Dr. Rao is a family doctor in Goosefoot, a small industrial town in Canada. The town has a population of 15,000 and is 2 hours by road from the nearest city, Weenigo. Goosefoot was built around the iron ore mining and forestry industries, but these are experiencing difficult times. One forestry operation closed 5 years ago and the mine is laying workers off. A proportion of its workers commute to the oil sands project and some have left permanently. Times are tough.

Dr. Rao has been in Goosefoot for the last 20 years. He came to Canada as an international medical graduate, having trained in India and worked in Britain. He arrived in town to replace one of the solo family doctors who was retiring. Dr. Rao worked hard to attract more family practitioners and built up a group practice of 5 family physicians: himself, 2 new recruits—Dr. Middleton and Dr. Paul—and 2 former solo practitioners—Dr. Nguyen and Dr. Cormier. They have a practice nurse, Nurse Jennings, and have negotiated access to the physiotherapy and occupational therapy services at the local community hospital. They also have a practice manager, Mr. Bertoli, who has made it his business to liaise with all local health and social service providers, including the voluntary organizations. He keeps the professionals in the practice up-to-date on the organization of services in the area.

When Dr. Rao arrived in town, the local hospital was designated as an acute care centre, and provided services in internal medicine, cardiology, respiratory medicine, general surgery and obstetrics. Rationalization of regional services and a shortage of health professionals in the area saw the hospital change its mission to long stay and community care, relying on outreach services from the hospitals in Weenigo for coverage in ophthalmology, cardiology, endocrinology and rheumatology as well as acute inpatient services.

In the Primer you will meet some of Dr. Rao’s patients. In particular, the Richards family is featured. They are:

• Paul Richards: A 50 year old miner who is now out of work. Paul is married to Julie.
• Julie Richards: A 50 year old woman who has worked in a number of part-time jobs and currently works 25 hours a week at the local supermarket check-out. Julie is married to Paul.
• Catherine Richards test: A 70 year old woman with cardiac problems and early dementia. Catherine is Paul’s mother.
• David Richards: A 21 year old man, who dropped out of high school. David is the younger of Paul and Julie’s 2 children.
• Audry Richards is the elder of Paul and Julie’s children. She has moved away from Goosefoot.

Some other patients are also mentioned:

• Mary Sulaweso: A 29 year old woman refugee from Nigeria.
• Peter Sulaweso: Mary Sulaweso’s 3 year old son
• Irina Rebikov: A 86 year old woman with terminal cancer
• Darryl Crow: A 55 year old man dying of lung cancer
• Mary Monye: A 26 year old woman originally from Nigeria, who immigrated to Canada as a child
• Myriam Fortin: A 29 year old single parent.