Dr. David Miller’s first hours in Canada were intimidating. He landed in Montreal from Ireland with his new bride, intent on spending three months working at a temporary job before returning home.
The Millers arrived during the October crisis 33 years ago when Quebec separatists kidnapped two political figures. As police and the army moved in with new search and arrest powers, Miller thought to himself “my goodness. I left a country like that.”
He headed for the back country of northwestern Alberta at Beaverlodge, where the reception was more pleasing. He never went back to Ireland.
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Miller was recently chosen from 24 nominees as Alberta’s rural doctor of 2003, the second time the award has been presented.
It was developed last year by a 12-year-old government agency that recruits and tries to maintain rural doctors. Those who work on the Alberta Rural Physician Action Plan, which educates and trains doctors, said many rural physicians are unsung heroes who provide long hours of medical care and contribute to their communities and medical colleagues’ knowledge.
Miller said the answers to get more young doctors to settle in rural areas are found in exposure and training. He said when serving their internships, doctors should be encouraged to work in smaller centres. Alberta now has 10 spots for doctors willing to spend two to five months working in places such as Lethbridge, Red Deer and Grande Prairie.
More training can also help a young doctor faced with a general practice on his own.
“It can be frightening. You can get in over your head.”
Miller said because people today live longer, that means disease is a bigger factor, but also there are more drugs and therapies available. But these new treatments are driving up medical costs.
“The cost in the last six months of life is huge. Say a person has a hip replacement and cataract surgery and then dies six months later of a heart attack.”
A problem especially acute in rural areas, Miller said, is getting injured people to medical help quickly.
“We learned from Vietnam that the first hour after an accident is really valuable.”
In northern Alberta oil rigs or on isolated prairie farms, that hour can slip by before an ambulance reaches the person and transports him to a hospital.
Miller said quicker access to service should be the predominant concern for rural medical care.
While nurse practitioners may help alleviate the doctor shortage in rural areas, Miller said there are not enough specially trained nurses acquiring the diagnostic skills to set up teams everywhere. He said doctors may also resist the team concept because of fee-for-service billing issues. Nurse practitioners would get all the easy cases and the doctors, left with the more difficult and time-consuming cases, would not see as many patients in a day.
The public may sometimes malign doctors, said Miller, but he said doctors got into the profession because of a desire to do good.
“You don’t last as a doctor unless you want to help people.”
However, that helping attitude leads to long work hours, which can be hard on a family. None of his five children went into a health-care job. Like some farmers’ kids, they saw their parent’s life as too onerous for its rewards.
