I am responsible for negotiating lease agreements, practice agreements, monitoring clinic finances, organizing clinic meetings, etc.
Q5. Do you have experience in other types of practice settings? if so, what is it the about your current setting that gets you excited to come to work each day?
Answer: I initially was a trainee in a teaching practice in the U.K. for a year. We provided comprehensive care with home visits, home care nursing support, domiciliary maternity care, etc., but no in-patient care. I then moved to the small, two physician village of Mannville, Alberta. This was a great introduction to work and lifestyle in rural western Canada. I was able to expand my provision of comprehensive care with the addition of having a local hospital with an E.R. and maternity services.
After 4 years of this very busy though enjoyable environment I realized it was not sustainable for me in the long term. I needed to be in a situation where I could have the support of secondary medical services (obstetrics, surgery, anesthesia, etc.) as well as more C.P.D. and teaching opportunities. Moving to the town of Westlock, twenty-nine years ago was the best move of my career. It is still a small town, though having the support of twelve family physicians with a variety of enhanced skills, being part of U of A faculty, quick access to tertiary care services in Edmonton, having privileges at our local hospital with access to comprehensive diagnostic services (Lab, Xray, CT, MRI) as well as PT, OT and a supportive local PCN make this a great work environment.
Q6. When you reflect on your career, did you imagine you would be where you are now?
Answer: When I graduated, I had no idea that I would be heading to Western Canada. I did want to work in an environment where I could utilize all the skills I had acquired in my training, be a teacher and I am pleased that is how things worked out.
Q7. What skills, attributes, or training do you think you possess that have gotten you to where you are now? Where or how did you obtain them?
Answer: My family medicine residency training in the U.K. included one year internal medicine, six months general surgery, six months obstetrics and gynecology, six months E.R., six months Pediatrics, six months geriatrics, three months psychiatry and a year as a trainee in a suburban/rural teaching family practice. This is longer than our standard family medicine training programs here in Canada though well suited to rural family practice.
Q8. How important is it to you to stay connected within your community of practice, your clinic?
Answer: My family and I are active in the local community. I am currently on the boards of directors of our local golf club as well as a couple of charitable organizations. We have regular clinic socials and occasional hospital ones. I feel it is important to engage with colleagues and the community outside just the work environment.
Q9. Can you name a person who has had a tremendous impact on you and your growth as a family physician (directly or indirectly)? Maybe a colleague, a mentor, or preceptor to you? Why and how did this person impact your life?
Answer: When I first arrived in Canada, my senior colleague in Mannville, Dr. Joseph Fernando was an inspiration and a mentor. He was a good example of how to provide comprehensive primary care with limited local resources. In Westlock, Dr. Alan Watt played a big part in supporting my growth and confidence in primary care obstetrics.
Q10. What is one gesture that you make an effort to practice everyday (or nearly everyday) that others could try?
Answer: Actively listen and make time (even when it’s in short supply) when talking to patients. It goes a long way in preserving relationships.