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Communities compete to attract physicians.

Smaller communities in Northern Ontario have found themselves not only competing against southern Ontario cities and towns, but also against each other in their effort to attract general practitioners.

"No one wants to come to Northern Ontario," complains Emo Reeve Jim Stewart, a member of the community's recruitment committee.

While the Ministry of Health and the Ontario College of Physicians say there are too many doctors in the province, Northern Ontario communities such as Englehart, Iroquois Falls, Smooth Rock Falls and Emo are losing their general practitioners.

Since May, Englehart has had only two of the four doctors it requires to adequately serve the local population.

Iroquois Falls lost three of its four full-time physicians during a six-month period.

In Smooth Rock Falls the community has lost two doctors.

The hardest hit has been Emo which, until recently, had to get by with temporary doctors.

Stewart says Emo lost all three of its doctors during the span of a few years. The last of the three left in June 1990.

However, Emo recently beat out Englehart in an effort to attract one physician from Salt Lake City, Utah. The physician was expected to start work in Emo this month.

While noting that better air connections between Salt Lake City and Emo were a factor in the American doctor's decision, Stewart says the deciding factor was the town's predicament.

"I think the big thing was that we had no doctors and Englehart had two," he explains. "He (the doctor) knows that he can come in and really be able to start making a contribution."

The problem of recruiting and retaining general practitioners is most apparent in the fly-in communities of the far north. In a declining scale, rural areas are somewhat better off, and the north's five larger centres have the least trouble attracting general practitioners.

The problem is that the north's smaller, remote communities are perceived as isolated, with few educational opportunities and fewer professional opportunities for spouses, according to Hugh Drouin, the health co-ordinator for the Ministry of Health's Northern Health Office in Thunder Bay.

"We're optimistic that if we can get a doctor here, then we can hold him," responds Stewart. "We're not as isolated as we once were. We're accessible to all the major centres."

However, it is also perceived that the workload is much greater in smaller communities.

"You're on call 100 per cent of the time," says Dan O'Mara, chief executive officer and secretary of the Iroquois Falls Hospital Board. He notes that there are cases of professional burnout among doctors in small communities.


For the people charged with the task of finding community doctors the search can be lengthy and expensive. In some cases communities have spent between $5,000 and $10,000 searching for a doctor to call their own.

Typically, a search includes nation-wide advertisements, recruitment tours to universities and job fairs both in southern Ontario and in other provinces.

In most cases it takes more than the promise of a career challenge to attract a general practitioner who is willing to call Northern Ontario his or her home.

In Atikokan, for example, local officials have offered incentive packages and higher rates of pay for isolation. The community has a full complement of four doctors - one of whom is currently on an educational leave.

"We could use another doctor, but that would be in addition to what we already have," said Kurt Pristanski, administrator of the Atikokan General Hospital.

Of the doctors serving the community, one has lived in Atikokan for 25 years and two have been in the town for four and five years respectively. The fourth doctor has only been in the community for about one year, but he replaced a doctor who had practised in Atikokan for 35 years before retiring.

Both Pristanski and Bob Michels, the general manager of the Atikokan Economic Development Corporation, believe that Atikokan's recreational advantages play a part in the community's success at attracting and retaining doctors.

Meanwhile, O'Mara points out that Iroquois Falls offers doctors a fully furnished medical clinic and office space in addition to a local golf course and indoor pool.

"They have a ready-made practice. It's all set up and running for them," adds Jake Armstrong, the administrator of Englehart and District Hospital.

The communities, however, are not alone in their struggle to attract and retain general practitioners.

Almost two years ago the province established the Northern Health Human Resources Committee to examine the problem and come up with potential solutions.

The committee recently held a three-day forum in Sault Ste. Marie which attracted 85 health-care professionals from across Northern Ontario.

The Sault Ste. Marie forum was intended to complement the committee's work. The committee is expected to submit its report to provincial Health Minister Frances Lankin early in the new year.

In October the province awarded a $2-million grant to Lakehead and Laurentian universities to establish research teams which will study issues relating to the recruitment and retention of health-care professionals.

Over the next five years the research teams will study factors influencing health-care professionals' decisions to locate and/or continue their practices in Northern Ontario.

In addition, they will develop a human resources health information base for the north, study the effect of education and training programs on attitudes about establishing a northern practice and foster the development of closer ties among northern health professionals, district health councils, teaching institutions and the general public.
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Author:Krejlgaard, Chris
Publication:Northern Ontario Business
Date:Dec 1, 1991
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