Local health care a team effort Everyone is entitled to adequate health care. From those living in the thriving metropolises to those hidden in the smallest hamlets of our nation, each Canadian should feel assured that his or her health needs will be met. Though this is the case, there are significant logistical differences when it comes to health care services in large versus small communities, and different municipalities are constantly working to overcome various obstacles that they face based on their unique needs. Amund Otterson, chair of Shellbrook’s Doctor Recruitment and Retention Committee, claims that the biggest challenge faced by Shellbrook when it comes to health care is physician supply. When it comes to physician recruitment and retention, Shellbrook Mayor George Tomporowski claims that the latter is the more difficult to achieve. “It’s one thing to attract them and get them here, it’s totally another thing to keep them,” he said. Otterson, who has been integral in this field for the past few years, concurs with this statement. “Retention is the more difficult part, not that we’re not having success with it,” he said. Many involved in this sector would surely echo Otterson’s thoughts, as much work is being done at various levels--provincially, regionally and locally--to aid in physician recruitment and retention. In order to get a look at the whole picture, it is perhaps useful to zoom out for a moment and take a look at health care from the viewpoint of Saskatchewan as a whole. “There are some significant changes we’ve done at the provincial level to really enhance the ability for regions and communities to work together in their recruitment of all medical professionals,” commented Scott Moe, MLA of Rosthern-Shellbrook. One such initiative involved an increase in the amount of training seats at the University of Saskatchewan’s medical program, a boost that bumped the number from 60 to 100. They also increased the amount of medical residency seats from 60 to 120. Another move they made was to open up an incentive program for new physicians who choose to work in underserved, rural and/or remote locations. If physicians choosing to practice in such locales commit to a certain length of service, equal to about five years, the government will reimburse them up to $120,000 for their service. Also, newly trained nurses and nurse practitioners can get up to $20,000 through this program. Moe also claims that the introduction of SIPPA (Saskatchewan International Physician Practice Assessment), which is a three month training and certification program for physicians coming from abroad, “Has been a major step forward in enlarging the pool of applicants.” A few more forward strides were mentioned by the MLA, including the introduction of “Sask Docs”, an entity that works with health regions and communities in regards to the recruitment and retention of health care professionals, as well as a new “rural locum pool”, which is a pool of physicians that will be on hand for short-term assistance in smaller communities. “What we’ve tried to focus on at the provincial level, is to ... make the recruitment environment more advantages, so that the health regions and the communities (have) a better chance at a higher success rate,” Moe said. While the province works at increasing the supply of physicians in Saskatchewan as a whole, the various regions and municipalities must look to their own areas and find ways to bring some of these doctors to their specific communities. A few short years ago, in Shellbrook specifically, this was proving to be a challenge. Since then, through the tireless work of various individuals, the situation has improved. “We have come a long way in two years,” Otterson said. “We’ve gone from a low of one doctor ... to where now we have five.” This improvement didn’t happen overnight, and it was not built on sweat alone. When things were at a low point, the Town and the RM of Shellbrook made some concrete decisions in the hopes that some monetary aid would make things more enticing for doctors who were in the process of deciding where to practice. One decision involved aiding in human resources issues at the clinic. More specifically, the Town and RM decided to fund the salary of two medical office assistants. In 2012, $100,026.94 was handed over for overhead costs at the clinic, and in 2013, up to the end of October, the total was $65,426.54. These totals were contributed as a 50/50 split between the Town and the RM of Shellbrook. Furthermore, a number of surrounding areas decided to band together and come up with a separate fund that would go towards providing personal incentives for physicians in order to make Shellbrook a more attractive choice. To build this fund, various communities agreed to pitch in $5 per capita annually. The participating municipalities include the RM of Blaine Lake, RM of Canwood, Village of Canwood, Village of Debden, RM of Leask, Village of Leask, Village of Parkside, RM of Shellbrook, and the Town of Shellbrook. An additional sum of money, equal to about $15,000, was donated to the fund from the Sturgeon Lake First Nation. It is safe to say that these initiatives have been successful. Since their introduction, the number of physicians in Shellbrook has increased to five, and another physician is scheduled to join the team in the new year. “I would say that if we hadn’t have stepped up to the plate ... we wouldn’t have some of these (doctors),” commented