Improving Access and Building Trust in Indigenous Healthcare
Source: McGill Health-E News
February 26, 2025
For many Indigenous patients, accessing specialized healthcare means leaving their community—an often daunting step rooted in historical mistrust. The General Internal Medicine Clinic at Kateri Memorial Hospital Centre (KMHC) launched in October 2022 through a collaboration between the McGill University Health Centre (MUHC) and KMHC is changing that by bringing specialist care closer to home.
The idea emerged during a discussion in the General Internal Medicine Fellow Residency Committee about community rotations. Medical residents and students expressed a desire to work more closely with Indigenous communities, recognizing that many patients were reluctant to leave home for extended periods to seek specialized care unavailable nearby. Romina Pace, MD, a junior scientist in the Metabolic Disorders and Complications Program at the Research Institute of the MUHC (The Institute), and Patrick Willemot, MD, both members of the Division of General Internal Medicine at the MUHC, brought this feedback to Rachael Eniojukan, MD, Director of Professional Services at KMHC, who agreed the initiative would be beneficial. With strong support from the MUHC, the clinic quickly took shape.
“Here in Canada, there’s a lot of mistrust with the healthcare system, and rightfully so, given the history of colonialism,” says Dr. Pace, referring to Indigenous patients. “We thought bringing care to the Kahnawa’kehró:non in a space where they feel comfortable would be beneficial.”
Since opening, the clinic has expanded from a half-day to two full-day clinics per month. Dr. Pace and Dr. Willemot now alternate sessions, seeing outpatients and offering specialized care for a broad range of conditions—including cardiology, nephrology, endocrinology, and rheumatology—so that patients can receive comprehensive treatment without leaving their community.
But beyond just providing medical care, the clinic plays a vital role in bridging gaps within the healthcare system. “Family doctors were trying their best, but sometimes they’d encounter cases outside their scope of practice,” Dr. Pace explains. Patients often avoided outside appointments due to discomfort or logistical barriers, leading to breakdowns in communication. By keeping care local, the clinic helps patients feel more comfortable seeking treatment.
This has made a meaningful difference, especially for those managing multiple conditions. “Many patients struggle to see multiple specialists due to work or family responsibilities. Our clinic helps streamline care by addressing multiple issues in one visit,” Dr. Pace notes.
Dr. Pace recalls one case that exemplifies this impact: “I had a young patient with a very serious medical condition who didn’t go to his appointments. His family doctor realized this and involved us in his care,” she says. “We’ve been following him for about a year now, and we were able to walk him through why his condition really has to be taken care of. He recently went to his specialist appointment at an outside hospital. I think we were able to make him feel more comfortable with the system again.”
Collaboration with local family doctors has been key to the clinic’s success. Rather than sending patients to unfamiliar institutions, Dr. Pace and Dr. Willemot work alongside family physicians to ensure continuity of care. “We don’t have to refer patients outside to another institution that they might not be used to, and there’s a lot of sharing of information with the family doctor which is really helpful for continuity of care,” Dr. Pace explains.
Bringing trainees into the clinic has been beneficial for both the trainees and the local community. “It’s about understanding Indigenous patients, where they’re coming from, their knowledge, and their ways of seeing the world, so that healthcare providers know how to communicate better,” Dr. Pace says. “Problems with communication, the words we use, and how we express things…. It’s really important to introduce the next generation of doctors and nurses to the community.”
“Exposure to healthcare professionals can also inspire community members to explore careers in healthcare. It’s not just about doctors and dentists. People can see there are also occupational therapists, nutritionists, and other professionals,” Dr. Pace explains.
The long-term vision for the clinic involves strengthening partnerships and expanding training opportunities. “I think McGill should continue working with KMHC to develop more training programs, making healthcare more accessible,” Dr. Pace says. “This exposure might inspire community members to pursue careers in healthcare, bringing that knowledge back home and building local capacity. Increasing partnerships with the MUHC and bringing in different medical specialties would be a great step forward.”
For Dr. Pace, working at the clinic has been a rewarding experience. “I enjoy the clinic a lot, it’s been a great opportunity for me as well. Learning from the patients and family doctors and seeing great programs being developed that honor traditional methods and knowledge, I’ve been lucky to participate.”
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