Recruitment, retention initiatives working Manitoba government endorses recommendations of Brandon Medical Education Study
After years of struggling to recruit and retain doctors in rural areas, Manitoba is starting to make progress on the issue, says a rural health administrator in the province.
John Stinson, chief executive officer of the Interlake-Eastern Regional Health Authority, said more doctors are staying in rural communities and medical students are inquiring about jobs in small towns.
“I would say in the last three years, in particular, we’re seeing less turnover,” said Stinson, who was the chief executive officer of the health authority in southeastern Manitoba before assuming his new role this year.
“More and more of our (medical school) graduates are staying in Manitoba.”
Earlier this summer, the provincial government took additional action to address the rural doctor shortage when it endorsed recommendations from the Brandon Medical Education Study.
The study, which began in 2011, examined ways to increase the number of doctors in rural and northern regions. The study authors, including Brian Postl, University of Manitoba faculty of medicine dean, and Deborah Poff, University of Brandon president, dismissed the idea of opening a second medical school in Brandon. Instead, they recommended training more doctors in rural communities by increasing the number of medical residency spaces in places like Winkler, Steinbach and Brandon.
In addition, they said the University of Manitoba medical school in Winnipeg should continue to admit more students from rural areas or students who have an interest in rural practice.
Last year, when a group of second year medical students toured hospitals and clinics in southeasternManitoba, Stinson noticed that allotting more medical school seats to rural students was having an impact.
“A lot of them were from the southeast area, another three were from the Interlake and another two were from northeast (Manitoba),” he said.
The increase in rural students in medicine, combined with the expansion of the University of Manitoba medical school to 110 seats from 70, has shifted the supply/demand curve for doctors in the province, Stinson said.
“We’re actually having physicians, who are in their final residency year, calling (us) and saying Selkirk’s a nice community, Beausejour is a nice community…. Are there any opportunities there? Five years ago, that didn’t happen.”
Although provincial initiatives like the Brandon study are helpful, rural leaders are still struggling to lure doctors into their community, said Joe Masi, Association of Manitoba Municipalities executive director. And recruiting a doctor often involves dangling a lucrative financial package, Masi said.
“We have situations … with communities having to provide homes for doctors, or clinics and so on,” he said, from his office in Portage la Prairie.
“In our view, (these) are not municipal responsibilities. But because your health system is so important to have people stay in your community, municipalities are forced to do these things.”
Joan Clement, president of the Manitoba Women’s Institute, said that rural towns have to maintain their health services. Otherwise, people will simply pack up and leave.
“We as rural communities have to recognize that we have to take some initiative on our own,” said Clement, who lives in Russell, Man.
Stinson understands the desire to keep doctors in the community, but said offering a house, cash or a clinic isn’t a long-term solution.
“If you say to someone, ‘I’ll give you $100,000 and a free house if you come and work here,’ they’re likely going to do that, but they’re not going to stay. It’s not sustainable.”
A better plan is working conditions where a doctor can establish an appealing and challenging practice, without having to work 80 hours per week, Stinson said.
A service model where every community has a full service hospital with an emergency room is no longer feasible, Stinson said.
A hub and spoke model, where doctors live and work in a larger town in the region and also provide regular service in the smaller communities, is a more sustainable approach.
As well, there should be more of a focus on health care that keeps people out of the hospital, rather than running a hospital, he said.
Medical service has to evolve, Stinson said, so rural residents need to let go of the idea that losing the hospital equals losing the community.
“We need to get away from that (competition) of municipality against municipality, trying to keep health-care workers,” he said.