LAKELAND, Alta. - A provincial program aiming to recruit doctors to 15 rural communities across Alberta this year has come up short. The $6 million Rural Education Supplement and Integrated Doctor Experience (RESIDE) Program launched last January and provided up to $100,000 in incentives to doctors looking to make a three-year commitment to work in one of the rural communities.
In the Lakeland region, Lac La Biche County and the City of Cold Lake were among the many communities struggling with doctor shortages that were hoping to benefit from the program. But after months of applications from 20 doctors not meeting requirements, the entire program has only recruited one doctor for the City of Cold Lake area to start next January, said David Shepherd, NDP health critic, in a press conference held on Sept. 12.
“Many of the 15 communities eligible in RESIDE are in crisis,” he said referring to bed closures, and service disruptions in emergency departments and obstetric units in many of the eligible communities.
The program should have seen $2 million spent each year, over the next three years, while aiming to hire 20 doctors annually in the rural areas. Considering the recruiting challenges this round, the UCP government has adjusted the program operated by the Rural Health Professions Action Plan (RhPAP). The three-year commitment requested of doctors has been reduced to two years, and the program is working toward expanding the eligible communities, while also including doctors who have “completed residency in Canada within the last five years.”
Shepherd says the changes do not address the problem, especially after the impact of COVID-19 on the health care system.
“You can adjust these parameters in the program, you can shorten time frames, you can increase the dollars, but that ultimately is not what’s going to solve the problem,” he said.
Changes are welcome
For others, the adjustments are a move in the right direction.
“You have to give people kudos for realizing a program didn’t work and try to alter it,” said Lac La Biche County Coun. Charlyn Moore.
Moore is part of the Lac La Biche Regional Attraction and Retention Society (RARS), which aims to retain health care professionals in the community. While the initial announcement of the RESIDE program last winter was welcome news, Moore says the board was notified “that there were zero applicants” that applied to Lac La Biche through the RESIDE program.
“We were definitely hoping that there would be more students that were interested in our rural location. I mean Lac La Biche wasn’t even the only one that wasn’t successful,” she said.
Larger problems than RESIDE
But considering the Obstetric unit at the William J. Cadzow Healthcare Centre has been closed for several months, and the community is short roughly six doctors, the problem is much larger than the RESIDE program, says Moore.
“The problem is not the provincial government, the problem is Alberta Health Services (AHS), federal immigration and the College of Physicians,” she says.
“We do have two doctors coming… Once they’ve landed in Canada they have to do their three-month practicums and there have been delays in practicums starts, so we’re not even 100 per cent sure when they are going to start their practicum yet,” added Moore.
As the County works toward hiring, the crucial roles required to sustain health care services in Lac La Biche are skilled physicians who specialize in anesthetics and obstetrics.
“We need a general practitioner OBGYN to fill that hole or a general practitioner anesthetist. Those are the two doctors you need to fulfill a hospital to have birth and surgeries and you’re not getting that from a brand new doctor,” said Moore.
Lakeland area working together
Considering the varying local needs, surrounding communities in the region have been filling the gap and working together as the rural shortages occur, said Town of St. Paul Mayor Maureen Miller.
“This whole northeast area refers to each other, whether it’s our surgeons, for MRIs or CT scans. It’s very important that we’ve got those support systems in Lac La Biche so that the community can cover us when we don’t have doctors to deliver babies.”
While the St. Paul community isn’t a part of the RESIDE program and at the moment isn’t in a similar situation as the Lac La Biche area, the program she says wasn’t effective, to begin with.
Miller says doctors who work in rural communities have to fill a wide range of duties that require more time and seeing more patients who have a broad spectrum of health care needs. A concern, she says the RESIDE program didn’t address.
“They’re unique because of the variety that they actually see within communities, so it’s a very broad practice that they cover: from children to geriatrics; from mental health to obstetrics. Their practice is very broad, and just because of the broadness of their practice, that’s already a heavily weighted expectation of our physicians,” said Miller.
Moore agrees, saying the challenge makes recruiting harder in rural communities looking to retain doctors whose work-life balance is impacted by the heavy demand.
“It’s not just a Lac La Biche problem. Rural doctors work a lot more hours,” she said. “It’s harder to get a work-life balance in the rural area because of the way our systems are set up, so whereas Lac La Biche County you always have a doctor on call and that doctor still works during the day — that seems to be the hardest problem with rural recruiting and it’s across Canada,” said Moore.
As hospitals deal with temporary closures and reduced services due to shortages, Moore says residents are forced to travel to neighbouring communities when need be – a concern she says is especially serious when neighbouring municipalities like Boyle or Athabasca are also impacted, forcing residents to travel even further.
“Unfortunately, because it’s affecting rural... it’s not like you have to travel 20 or 40 minutes, you have to travel two hours. That’s the biggest hindrance to our residents right now,” said Moore.
And with extra travel comes extra expenses for people seeking medical services.
“That expense to and from our regional and our central care centres is onerous for any family,” said Miller.
As the provincial government works toward changing the RESIDE program and supporting rural health care facilities, Miller says she’s hopeful the change from a three to two-year time frame will support retention in rural communities that are part of the program.
“They’re bringing their families and purchasing homes, so you want to know that it’s a community... that’s going to work for you and your family as well,” said Miller.