Bob Ernst, Reeve of the RM of Shellbrook. “They had other offers, I’m sure they did. But they liked Shellbrook when they came, and they could see what we were going to do for them. I think they are all very happy with what we’ve done.” Local communities have contributed money in order to see this goal realized, but those in charge feel that the results were well worth the cost. “The town takes that responsibility because we think it’s good economic development, and also it’s our goal--our responsibility--to create a healthy community,” Otterson said. “The town really benefits from having physicians. People move to Shellbrook because we have doctors. We’re always talking about economic development, if you just think about the economics of having physicians in town: people come to town from other areas to make use of the physician services, and there are just other spinoffs ... everybody benefits.” “If you talk to the business folks, there’s no question that when we were down to one doctor it impacted their traffic,” Tomporowski added. These various initiatives are revisited annually, and at some point the decision will need to be made as to whether or not these incentive programs are to continue. The decision-makers are somewhat conflicted when it comes to this topic, but there are hints that they are leaning a certain way. “Personally, I think we need to continue the support,” Otterson said. “From the point of view of showing that we are caring, that we are supportive of the physicians. It’s a way of letting them know that we’re here and we appreciate their participation. I think it’s a token gesture, really, even though it amounts to a considerable amount of money. I think it’s a worthwhile gesture.” Mayor George Tomporowski sees it as two separate issues. In his eyes, the first question involves the Town aiding with overhead at the clinic. “In an ideal world we’d love to not have to do it,” he said. “But for us to attract physicians, (it’s necessary). And this is not unique to this community.” As far as collecting a fund in order to help with the personal costs of moving to town and getting settled? “I have no issue with that,” the mayor said. “A lot of these folks are relocating from a long ways away, and to give them a little hand to get things off the ground, to get them on their feet, (is reasonable).” Bob Ernst has a similar view when it comes to the RM providing funds for the clinic. “We did it a bit reluctantly, because we felt as though we were paying the levy already,” Ernst said. “But we also felt ... that to get these doctors here we’ve got to give something, or else they’re going to go somewhere else.” Mayor Tomporowski is correct when he says that these challenges are not unique to Shellbrook, and different municipalities are choosing different ways to cope. “It really varies from community to community,” Otterson said. “I’ve heard of communities where the town owns the clinic, where the town covers a good part of the overhead--there’s a variety of models out there.” In between the province and the municipality lies the Prince Albert Parkland Health Region. In reality, the health care professionals are employees of the region itself, even though cooperation is often necessary. “I continue to think of the region as a partner in this,” Otterson said. “I just think that the local influence is very important ... You do need that rural advocacy to make sure you are looked after. We trust that the system works, but we definitely need to be involved.” Some in the community feel that, since the Town is somewhat involved in health care, they should head to the Town Office with their displeasure. “It’s a little bit frustrating for us when we get the complaints,” Tomporowski said. “I’ve told a lot of folks that they’re talking to the wrong people. We don’t run the clinic. It’s operated by the health region, so those are the people that need to know you’re unhappy.” Despite all of the progress, many are currently dissatisfied, mostly because of wait times being experienced when trying to get an appointment at the clinic. These issues were addressed by representatives from the health region in a previous Chronicle article. Local representatives, however, are confident that the region will come through in the end. “Look where we were two years ago, we’ve come a long way from that low point,” Otterson said. “With the (Parkland Integrated Health Centre) opening, the supply is not meeting the needs fully, but we believe that the region is making efforts to improve that.” “I think it’s improving,” added Tomporowski. “We’re still in a learning process. Not just the municipality, we all are, including the health region. Maybe we need to be a little bit patient.” Scott Moe agrees that, from the provincial level all the way down, things are moving in the right direction. “It’s taken a team effort, to say the least,” he said. “It is working. Right now we have 300 more doctors in the province than we did just a few years ago, so it is coming at the provincial level ... We need to be a little bit patient at the local level.” As he looks forward, Mayor George Tomporowski envisions a future where municipalities will continue to contribute to health care in order to ensure that local needs will be met. “We’ll always be involved,” he said. “I don’t ever see us not doing doctor recruitment and retention.”
Posted on: Fri, 29 Nov 2013 14:39:42 +0000
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