Most people try to limit their time in the emergency room, but Dr. Tom Armstrong has spent the last 45 years there.
Armstrong, who served as the chief of the emergency department at Royal Victoria Regional Health Centre (RVH) for nearly two decades, admitted that while growing up on a farm more than 200 kilometres from Barrie, a career in medicine wasn’t necessarily always on his radar.
The 74-year-old doctor, and now recently retired, grew up on a farm near Cayuga, about 45 minutes south of Hamilton. He tells BarrieToday he was often exposed to veterinary medicine in his youth, which is likely what eventually spurred his interest in the field of medicine.
“I really just developed an interest in medicine at that time, and that just sort of progressed. As I got into high school and university, I felt the need to switch into possible human medicine … (and) that's what initiated medical school,” says Armstrong, who attended the University of Toronto and graduated from medical school in 1975.
The father of three and grandfather of four also simply enjoyed working with people and never shied away from things that were difficult — two big factors that came with the job of being a physician.
“I enjoyed challenges and I found medicine to be a definite challenge,” says Armstrong, who has worked in family medicine, anesthesia and emergency medicine over the course of his long career.
Armstrong says his initial desire was to pursue a career as a family physician, so after completing a one-year, rotating internship and a year in anesthesia and internal medicine, he began to look for a place to set up shop.
“My wife was finishing law school at the time in Toronto, so I looked around for a family medicine practice," he says.
Armstrong was aware of two family practices in need of a doctor — one in Collingwood and the other in Innisfil. After checking them both out, he decided Innisfil would be a great fit and joined the office in 1977.
“It was definitely more of a rural-type of farming community, which was my background, so that’s where I decided to go," he says.
At the time, he says family physicians in the area were required to join the medical staff at the local hospital in Barrie and were expected to do an emergency medicine rotation. While some of his colleagues may have merely tolerated the opportunity, it didn’t take long for Armstrong to find he actually loved working in the emergency department.
As the years went on, he realized he'd developed a strong passion for emergency medicine and ultimately left his family practice in 1982.
“Barrie was growing rather rapidly in the 1980s. Back then, the family medicine department covered emerg," he says. "Family doctors would be called for their patients or would be on city call for patients who had no family doctor. They’d go to emerg, address the issue and then go, but there was no on-site doctor at that time.
"It was really quite evident that care would be benefitted by a doctor being on site,” Armstrong adds.
Given his special interest in emergency medicine, Armstrong soon volunteered to take on that role when the opportunity arose.
“The hospital had a special meeting and they created a separate emergency department, and because I was interested I volunteered to be the chief of emerg and I transferred into full-time emergency medicine," he says.
Despite the stress that came with the job, Armstrong says he enjoyed the sense of urgency that came with some of the more complex cases and the fact that not one day was ever the same.
“I enjoyed the challenges and that the demands would change. You never knew what was coming in and it was always something different. It was a variety of dynamic medicine that I enjoyed," he says.
Over his four-decade-plus career, Armstrong has seen a lot of change, not only in the local ER but in emergency medicine as a whole.
“The amount of investigative tools you have today is pretty impressive," he says. "Since starting in emergency medicine, there’s been the development of ultrasounds, CT scans, MRIs and that has changed the whole outlook and changed emergency medicine to a large degree.”
One of the things Armstrong is particularly proud of is being part of the regular updating of the hospital’s emergency disaster plan. In fact, he was working the day a deadly tornado hit Barrie on May 31, 1985. He saw the plan in full effect that dark day in the city's history.
“I was very impressed with how it worked and it was a full team effort. That is one thing that really sticks in my mind," he says.
Another proud moment for the longtime physician is getting to see one of his children follow in his footsteps. He was even allowed to be on stage and give his daughter her diploma.
"I enjoy watching her go through medical school and we have had many discussions about issues,” he says.
Armstrong's daughter now works as the clinical director of the emergency department at RVH.
Meanwhile, something he believes hasn’t been as positive of a change has been the decline in the number of family doctors who also work in the ER.
“When I came to Barrie, it was basically a small city and family doctors were the ones that did a lot of the primary care at the hospital," Armstrong says. "As the hospital has grown to such a size, one thing I find is family doctors are not in the hospital nearly as much because the care has been taken over by consultants and specialists.”
In a perfect world, Armstrong admits he’d prefer to see family doctors have a more involved role in patient care in the emergency department.
“The family doctors were the ones who patients relied upon," he says. "They trusted them and they knew them. Now, you have somebody in care of you, but it isn’t the same knowledge of your background. It’s just not quite the same.”
Having formally retired last year Armstrong has a few words of advice for anyone just starting out in the field - and that includes simply doing what you love.
“In school you have a lot of guidance, but I am not so sure that guidance always leads in the most positive direction," he adds. "They’ll often look at your marks and say if you're good at mathematics you should be an accountant.
"I think the more basic questions should be (if) you like to work with people or do you like to work solo? Do you like to work indoors or outdoors? What are the challenges you’d like to see in your life?”
