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New CEO to address doctor shortage

If there is a hope for beleaguered rural communities in finding and keeping doctors, that hope has just been given a face.

If there is a hope for beleaguered rural communities in finding and keeping doctors, that hope has just been given a face.

The provincial government recently announced they've hired the first CEO for their newly-formed Physician Recruitment Agency, which was announced in March.

The CEO, Edward Mantler, has previously worked at the University of Alberta Hospital, where he oversaw operations, and for the Calgary Health Region, as director of the medical access and innovation department, where he co-ordinated access to a range of medical services for a diverse population of around two million people, approximately half of whom lived outside the urban centre.

Mantler also spent the first 15 years of his career working in Ponoka, Alta., a rural community of approximately 5,000.

"Physician recruitment is a highly competitive market at the moment," said Mantler.

Mantler said one of the biggest tasks will be to determine what factors, besides money, influence a physician's decision to practice in a rural setting.

"I'm hopeful that through the work of the agency we can better understand what those incentives are," he said.

Mantler, who will be earning just under $150,000 per year, said the operating budget of the PRA has been set by the provincial government at $3.5 million, although an annual budget has yet to be determined.

Since its inception six months ago, PRA has established a board of directors which has met a couple of times to outline strategies and priorities.

Biggar MLA Randy Weekes stated some of the goals of the agency, which include: decreasing the annual turnover of physicians to less than 10 per cent; increasing the number of Saskatchewan residents who study medicine by 25 per cent; increasing the number of University of Saskatchewan medical graduates who establish a practice in the province by 10 per cent; and increasing the number of Canadian-trained doctors by 10 per cent.

When asked why the shortage of physicians has become such a big problem, Weekes replied, "it's just what's been going on for years under the NDP."

Weekes said 52 rural hospitals were closed over the 16 years the NDP were in power.

Judy Junor, NDP health critic, says this argument is irrelevant.

"That happened in the early 90s, when the province was basically bankrupt," said Junor. "The Saskatchewan Party has been in government for three years, are they going to run on that excuse forever?"

Junor said she wants to know why, when the province is supposed to be booming and growing, rural communities aren't feeling the benefits.

Having toured over 40 rural communities recently, Junor said many of the communities' leaders and health providers have expressed to her the feeling they are on their own. Also, Junor said no one has even heard of the Physician Recruitment Agency, although it was announced six months ago.

Junor said many communities have come up with their own strategies to recruit and retain doctors, including building and paying for office space and offering free accommodation for doctors and their families.

The North Saskatchewan River Municipal Health Holdings, for example, was set up by a number of municipalities to co-ordinate the effort of recruiting and retaining physicians. Currently, the NSRMHH represents 11 municipalities, comprised of towns, villages and rural communities, and offers a number of incentives to physicians, such as re-location and signing bonuses, free use of a vehicle and housing for six months and turnkey clinics.

NSRMHH also operates the three clinics in Edam, Turtleford and St. Walburg.

NSRMHH represents just one of the initiatives taken by municipalities to secure adequate medical care.

Some municipalities have enforced a direct health levy, while others have used the municipal tax base money for health purposes, effectively short-changing residents on roads and infrastructure because the need for doctors is so great.

"These communities are paying for health care twice," said Junor.

She questioned the ability of a CEO from Edmonton to deal with a problem affecting rural Saskatchewan, as well as the wisdom of spending money on a new co-ordinating body instead of allocating that money to the rural communities who have already developed strategies.

"I don't see that [the Physician Recruitment Agency] has any way, or any authority, or any policy program in place to help these communities who need this help now," she stressed.

Ryan Bater, leader of the Saskatchewan Liberal Party, took a more temperate view of the new agency, saying he gives everything a chance.

"The recipe sounds good, but the proof will be in the pudding," he said.

However, Bater did say he is sceptical whenever governments create new agencies to solve problems.

"Added bureaucracy won't necessarily fix the problem and it's a big problem," said Bater.

He stated more emphasis should be put on retaining rural doctors than on recruiting new doctors, and said a big issue in retaining those doctors is a problem of lifestyle.

"Most doctors graduated from a university in an urban centre and are accustomed to urban life," said Bater.

He agreed working harder to keep Saskatchewan medical students in the province, many of whom are accustomed to rural life, could be a potential solution.

He also added physicians in rural settings are often expected to provide more services and work longer hours than their urban counterparts.

"They should be focusing on the lifestyle of rural physicians, not so much the money, but making sure physicians are able to enjoy their lives in rural Saskatchewan," said Bater.

Biggar MLA Randy Weekes echoed that statement, saying there has to be an attraction for the whole family.

"It's little things, like if the doctor has a spouse, trying to find them a job in the community," he said.

Weekes also addressed the issue of physicians often having to work longer hours in rural settings. He described the situation in Biggar, where they need six doctors for a proper on-call rotation, but have the patient base for only three doctors.

Weekes said the provincial government has recently announced a pilot project that will see medical students complete their residency requirements by interning in rural areas.

Weekes said he thinks the initiative will not only reduce the workload of rural doctors, but will encourage Saskatchewan medical students to stay in the province.

"If they do their residency in the community, they're more likely to stay there if there's an opening for a doctor," he said.

The pilot project will take place in Swift Current with four medical students.