North Wellington physician recruitment update

Health­care recruitment in northern Wellington seems to be a twist on the ideology of the book Field of Dreams.

In north Wellington’s book, the phrase could well be “if you recruit them (prospective doctors), will they will stay?”

Allison Armstrong, Recruit­ment Co-ordinator for the Wellington Healthcare Alliance and Suzanne Tivers, Executive Director of the Mount Forest Family Health Team, were at council on June 8 to provide information about the North Welling­ton Healthcare Recruitment committee.

Councillor Dan Yake introduced the pair and said, “They do a wonderful job for our community and work very hard in an area that is very important to our community.”

Yake said Armstrong has been the new recruitment coordinator for the past few months. Tivers chairs the re­cruit­ment committee. They provided an update on doctor recruitment efforts.

“I also have a cheque here as well, as requested by the recruitment team,” Yake said. He quipped, “I’ve been ask­ed to say if it goes well, you get the cheque … If not we may keep it.”

Tivers said “We’re hoping this is the beginning of a conversation. Physician recruitment and health care recruitment is is very much a community project.”

She said members of the Society of Rural Physicians of Canada have worked in rural communities for most of their careers. The society is a voluntary professional organization representing over 2,000 of Canada’s rural physicians and its mission is to provide leadership for rural  physicians and to promote sustainable conditions and equitable health care for rural communities.

“All of our physicians are members,” she said. She noted Dr. Ken Babey is a founding member.

Tivers said in 2004, the society did research on the is­sues relating to recruiting phys­icians to rural communities.

“What they found was that 90% of medical students came from wealthy urban families. So right off the bat, rural communities are fighting an uphill battle.”

She said it means rural com­munities, in general, are not sending people who grew up in the community to medical school.When they do, they may not return.

Tivers, a nurse by training, grew up in a small town in Northern Ontario, but never moved back.

The other issue, Tivers ex­plained, is medical schools not only promote specialist care and research, rather than family physician work, but their locations also mean medical students are required to live in the city for seven to eight years.

“We often lose them at that point,” she said. “Even if a physician chooses a rural practice there are challenges which make it more difficult to keep them here.”

Maintaining one’s license requires a set number of hours taking courses that may not be available locally.

On a bright note, she said some of that is changing. Through technology some of that education can be accessed remotely. “It’s a real bonus for us.”

She noted the hours of work tend to be higher in rural areas. The group is in discussions with the Ministry of Health right now over that. The roster targets for the family health team and existing physicians are based on urban models – where a doctor does primary care and nothing but primary care and they do not have to worry about delivering babies or assisting with surgery, covering for emergency departments, being the coroner, or being a chief of staff at a hospital.

She said the aim of the society is that every rural Canadian should have access to a well-trained family physician with primary support team. She said they also need access to emergency and other general hospital services within a reasonable time and distance.

Tivers, a member of the primary care committee on the Waterloo-Wellington Local Health Integration Network, cited recent News about the county and local municipalities wanting to work closer with their organization.

“I think that’s a good idea. For our rural communities, it’s a really big issue in terms of meeting the needs of people who don’t have access – Access to specialized diagnosis and treatment within an integrated system with outcomes comparable to patients who live in cities, helps to keep physicians, particularly newly-trained ones, feeling like they are not out on a limb and that their licences are not at risk by having to be all things to all people.”

Tivers said things the community has in place, which she considers “pluses” include the rural development program and educational programs that have a rural focus.

Armstrong spoke on the enhanced training of medical students in rural residency programs.

She cited McMaster’s School of Medicine’s Waterloo specialized campus which focuses on rural medicine.

The intent, she said, is to place those students into more rural areas and, as a result, local recruiters are working to increase and promote student and resident placement into hospitals in North Wellington.

She wants to see a recognition that there is a difference between urban and rural medicine and that rural learning experiences for medical students increases interest and understanding of rural practice.

Armstrong said they are also working with the Uni­versity of Toronto to develop something similar, and rural residencies.

Tivers said the recruitment committee is taking a bit broader approach when it looks at who gains as a result of successful recruitment of not only physicians, but all health care providers.

She said those who gain include patients, local hospitals, primary care providers, municipalities, employers, and other businesses.

“It’s a lot easier to attract businesses if you know there is health care available in the town you are living in. The whole community gains from it.”

When it comes to marketing, coordination is taking place with the Palmerston, Mount Forest, and Fergus hospitals in the recognition that a person can live in one area and work in another.

Armstrong said “We know that medical student-resident community placement work … Once they get a taste of rural medicine … They want to stay. “Fergus is a great model of how that works.”

She cited the number of residents who have stayed on as phy­sicians in the Centre Well­ington area. “We want to repeat that experience in North Wellington.”

Tivers noted Mount Forest’s recent success in recruiting physician Annie Lu, who works in Mount Forest, and at Groves Hospital in Fergus.

“She grew up in downtown Toronto, but she loves rural medicine,” Tivers said.

Lu was quoted as saying, “I had such a great experience working in Mount Forest that I knew it was the place to come back to when I finished my training. The physicians, staff and patients were all very friendly and welcoming.”

As a result of her experience, Lu is working with the University of Toronto Medical School to increase interest and student and residential placements in rural medicine.

Tivers said without municipalities, recruiters would not be able to offer the same programs.

They are also working on community partnership development (between Palmerston, Mount Forest, and Fergus).

“A doctor in any one of one of our communities is a help.”

As part of the Family Health Team in Mount Forest, Tivers said a review was done of the geographic area the clinic serves on a regular basis.

She said 20% of those are from Huron, Perth and Grey-Bruce – not including South­gate Township.

“People are travelling a long way to get their primary health care.”

In terms of recruitment, North Wellington Health Care is considering a formal connection between Arthur medical clinic and Groves Hospital recruitment committee in de­vel­opment

She said Dr. Tom Landoni made that choice because most of his patients go to Groves hospital. Therefore he works with the Upper Grand Family Health Team.

However, the Minto-Maple­ton Family Health Team and the Mount Forest Family Health Team work closely.

“We all know the more we share our resources, the better.”

She also said a previous meeting considered if the Ar­thur clinic would work better with Mount Forest or Groves hospital. After talking with the Groves committee, she said it was quite receptive to having Arthur representation.

Yake said the issue came to the health team as a result of comments made at council to help with doctor recruitment in Arthur.

Tivers summarized the municipal recruitment funding requests for 2009 as follows: Mapleton, $10,000; Minto, $10,000; Wellington North, $10,000; and Southgate, $2,500.

Yake said it is important to keep the lines of communication open, for council to know where the money is being spent.

Councillor Ross Chaulk is pleased the team is speaking with Landoni.

While pleased with the doctor recruitment in Mount For­est, he was concerned Arthur recruitment would be left out.

The recruitment team did get its cheque.