Profile

After several years as a physician in the city of Sofia, Bulgaria, Dr. Yordan Karaivanov sought a change of scenery and a new dynamic. Driven by an interest in rural medicine, in 1995 he contacted several rural hospitals across the world with the intention to do a six-month locum.

One community replied almost immediately. In their detailed response, they described the virtues of working and living in Labrador. Feeling so welcomed and impressed by their reply, Dr. Karaivanov accepted their offer.

“I landed in Goose Bay in minus-35 weather, and in just two days I was working in the emergency department,” he says. Now he and his wife — also a doctor — are entrenched in the Happy Valley-Goose Bay community.

While working in a family medicine clinic and teaching medicine at Memorial University, Dr. Karaivanov has served in many leadership roles, including as Newfoundland and Labrador Medical Association president, Canadian Medical Association and College of Family Physicians of Canada board member, Newfoundland and Labrador Health Services chief of patient safety and quality of care, and College of Physicians and Surgeons of Newfoundland and Labrador council member.

Through it all, he has kept the needs of rural families front and centre.

“It’s frankly hard to believe the true scope of practice for a rural Canadian doctor,” Dr. Karaivanov says, adding that something always happens to push physicians out of their comfort zones because they have few supports to rely on.

Dr. Karaivanov considers this level of practice intellectually challenging and deeply rewarding. It is a role that requires clinical courage because physicians have to be confident in taking measured risks to help patients who can’t face delays and indecision. “You become a better doctor because you are always learning,” he says.

Half the population of Happy Valley-Goose Bay is Indigenous, and Dr. Karaivanov has had the privilege of caring for many generations of the same families. For Dr. Karaivanov, it’s been an “incredible opportunity” to really get to know his patients. And since he also knows his patients’ relatives, he gains more context and deeper insight into his patients and their needs.

Dr. Karaivanov also devotes time to research projects on the acute health concerns faced by local Indigenous families. With his intimate view of the profound burden of chronic disease in these communities, Dr. Karaivanov is trying to create solutions to tackle the social determinants of health that are contributing to these illnesses.

Looking back, he wishes that he had started more research when his career first shifted to Goose Bay, although the first 10 years saw him working more than 100 hours a week. Still, he believes that research, like providing care, is becoming harder in rural settings, so creating networks and alliances are essential but take time.

“I encourage younger doctors to get involved in research and advance their leadership skills,” he says. “It helps in so many ways, keeps you involved in your practice and gives you wider credibility.”

Dr. Karaivanov views many experiences as learning opportunities, and this outlook inspired him to join the Physician Council.

Dr. Karaivanov believes that one exciting development is the Medicus Pension Plan^TM, as he fields plenty of questions about it from colleagues and students. He also believes that since most doctors can’t access defined benefit pensions, there may be more opportunities than ever before to incorporate and gain access to Medicus.

It’s now been nearly 25 years since Dr. Karaivanov arrived in Labrador. His wife has become an expert in fetal alcohol disorder and runs a clinic dedicated to this condition. Their daughter is studying at McGill University, and their son is studying in Dublin — a city at nearly the same latitude as Goose Bay. “But if you look at isolation and temperatures,” Dr. Karaivanov says, “we qualify as the North.”