WINNIPEG – Dr. David Cram’s pager goes off twice as he talks on the phone from his home in Souris, Man., after dinner.
He puts in 10-hour days. And almost every second night and every second weekend, he’s on call in this town about 50 kilometres southwest of Brandon. He doesn’t receive overtime. Like most family doctors in Manitoba, he’s paid according to the number of patients he sees.
But money is not the issue. Rural doctors often work long hours treating a variety of problems with little opportunity for professional development, holidays or plain old time off.
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“I’m keeping a pace up I cannot continue to keep up,” Cram said. “I’m either going to have to cut my hours or leave. And I don’t want to leave. But the government is not sending out any messages that there’s any help coming.”
At the beginning of February, the Souris hospital closed its emergency room for a week to all but the most serious of injuries so the three doctors (one works only half-time) could have a mental and physical break.
Meanwhile in Gladstone, Man., administrators are losing their last doctor. He is leaving in July to go back to school to specialize because he’s burnt out from the rigors of rural family medicine.
The shortage of rural doctors is not a new problem in Manitoba. In fact, in 1989, the government and medical association held a symposium on the issue. Although many recommendations were made, few have been put into place.
Recruiting doctors to rural practice has never been easy. Portage la Prairie doctor Robin Carter said it took his hospital 14 months to find a University of Manitoba graduate who “had a reasonable chance of being happy here and staying on,” even though the town is only an hour away from Winnipeg and there are less on-call hours than most rural hospitals.
Don’t stay in country
Carter said that during the last 30 years, an average of four new doctors from the University of Manitoba each year take up rural practice with any kind of permanence. The rest have either gone on to become specialists, left the province, or set up in Winnipeg or Brandon.
Cram is worried about what will happen in Souris in the next couple of years. The half-time doctor is saving money to travel to more attractive working conditions in the U.S., while the other full-time doctor is in his 70s and will soon retire.
“Hospitals are going to close, guaranteed,” said Cram, and he thinks health care will move toward more regional centres, as has already happened in Saskatchewan during the past few years.
Manitoba health minister Jim McCrae said closing rural hospitals is not on his agenda. Any decision to close hospitals is up to regional health boards, he said.
When asked what will happen if Gladstone cannot find a doctor, McCrae said: “We don’t answer that question because we’re working very hard to make sure that we do have proper assistance there for those communities and their medical needs.”
