Celebrating over 40 years of long term family practice
For over 40 years, Dr. Ken Hook practiced as a comprehensive family physician as part of the group practice in Tavistock, Ontario. And if it were not for a personal health scare and the global COVID-19 pandemic, he would still be doing what he loves, looking after patients and teaching.
“I didn’t choose to retire,” said Dr. Hook. “I loved my work, I enjoyed looking after patients, I really enjoyed teaching. It wasn’t my first choice as to what to do with my life, but retirement is an adjustment.”
He chuckles, “The garden looks great this year.”
Dr. Hook had maintained a small but full scope practice until the fall of 2018 when he developed lymphoma and became quite unwell due to the required chemotherapy.
“In the winter of 2018 I had to hand my practice over to a younger colleague, Dr. Reaume, who very kindly accepted all of my patients.” said Dr. Hook.
Following his recovery, Dr. Hook went back into the clinic, working one day a week in urgent care, but then COVID-19 hit. Now over 70 years old, and immune compromised, the decision was made that his partners would look after his call days for him.
“You have to keep seeing patients to stay clinically proficient,” said Dr. Hook. “Because I had missed so much time, I decided not to renew my license.”
The early years
Dr. Hook’s career journey began in 1971 when he graduated from McGill University. He then came to Western University to do a residency in Family Medicine. At the time, a Family Medicine residency was not required to get a licence to practice, and was only offered at McMaster, Western and the University of Calgary.
It was during his residency training that Dr. Hook met his wife, Janet. They married in 1975 and then went to Africa where he would work in Malawi, intending to support their primary care teams which were delivered by medical assistants, midwives, and nurses.
“I was stationed in a remote hospital, and ended up doing everything from office practice to Caesarean sections,” said Dr. Hook.
In December of 1975, the family returned to Canada, and in 1976 Dr. Hook joined the clinic in Tavistock.
“Wayne Weston had just left the clinic after having been in Tavistock for 10 years,” said Dr. Hook.
It was Dr. Weston who had introduced the practice to the teaching of medical students and residents. Residents were already in the practice in 1976.
“I was very green myself and didn’t do a very good job at teaching then,” said Dr. Hook. “We stopped having residents two to three years later to take our breath.”
Joining the university
Fast forward to 1991, and with Dr. Ian McWhinney as Chair of the Department of Family Medicine, Western once again approached the clinic in Tavistock to take on the teaching of residents.
“We said yes. We had reached a certain maturity at that time and thought we had enough experience to be effective teachers.”
Dr. Hook remembers that time fondly.
“The Department of Family Medicine was very helpful. Dr. Susan McNair was the Department’s lead for community medicine and was a fantastic support in getting us set up.”
Starting in 1991 Tavistock took two residents each year, a new R1 and a R2 from the previous year.
“That was lots of fun,” said Dr. Hook. “I really enjoyed having the residents to work with. I learned so much by helping them to learn.”
Ontario College of Family Physicians
In 1993 Dr. Hook joined the Board of the Ontario College of Family Physicians (OCFP). He later was invited to join the Executive Committee.
“One thing led to another, and I ended up being President of the Ontario College of Family Physicians from 2000-2001,” said Dr. Hook. “That was a huge honour.”
At that time, the OCFP was very concerned by the shortage of family physicians.
Family physicians that chose to do walk in clinic work, looking after simple problems quickly, could earn much more than a comprehensive family doctor.
“The College recognized there was a need to support comprehensive family doctors better,” said Dr. Hook.
The OCFP Board developed a plan that would better compensate family physicians that were doing comprehensive work and promoted this idea to the Ontario Medical Association (OMA).
“During my year as President, the Ministry and the OMA agreed to accept a different payment method.”
The Ontario Family Health Network Agreement was subsequently offered to groups of family physicians throughout the province.
“It made a big difference in how family physicians were financially recognized, and it supported the type of care comprehensive family doctors provided,” said Dr. Hook. “Now we knew who our patients were and could do things like send letters to patients to update their preventative care interventions. It was quite something to be part of that.”
Looking back, Dr. Hook still relishes being a part of the change that made a big difference for physicians and patients.
Teaching
For Dr. Hook, the most positive part of both teaching and the care of patients is the relationship that develops.
“When I had a resident, we managed my practice as a team and we worked together, we learned together and that was exciting,” said Dr. Hook. “The residents would discover something and teach me.”
After 44 years of practice, looking after several generations of the same family, Dr. Hook developed close relationships with his patients which he cherished.
“I was able to share that with my residents, so that they too would be able to learn what a joy it could be to practice family medicine and have a close, trusting, and privileged relationship with one’s community and one’s practice.”
It is a privileged relationship of trust that no other profession enjoys, maintains Dr. Hook.
“Even school teachers have their students for just one year. We have our practice for the entire time we are in practice. We are able to develop very deep and very meaningful relationships.”
Looking to the future
Dr. Hook sees family medicine as the key to sustaining our healthcare system, especially with the increasing numbers of patients with multiple comorbid conditions, and he thinks that everyone should have access to a family physician they can depend on and trust.
“Family medicine is going to become even more complicated and harder, but I think the solution to that is information technology and team-based care,” said Dr. Hook. “I worked with some wonderful pharmacists over time who really helped me manage my patients with challenging co-morbidities.”
He hopes that all family physicians who want to be part of a multi disciplinary team can have the opportunity to practice as such.
“In Ontario there are only about 250 teams. Only a small percentage of patients can get care from family health teams, and I would like to see that change in the future,” said Dr. Hook.
Retirement
As he adapts to retirement, Dr. Hook looks forward to spending more time at his cottage and seeing a little bit more of his children and grandchildren.
“COVID has really interfered with that, but within the constraints imposed by COVID, both my wife and I are looking forward to have more time to see our children.”
The Department of Family Medicine would like to recognize Dr. Ken Hook’s longstanding relationship with the Schulich School of Medicine and Dentistry at Western University and the impact he has had over decades of training learners and residents.
