Melanie MacCara MD CCFP FCFP

William M. Glenn

I’m an old-fashioned, cradle-to-grave kind of family doctor,” says Dr Melanie MacCara. Graduating from Dalhousie in 1993, she started her solo practice the very next week in the same rural Nova Scotia community where she grew up. “Twenty years later, I go to my son’s high school graduation and some of the babies I delivered were graduating too!”

So Dr MacCara probably surprised her patients, her family, and even herself when she decided to join the Eastside Collaborative Practice just down the road in New Glasgow.

The Pictou County Health Authority was consolidating a number of its community-based programs—including a diabetes education centre, a pain clinic, mental health services, and addiction counseling—in a new community health centre and several neighbouring buildings. Dr MacCara joined the collaborative practice team in 2009.

“It’s not for everybody, but that’s the direction family medicine seems to be going,” she says. One of the big attractions is the support. The team currently consists of 5 family doctors—each with her own practice—backed by a nurse practitioner, a family practice nurse (who is also a wound specialist), a chronic disease management nurse, a half-time dietitian, a half-time social worker, and various support staff.

Members of the team bring their own expertise and experience to meetings, offering advice on patient care. “Sharing your patients is a different way of doing medicine. Everything can’t always be your way,” Dr MacCara explains. “In the end, we are all working together and doing it as a team. I know it sounds so ‘Pollyanna’ and too good to be true. But that’s the way it is.”

There is also strong administrative support, with the clinic handling all the time-consuming human resources, accounting, and technological concerns. “I’m not computer savvy at all,” Dr MacCara laughs, “and I got all my medical records online when I came here.” In addition, she doesn’t handle obstetrics any longer; so her life isn’t dictated by a beeper. Nor does she have to make a trip into the hospital every day, clearing her schedule for more one-on-one time with her patients.

“Still, I seem to be working all the time,” Dr MacCara says. “And despite all the support, I make sure at least some of the hands-on procedures are booked with me. I still give injections and Pap smears on occasion. I don’t want to lose touch with my patients. I’ve been seeing some of them their whole lives.”

“I don’t want to lose touch with my patients”

PHOTOS (LEFT): Dr MacCara with (seated) Dr Sviatlana Yatsynovich (“Dr Lana”), who is the Clinician Assessment for Practice Program physician, and Sheri Sheehan, the chronic disease management nurse.

PHOTOS (RIGHT): Dr MacCara; her husband, Darrell Spears; her son, Liam; and her daughter, Merrilee swimming with the dolphins in Cuba. Dr MacCara walking on the Samson Trail along the East River in New Glasgow, a favourite spot for a run or walk before work.

Notes

THE COVER PROJECT Canadian Family Physician has embarked on a project to assemble the portrait of family medicine in Canada. Each cover of the journal features a family physician chosen at random from our membership list, along with a short essay—a brief glimpse of the person and the practice. Over time, the randomness will become representative and the differences, taken together, will define what it is that all family physicians have in common.