'Disturbing' shortage of rural Manitoba doctors fuels calls for new recruitment approach

New figures show that despite years of recruiting, rural Manitoba is still short dozens of family doctors, fuelling calls to find another way to sustain health care in rural Manitoba. 

In the Interlake-Eastern Regional Health Authority, there are currently 31 vacant family physician positions. With 84 positions in the region, that represents a vacancy rate of about 37 per cent, according to figures provided by the health region.

"It's disturbing," said Dr. Tom Smith-Windsor, president of the Society of Rural Physicians in Canada. "Rural Canada needs the same level of health care as the rest of the country."

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In Manitoba, the situation is most pressing in the Interlake-Eastern Regional Health Authority.

The Prairie Mountain health region in western Manitoba, meanwhile, needs 25 more doctors to meet a full complement of approximately 180.

Elsewhere in Manitoba, the situation isn't as dire. In the Southern health region, where a full complement of family physicians is considered to be 140, only 2.5 positions are vacant.

In the Northern health region, 6.25 positions are vacant.

Towns share ER resources 

The town of Carberry, Man., about 40 kilometres east of Brandon, at one point had enough doctors to staff its own emergency room, where family doctors work shifts. It moved to having to split ER service with a hospital in a nearby town and now has periods where both facilities are closed due to a lack of doctors.

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Mayor Stuart Olmstead said the doctors and other health-care staff work hard to keep the ER open as much as they can in the small town, but sometimes there simply aren't enough staff, meaning residents have to travel to Brandon for care.

"We can't just always be pushed down the road for this, that, the other thing," Olmstead said. "You have a retirement, you have a vacation, you have somebody go off sick ... next thing you know, the place is closed." 

Olmstead said he's seen services at the local hospital cut or moved in the past several years. 

"This might be the new normal," he said. 

For Smith-Windsor, the figures are a sign that current recruitment tactics aren't working very well. 

"The old technique was to try and fill rural sites with immigrant doctors — doctors that were immigrating to Canada from elsewhere," he said. "History has shown that although they fill the gaps, they tend not to stay in rural communities."

Increase rural training spots 

Smith-Windsor, who practices in Prince Albert, Sask., said the key may be to increase the number of training spots in rural Canada.

In his town, the local hospital became a rural division of the University of Saskatchewan's family medicine program. Students complete 16 months of a four-year program in Prince Albert.

Since the program started in 1997, more than 80 per cent of its graduates have stayed in rural Saskatchewan. 

In Manitoba, the University of Manitoba operates satellite programs for family medicine students in a number of communities, including Brandon and Dauphin in western Manitoba. Programs like those, Smith-Windsor says, should be expanded. 

"Training in a rural site certainly, I think, is the key to success in recruiting to rural sites," he said.

Number of rural doctors rising

Olmstead agrees, saying communities have doled out a lot of money for doctor recruitment and retention over the years. 

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"We can give them everything and anything in dollar on the barrelhead to bring them here, but to keep them here, that's the challenge," he said, adding that communities like his may have a better chance of keeping young doctors if they're trained nearby. 

"We can't force them to stay here," Olmstead said. "If we train more here, we have more of a chance to keep them here." 

While many areas are still short doctors, the number practising in rural Manitoba is on the rise. According to the College of Physicians and Surgeons of Manitoba's 2016 annual report, 646 doctors were practising outside Winnipeg in 2016, 24 more than in 2015.

This year, 34 of the 113 graduates at the University of Manitoba are moving into family medicine. Six of those are going to northern and remote comminutes, while 12 are going to rural locations, according to the university.

Smith-Windsor is optimistic there will be a day when rural Canada's physician shortages are solved, as the number of rural training sites increases.

He believes having more doctors will also keep people from moving out of rural communities. 

"I don't think the expectation should be that people need to leave their home communities so they can receive health care when it's needed," he said.