Keeping new medical graduates out of hospitals may not be in best interest of rural areas: Gower

Dr. Sarah Gower says the New Graduate Entry Program (NGEP) launched by the province this year “may create an entire generation of family physicians who are not comfortable or experienced working in hospitals (an important component of rural medicine).”

The Elora-based doctor spoke to Centre Wellington councillors on Nov. 23 on behalf of the local Community Stakeholders for Health Care Recruitment and Retention committee.

Gower has been in Centre Wellington for the past five years and shares a practice with her husband Dr. Kapasi. Both also work at the Groves hospital in Fergus, “as all of [doctors] in the community do.”

Gower specializes in obstetrics, delivering babies, while Kapasi works with anesthesia and does some emergency room work.

Gower noted the recruitment committee, of which she is a member, is run through the hospital, but because physicians in Fergus, Elora and Arthur also work at the hospital, it becomes the committee for the community as well.

She thanked the township for its past financial assistance, which she said helped the committee “to successfully market and promote our community in 2015 as an excellent place to learn and practice health care.”

Though one local doctor is retiring, his family practice is being taken over by one of the new recruits, Gower said.

She noted that with the exception of herself and her husband, every new physician coming to the area in the past several years started out as a learner in the community.

She told council the area is stable and there are relatively few residents without a regular family doctor, but there are some provincial-level changes that could create challenges in the future.

Gower said Ontario doctors and the provincial government are at odds over health care reform, including a reduction of fees for physicians that could discourage good physicians from setting up practices in Ontario.

At the same time, there is an aging population that requires more care in general.

“It’s a bit of a tricky time right now with the government,” Gower said.

But the biggest thing which may affect rural areas is the NGEP launched by the government in September. Part of that program restricts graduates in what they can do.

“They are limited in how much they can work outside the daily clinic. They can see patients, but are not allowed to work in the hospital – such as emergency room work, anesthesia, obstetrics, palliative care or public health clinics,” Gower said, noting those are exactly the types of activities in which doctors in rural areas are involved.

She noted the program currently is only in effect in areas not considered under-serviced  – Centre Wellington still is considered under-serviced or a high needs area – but should that status change, Gower said it would mean new recruits would not be able to work in hospitals for the first three years.

If the graduates do decide to remain, Gower said they would not have those three years experience working in the hospital setting and may no longer be comfortable there.

“The government is essentially creating a generation of family (doctors) that will not be comfortable working in hospitals,” Gower said.

While it may not be an issue in Toronto, where there are a lot of doctors to fill in the gap, “it could be very devastating to our area 10 to 15 years down the road if all the new graduates are not interested in working at Groves and the older generation of doctors begin to retire.”

“Even though we are well-serviced now, we are always trying to look ahead.”

Gower said the focus for the upcoming year is to work with medical staff in terms of planning for retirements.

“These guys are awesome, but it sometimes take two or three of us to fill the shoes of one of the retiring physicians,” she said.