The biggest single factor in determining whether a doctor will work in a rural setting isn’t money, housing, travel allowances or facilities.
It’s the size of the high school the doctor’s spouse attended.
That’s based on the notion that the smaller the high school they attended, then the smaller the community they grew up in, which makes them more amenable to a rural lifestyle.
“The attitude of the spouse and family is absolutely critical to a rural practice,” said Dr. Robert Woollard, a professor of medicine at the University of British Columbia and vice-head of the school’s rural co-ordinating centre.
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A doctor’s spouse, whether male or female, needs to embrace the rural lifestyle and feel comfortable and able to function in a small-town setting for it to work.
“If you or your family have rural roots, you’re more likely to survive,” Woollard said in an interview during the annual meeting of the Canadian Medical Association.
Rural experience
Woollard knows whereof he speaks, having spent 16 years as a family physician in Clear-water, B.C., about 120 kilometres north of Kamloops in the North Thompson Valley.
He has been at UBC for the past 20 years, spending part of his time developing a training program for rural physicians.
A recent study by the Canadian Institute for Health Information showed that just nine percent of Canadian doctors work in rural areas, servicing 21 percent of the country’s population. Also, rural Canada is home to only two percent of all Canadian medical specialists.
The study defined rural as centres with population less than 10,000.
That contributes to higher mortality rates for rural versus urban residents, especially children and adolescents.
While many rural groups trying to recruit physicians rely solely on financial incentives, Woollard said that won’t work for long.
What’s needed is an integrated approach, providing a package of educational, social and fiscal benefits.
“Money is certainly helpful, but there’s no amount of money that can pay someone to do what they don’t want to do,” he said, adding getting someone to move to a rural area is one thing, but getting them to stay is another.
“We routinely inspire urban kids to take a fling at a rural practice for four or five years, then the kids start to grow up and they want to go back to the city.”
Strategies to boost the number of rural doctors include conducting educational programs to attract rural students into medical school and having medical students do part of their training in rural areas.
If they spend their entire time in medical school in a large urban hospital, he said, they’ll be afraid to move into a practice where they don’t have an MRI machine next door or a specialist down the hall.
At the same time, it’s also important to have good facilities in rural areas so doctors feel they can practice good medicine.
