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B.C. doctors offered $100,000 to work in rural areas, including Vancouver Island towns

CINDY E. HARNETT / TIMES COLONIST
MARCH 13, 2013 10:17 PM

The B.C. Medical Association and the province are prescribing a $100,000 bonus to encourage family doctors and specialists to set up shop for three years in rural B.C. towns, including Tofino and Port Alberni.

The offer applies to general and specialist physicians who commit to practise in one of 17 rural B.C. communities, including four within the Vancouver Island Health Authority. The BCMA and the province announced the joint Rural Physicians for British Columbia incentive program on Wednesday.

A number of rural B.C. communities are constantly in crisis due to an insufficient number of doctors — Port Hardy, for example, said Dr. Granger Avery, co-chairman of the BCMA and Health Ministry joint standing committee on rural issues.

The incentive will make a significant difference in recruiting doctors and could keep some hospitals from closing, said Avery, who has practised in Port McNeill for 36 years.

“One doctor can make all the difference in services being available or not available,” Avery said.

However, he said, it’s only a “stop-gap” measure and a long-term solution to create sustainable health care in rural and remote communities is still needed.

To that end, a proposal is being developed to study three to six chronically under-staffed rural communities so as to assess new ways of providing services and paying doctors that would support sustainable health care in those communities.

The incentive program’s 17 designated communities are Port Alberni, Port Hardy, Tofino, Galiano Island, Bella Coola, Burns Lake, Chetwynd, Clearwater, Cranbrook, Hazelton, Kitimat, Nakusp, Pemberton, Princeton, Quesnel, Terrace and Tumbler Ridge.

Within VIHA, Galiano Island needs one general practitioner; Port Alberni needs one emergency physician; Port Hardy needs two general practitioners; and Tofino needs one family doctor.

Tofino Mayor Josie Osborne said incentives are needed to attract physicians despite the West Coast’s inherent quality of life.

Tofino has three-full time doctors and needs another to serve the town’s 2,000 year-round residents and up to 4,000 tourists and seasonal workers in the busy summer months.

In addition, Tofino’s hospital also serves Ucluelet and the surrounding area — including the First Nations communities of Clayoquot Sound. The doctors also work in clinics and are on-call.

“At some point, it’s easy to see that a very small number of doctors cannot sustain the services required, threatening the viability of our hospital,” Osborne said.

Health Minister Margaret MacDiarmid, who has worked as a doctor in rural B.C., said the incentive would benefit both families and health-care professionals.

Doctors who sign up for the program will receive $50,000 when they begin working in one of the communities and another $50,000 after their first year of service.

The catch: They’ll have to refund all of the money if they don’t practise the full three years.

Medical school residents who graduate to full-time practice in one of the designated rural communities are also eligible. The incentive is not available to doctors already in the designated towns or serving another rural community in B.C.

The incentive program, worth $1.7 million, comes from a Physician Master Agreement signed last summer between the BCMA and the province.

The deal, which put $90 million in new money into health care over two years, allocated $10 million to expand access to doctors in rural and remote areas of B.C.

The Health Ministry couldn’t say Wednesday how much of the $10 million had been allocated.

charnett@timescolonist.com

© Copyright Times Colonist



Paradise available, needs doctor

Brian Hutchinson | March 20, 2013 5:51 PM ET
More from Brian Hutchinson | @hutchwriter

Galiano Island needs a medical doctor. Just one, and not some fancy pants specialist either. A general practitioner is all that’s required, someone willing to live and work on a lovely Pacific island that’s populated with artisans and inventors, affluent retirees, down-to-earth farmers and amusing if squabble-prone eccentrics.

There are beaches and forests. A scenic little golf course. An abundance of recreational and cultural activities and a famously mild climate. Vancouver and Victoria are short ferry hops away.

No one wants the job. “We’ve been looking for a doctor for three years now, and we’ve only had a few serious candidates,” says Linda Ruedrich, manager of the Galiano Health Care Centre, a non-profit society that operates the island’s only medical clinic. “We liked two of the doctors who applied, but they didn’t pick us.”

The problem isn’t unique to Galiano. Dozens of communities in British Columbia — and hundreds more places across Canada — suffer from a general practitioner shortage. It’s so acute that provincial governments are supplementing their existing rural doctor recruitment programs with offers of cash. Piles of it.


 

We’ve been looking for a doctor for three years now, and we’ve only had a few serious candidates. We liked two of the doctors who applied, but they didn’t pick us.


 

Earlier this month, Saskatchewan announced it will pay up to $120,000 to recent medical graduates willing to settle in rural communities with populations under 10,000. The cash bonuses will be paid out over five years.

B.C. upped the ante last week, offering $100,000 to any qualified GP who relocates to one of 17 rural communities considered in crisis. The commitment is just three years, compared to five in Saskatchewan. A $50,000 payment becomes due when a new physician starts work in a designated town, and another $50,000 payment is scheduled after one year of service.

Galiano Island is on B.C.’s “communities in crisis” list. So is Tofino, the widely-known resort town on Vancouver Island. Tofino boasts a hospital and a few full-time docs, but there aren’t enough to meet local demands. Other communities where the $100,000 cash bonus is offered: Bella Coola and Kitimat, on B.C.’s north coast; Quesnel and Burns Lake, which are deep in the central interior; Cranbrook, a busy mountain town in the province’s southeast corner and close to U.S. border.

Doctors who choose to settle in these communities — and almost 200 other towns in B.C. — are also eligible to receive tens of thousands of dollars each year in additional incentives and fee premiums.

The 17 “communities in crisis” were identified by members of B.C.’s Joint Standing Committee on Rural Issues, made up of provincial health bureaucrats and B.C. Medical Association members. “They were, in our judgement, the most needy,” says committee co-chairman Granger Avery, a GP who has worked for 36 years in rugged Port McNeill, on northern Vancouver Island.


 

Rational risk takers” are required, says Dr. Avery. “Not cowboys, but not nervous nellies, either.


 

Dr. Avery is of the old school, a rural doctor who will handle almost any medical situation; he hasn’t much choice. Rural doctors like him don’t have the luxury of referring a patient to a medical specialist, he points out. “You can’t simply send your patient away,” he says. “For some, that’s quite a challenge. But I enjoy the variety.” One minute he may be treating a drug addict; the next, he may be required to help someone who has been crushed by a log.

He’s among the last of a dying breed; medical schools just aren’t producing a lot of GPs any more, he says, and those who do graduate aren’t interested in heading to the sticks. Heavy workloads are one factor. Working solo means always being on call. “That’s very wearing,” says Dr. Avery.

There’s the risk factor, too. Doctors working alone in relative isolation can find themselves responsible for patients with life-threatening trauma or illness. Evacuating such cases can be difficult, sometimes impossible. Few doctors want to shoulder that burden. “Rational risk takers” are required, says Dr. Avery. “Not cowboys, but not nervous nellies, either.”

For some, “no amount of cash can compensate” for the constant pressure and demands, he acknowledges. Does he expect the $100,000 cash bonus scheme to work? Will gorgeous Galiano finally land a permanent GP? The prognosis is not clear.

“Nothing we’ve done so far has really solved the problem,” says Dr. Avery. “Every time we think we’ve come up with a solution, someone else comes along and offers the same.”

bhutchinson@nationalpost.com

 

President, Canadian Medical Association (CMA)