New network could help support rural doctors and avoid burnout, research group says

A focus group study from a research group focused on northern Ontario issues says a rural coordination centre could help physicians connect with peers across the region. It could also help communities find replacements when doctors need time off.

The new program would be called the Rural Coordination Centre for Northern Ontario, and would be modelled on a program in British Columbia that has been around for nearly two decades.

Over the past few years, northern Ontario has faced a physician shortage, as several small hospitals have been forced to close emergency departments due to a lack of staff. The vastness of the region, coupled with a population of under a million people, often forces physicians to work in isolated situations, according to Dr. Sarah Newbery, the associate dean of physician workforce strategy at the Northern Ontario School of Medicine (NOSM) University.

Newbery is also co-author of a recent focus group study with the Northern Policy Institute and a family doctor in Marathon. The study included two dozen doctors looking at the role a coordination centre could play.   

"Communities are largely left on their own to find doctors to fill in when their own local doctors need vacation or need to go away for education or an illness leave," Newbery said. "There's no service that actually coordinates that. And we know that when we can assure communities and assure doctors that we can provide locums, that we're actually more likely to retain the doctors."

The Northern Policy Institute study reported that individual doctors in northern Ontario are concerned "for their colleagues and themselves around the feelings of isolation and burnout." It also noted that physicians are forced to manage high workloads while also engaging in non-clinical practices such as teaching and mentoring

Newbery said another stress is when rural doctors need to take a break from their practice for personal or educational reasons. Rural communities and even some doctors are forced to find replacement - or locum - physicians on their own.

Success in British Columbia

The study concluded that many solutions could be found by looking to the Rural Coordination Centre of British Colombia (RCCbc), which was founded in 2007.

"The RCCbc was built on the concept of a network," says Leslie Carty, the RCCbc's executive director of operations. "We want to network practicing physicians and have them surface what's happening in their communities so that we can see where there's interest in either creating innovative change or providing opportunity."

While the RCCbc does not directly hire physicians for rural and remote communities, it does help to create programs and opportunities for rural physicians and other medical professionals, says Carty. These include working in partnership with the province's First Nations Health Authority to support doctors at nursing outpost stations.

The physicians network also allows rural physicians from different communities to connect with one another, providing the ability to share challenges and successes they've found in their practices. One of the ways in which physicians are able to connect is through real-time virtual support, which has allowed rural physicians to seek assistance and guidance both for patient transport and medical care.

"At times, being in a rural community is quite isolating because there aren't that many people, you feel like you're a bit on your own," says Dr. Josh Greggain, a rural family physician in Bowser, British Columbia. "[The RCCbc has] made me feel completely connected to other people, to other communities, and other leaders within [the RCCbc] who've helped me to guide both my practice and my leadership journey."

Most recently, the RCCbc found success setting up a Virtual Emergency Room Rural assistance program, which helps rural and remote emergency departments manage staff shortages throughout the night. The program connects emergency physicians with the departments virtually to work overnight shifts, despite being thousands of kilometres apart.

Bringing connection north

The formation of a Rural Coordination Centre for Northern Ontario was endorsed by the Northwestern Ontario Municipal Association in January 2024.

The initial goal of a coordination centre for northern Ontario would be to retain physicians already operating in the region, which can boost the chances of attracting new medical professionals to these rural communities, Newbery said.

"The physicians that we need for rural northern Ontario are largely rural generalist family physicians," she said. Rural generalist physicians can operate in multiple departments, including emergency and palliative care.

Newbery gave an example of physicians and communities needing to know which physicians are able to speak French and which ones have Indigenous cultural safety training when looking for backfill support.

Last fall, the Ontario Medical Association included the need for a rural coordination centre in northern Ontario in an advocacy campaign to address physician vacancies across the province. 

A rural coordination centre would allow the Ontario Medical Association (OMA) to focus on the individual needs affecting each community in northern Ontario, said OMA president Dr. Zainab Abdurrahman. "It allows us to make sure that we are looking at each of the communities differently because we know some of the communities are just having hard time just getting physicians in the door."

Abdurrahman said that the OMA was able to secure funding for a rural coordination centre in April as part of the physician services agreement with the provincial government.

While there is currently no projected launch date for the coordination centre, Newbery says that commitments from the Ontario Medical Association and the provincial government are promising.

"We currently need more than 160 rural family doctors across the north," Newbery said. "And if we don't do something meaningful to support them in their work, we will lose them."