A considerable number of Saskatchewan centres are facing interruptions to – and even elimination of – certain health care services in their communities because of doctor shortages says the province’s Minister Responsible for Rural and Remote Health.
That fact emphasizes the importance of a collaborative, broad-based approach to securing doctors for rural communities such as the Melville and District Physician Recruitment and Retention Committee, according to Randy Weekes.
Weekes, who was appointed to the portfolio in May, visited Melville last week, his 26th stop on an “outreach” tour that will hit about 40 communities around the province to observe and discuss health services and concerns.
Arguably one of the most serious challenges facing communities is finding and keeping doctors in the smaller communities, Weekes said following his hour-long meeting with a dozen business, professional and municipal representatives at Melville City Hall.
The challenge is wide spread. Currently, there are concerns about attracting and retaining doctors in communities ranging from Wadena to Fort Qu’Appelle, and from Canora to Davidson. In Wadena, the impending loss of a doctor raised the possibility that town’s hospital would have to become a long-term care facility, while doctor shortages have forced the suspension of emergency services in communities like Canora and Kamsack.
“The common theme is doctor recruitment and retention... a fairly common issue in rural Saskatchewan,” says Weekes who, prior to his City Hall meeting, met at St. Peter’s Hospital with Melville’s four doctors. Your (Physician) Recruitment and Retention Committee is doing a great job... Everyone in the health care system needs to work together, communicate well together, especially the doctors, with your health care recruitment and retention committee to attract new doctors.”
Doctor shortages, he points out, are not unique to Saskatchewan but plague communities across Canada and even around the world. To address provincial concerns, Weeks says the government has launched a number of initiatives that include increasing the number of spaces for medical students at the University of Saskatchewan’s College of Medicine.
There are financial incentives for new doctors from the province to remain, Weekes says, adding doctors are doing some of their residencies in rural communities in hopes they’ll stay in those centres or other rural centres.
The province has launched the Saskatchewan International Physician Practice Assessment (SIPPA) program. This assessment, according to the government, is the new process for assessing family medicine International Medical Graduates’ (IMGs) readiness to practise in Saskatchewan.
According to the government “the assessment will ensure that family medicine IMGs have the appropriate mix of academic knowledge, technical skills, and clinical judgment to provide safe patient care”. All IMGs are required to take the assessment before practising in the community to which they were recruited.
While it’s essential physicians practising here have the necessary skills to provide top-notch health care, Weekes acknowledges the efficacy in removing unnecessary hurdles to their recruitment. Currently, there are about two dozen foreign doctors going through the assessment process.
As part of the Brad Wall government’s emphasis on the “collaborative” approach to health care, Weekes visited Nova Scotia in July to learn more abut its innovative Collaborative Emergency Care (CEC) model.
That model calls for keeping emergency rooms open, reducing patient wait times and providing a “team-based” approach that offers continuity of care. The objective is to provide patients get proper treatment before a minor health issue morphs into a health crisis.
Weekes cites an example for keeping an emergency room open that could see two registered nurses or one registered nurse and a paramedic on duty. An incoming patient would be assessed by those health care workers who would be in contact with a physician to make the determination whether the patient needs to get immediate emergency treatment or whether the patient could get physician treatment later that day or the next.
“It does two or three things,” Weekes explains. “They’ve found it takes the pressure off the emergency care because patients know they have got an appointment with the doctor the next day or so.
“It also provides better quality of life for the physicians because they’re not on call (nor) on emergency. We’re in the pilot process of setting up a pilot project” in Saskatchewan.
Mayor Walter Streelasky says the CEC approach may be relevant for communities that have only one or two doctors, unlike Melville which has a stable contingent of four. MDPRRC, however, is actively searching for a fifth doctor, not only to ease the demands on local doctors from patients within the Sunrise Health Region but from those in other health regions. Many of those patients seek doctors in Melville because of difficulty in acquiring physician care in their home health regions.
MDPRRC has representatives from about 18 municipalities and groups ranging from the City of Melville to the Town of Ituna to the RM of Cana.
“We did talk about recruitment, we did talk about the help we need and that between the fact we have some excellent facilities and the fact we have an excellent professional staff at St. Peter’s (Hospital)/St. Paul (Lutheran Home) that this served us well and that people were coming from places like Balcarres, Broadview...”