Life is fragile and can change dramatically in the blink of an eye. The husband-and-wife physician team of Drs. Chris and Mairi Burnett can attest to that, as Mairi was recently diagnosed with multiple myeloma, a cancer of the plasma cells in her bone marrow.
Not only is Mairi’s future uncertain, but so is the couple’s medical clinic of nearly 15 years, Niverville Open Health. Today they speak candidly about the difficulties they’ve faced in the past few months as well as the uncertainty of the road ahead—and what that might mean to the community as a whole.
Diagnosis and Prognosis
Last fall, Mairi unwittingly transitioned from medical practitioner to patient. Her symptoms of fatigue and breathlessness, which at first she chalked up to age and lack of exercise, eventually resulted in a barrage of tests and a cancer diagnosis.
Multiple myeloma, she says, causes a person to become anemic and prevents the blood from clotting properly. As well, sufferers become extremely susceptible to infection and bone fractures. The immune system is also significantly compromised.
“We’ve picked it up relatively early,” Mairi says. “So my left arm and my skull are the only bones that were picked up as being affected [so far]. Those are the ones that the marrow has been changed enough to see it on an X-ray.”
She adds, though, that this kind of cancer is incurable. Remission is the best case scenario for any multiple myeloma patient, and even if remission is achieved a patient likely has to undergo regular and ongoing treatments over the course of their lifetime.
“Best case scenario is that I’ll be back to normal by September or October,” says Mairi. “Worst case scenario is that I don’t respond to the treatment and then I just get worse and worse.”
Dr. Mairi’s chemotherapy treatments began in late fall. But just four treatments in, she was struck down with pneumonia, likely a result of being exposed to a sick patient at the clinic. A lengthy hospital stay and round of intravenous antibiotics left Mairi with no choice but to give up her practice.
Now, back on chemotherapy, the next few months will indicate whether the chemo has been effective in killing off enough cancer cells in her bones. If it has, Mairi will be looking at a bone marrow transplant come spring.
“The [transplant] doesn’t get rid of all the [cancer] cells,” says husband Chris, “so there’s still going to be little pockets of it somewhere and you hope that it’s going to be a long time before it comes back.”
Ramifications for Open Health
When Chris and Mairi became aware of the full scope of what she was facing, they chose not to renew the contract of their one physician assistant, who required their availability in order to practice at the Open Health clinic.
“That left us, in December, with one physician contributing to the overhead—myself,” Chris says. “[Without Mairi and the physician assistant], we had just lost about 60 percent of the income for the clinic.”
Ever since, Chris has been putting 100 percent of his salary back into the business in order to pay the overhead, just to keep the clinic doors open.
In January, he finally reached out to Niverville’s town council and the Niverville Heritage Holdings board for assistance in finding a solution.
“If we can’t find a solution, I’m going to run out of savings and we’re going to have to close the clinic,” Chris says. “I don’t want to do that. I want to stay here working… and I’d like to work for another ten years. I think if Mairi comes back it will be part-time, but obviously we can’t continue paying the costs of the whole clinic.”
How to Move Forward
As of late January, town council has engaged the services of Kathy McPhail, former CEO of Southern Health-Sante Sud. McPhail has been commissioned to research and create a report which will assess the current threats to Niverville’s medical clinic, look for new opportunities, and make recommendations on short-term and long-term solutions for the clinic.
Chris says this is a wise move, as he puts great stock in McPhail’s expertise.
“I think we can trust her to look at the needs of the town rather than the needs of Chris Burnett,” Chris says.
In the meantime, he’ll be faced with eliminating some staff members to help alleviate some of the financial burden.
As for the mental healthcare and public healthcare workers at Open Health, as well as the dietician and chronic disease nurse, their salaries are paid through the regional health authority and they are not at risk of losing their jobs because of the Burnetts’ situation. But if the clinic is forced to shut down, their location may be at risk.
While one might expect it to be an easy solution to just look for new doctors to take up residence at the clinic, Chris says it’s not that simple. Finding physicians that are willing to travel outside city limits and pay a percentage of their income to clinic overhead is a challenge for most rural clinics.
Approximately 15 years ago, Chris says, Winkler was faced with a similar situation. The six doctors they had were leaving for jobs elsewhere, leaving the city at a loss until an arms-length corporation turned the clinic into a not-for-profit entity, paying physician salaries and providing management of the clinic.
Those six departing doctors have since led to the successful acquisition of 40 physicians today. While this may be a solution for Niverville, Chris cannot speculate on the feasibility of such a model here. In the meantime, he waits to see the outcome of the report.
Struggles and Support
“I think the hardest thing for me is, at a time when I’m supposed to be supporting my wife through this, I’m in for the battle of my life for the business,” Chris says. “I’m coming home [after a full day at the clinic] and I’m retreating for another four hours of [paper]work in the evening.”
For Mairi, reconciling herself with the fact that her career has come to an abrupt halt has been a big challenge.
“To suddenly go from working extremely hard… to not doing any medical work is quite hard,” she says. “Part of me understands that I can’t do the job right now, but my mind [is saying something else].”
But the community and client support in the past few months has gone a long way to buoying her spirits during this difficult time.
“We’ve been here for over 14 years now and I’ve sort of felt on the edge of the community, because I’m a doctor,” Mairi says, referring to the arms-length relationship that usually occurs between professionals and their clients. “This [illness] has just blown that open. [There’s been] so much support from the community that I’ve really felt a part of it in a huge way like I’d never really felt as much before. I feel embraced, like it’s my family now and not just my community.”