More rural generalists called key to small town health-care crisis

How do we get more doctors to consider life in small town Alberta? That's the challenge facing communities outside of major centres across the province. And one Drumheller doctor says he's got some ideas.

Dr. Rithesh Ram says on-the-ground experience can be greater than what one might experience with a big city practical education.

"The breadth and depth of our knowledge and skills is very different," Ram told the Calgary Eyeopener on Tuesday, comparing small town to big city.

"We are specialists in our field as well as unrecognized specialists in emergency medicine, internal medicine, mental health, women's health, geriatrics, addictions — all because we provide full-scope patient care in emergency departments, hospitals, in operating rooms delivering babies, as well as clinics."

Train students in rural environments

Ram founded Riverside Medical in Drumheller. He is also the director of the University of Calgary's longitudinal integrated clerkship program, known as UCLIC.

He says some of the answers to the rural medical care crisis are well known.

"We know that to be the most successful, you must actually train students in rural areas, and we have programs that are doing that successfully with limited resources. Arguably, these programs should be broadened and expanded as they work, but with a larger focus and a large mandate."

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Rural preceptors or rural generalists are seasoned doctors who mentor students in smaller communities. Ram says programs that attract them have been very successful, but more are needed.

"They are going to get fulfillments from having the trainees there, and it is one of the best pipelines to ensure that rural practices are going to be successful now and going into the future," he explained.

"Once these students realize what practising can be like in a rural area, what life can be like in a rural area, they are much more likely to come and apply, stay and live forever."

Short-, medium- and long-term solutions needed

Dr. Aaron Johnston is the associate dean of the University of Calgary's distributed learning and rural initiatives.

He says it's important to focus on solutions that cover a variety of time frames.

"We need to address the short-term solutions as well as the medium- and long-term issues that we have. We can do that in several ways, I think," Johnston said.

"No. 1 is by supporting the rural generalists who are already out there doing this hard work. It is important to think about, 'How do we make things as good as possible today and then how do we aim towards a better future?'"

That's in the short term. Longer-term solutions are more educational in nature.

"They both need to be enacted so that we can support not just the rural medical providers but actually rural citizens of Alberta so they can get great medical care."