Dr Brenda Hefford knows first-hand the value of collaboration and connection.
This approach to leadership has served Dr. Hefford well over the past 20 years during a journey in which she championed primary care in BC’s health care system.
Now after nearly 11 years at Doctors of BC, Dr Hefford has retired from her role as the Doctors of BC vice-president for physician affairs and community practice, with the intent of slowing down and focusing more on enhancing her clinical practice.
“It’s bittersweet but it was not a tough decision to make because it was not fast or reactive. In fact, I stayed longer than I thought I would because I wanted to see some things through,” Dr Hefford says. “It just felt like it’s the right time.”
Dr Hefford never expected to become a vice-president at Doctors of BC. This was a culmination of a 20-year leadership journey that started around in her local community in 2006 and evolved out of a passion for primary care and a desire to improve working conditions for family physicians in White Rock and South Surrey.
While practicing in her longitudinal family practice, including following patients in hospital, and providing maternity care including as medical director of Peace Arch Hospital, Dr Hefford loved the fact that White Rock was a strong primary care community where family physicians and specialists worked well together. But like today, there were challenges.
“We had a problem, which persists in many communities today, and that is that family physicians were stepping away from their work in the hospital because of many pressures,” Dr Hefford says. “There were more patients who were not attached a family doctor so the burden on family doctors was getting greater.”
Family physicians in her community suggested ways to better meet the needs of patient care in hospitals, but progress took time. This started to change when BCMA (BC Medical Association, Doctors of BC’s previous name) and Ministry of Health leaders from the GPSC (the previous name for the Family Practice Services Committee (FPSC)) visited the community and introduced the idea of forming a Division of Family Practice.
Prior to that, the Fraser Health Authority, which includes White Rock and South Surrey, offered an enhanced family practice initiative, funded through federal primary care transition funding in which family physicians could apply for funding for the adoption of electronic medical records, renovations to their clinic to accommodate the changes, and funding for a nurse. Dr. Hefford’s clinic, along with other White Rock practices, was one of 15 sites in Fraser Health approved for funding and this introduced the value of transforming primary care practice to the physicians.
“The FPSC leaders of the time took the time to come to our communities, talk to us, understand us,” she says. This convinced her “of the value of collaboration and relationship.”
“It was the first time I heard the Ministry of Health and the medical association both speaking about the value of primary care,” Dr Hefford says. “To me, that was inspirational and hopeful.”
Dr Hefford brought together physician leaders in White Rock to create a vision for how primary care services would fit into a Division of Family Practice. Over a series of workshops with FPSC and Fraser Health leadership supported by then Assistant Deputy Minister Stephen Brown, they worked together on the vision for Divisions as a vehicle to help with problem solving and improving the system.
White Rock, along with Prince George and Abbotsford, was one of the first three communities to develop and sign a document of intent (also signed by the Ministry of Health, health authority, and BCMA) for becoming a Division of Family Practice, and in March 2009 completed the process of becoming a not-for-profit society.
This work, which happened during Dr Hefford’s time as medical director of Peace Arch Hospital, led to a new role as executive lead for primary care development for the Fraser Health Authority, helping to create the Divisions of Family Practice in the Fraser region.
In 2011-12, the then-GPSC announced an attachment initiative with three prototype communities, including White Rock, and Dr Hefford became the provincial physician lead for this work and later for the provincial A GP for Me initiative.
“The prototype communities achieved a lot of success in this initiative: in our community we went from no family doctors having accepted patients for several years to being able to offer full attachment to everyone within 18 months,” Dr Hefford says.
Dr. Hefford was involved with the GPSC as a guest in these various leadership capacities and became a core member in 2013. As the provincial physician lead for A GP for Me, Dr. Hefford held a contract with Doctors of BC and later was hired into the role of executive director for practice support and quality, supporting FPSC, in August 2014.
This role involved overseeing a team of 70 people, including the program support for the Practice Support Program (PSP), the Divisions of Family Practice, A GP for Me, as well as the integration of the previous Provincial IT (PITO) team, which introduced electronic medical records into family physician offices.
In 2019, Dr Hefford’s role was redefined as vice-president for physician affairs and community practice for Doctors of BC, working alongside the operational team, CEO, and executive on strategic leadership for primary care.
“This was an exciting change for me, as it freed me up from a management role to be able to focus on collaboration, strategic problem solving, partnership development, and the ability to work across the organization to support primary care,” Dr Hefford says.
It’s been an intense leadership journey that has seen highs and lows. Dr Hefford is most proud of helping in the formation of the Divisions of Family Practice, leading the Doctors of BC primary care engagement in summer 2022, and being part of the development of the Longitudinal Family Practice Payment Model launched in 2023.
Work continues through FPSC, BC Family Doctors, and the Ministry of Health in addressing rural challenges and supporting family physicians in providing facility-based services.
“When I look at staff of Doctors of BC, I’m in awe of their intelligence, commitment, creativity and I feel we’re leaving things in good hands,” says Dr Hefford. “Over the past several years, we have built a strong foundation for primary care. I really hope we continue to build on that foundation in collaboration and partnership. Although it takes work and commitment, I do believe we build a stronger system and more effective change when we work together.”