Humboldt's doctors are no longer accepting new patients.
That means that while anyone can still receive medical care at the Humboldt Clinic, if one of the eight physicians at the clinic is not already your family physician, you can't get one here.
The Journal sat down with some local doctors last week to discuss the situation.
"A lot of us have had closed practices for... seven or eight years," said Dr. Jacqueline Bourgeois. "That's true for everyone now. A lot of the physicians here now have been here for a significant space of time. They have a large client base."
Between the eight doctors at the clinic, they see about 35,000 patients, with each doctor looking after at least 4,000 people as their family physician.
They also run five peripheral clinics in the surrounding area, and assist visiting surgeons with procedures at the Humboldt District Hospital.
Outside the clinic, the doctors make rounds at the hospital, checking on inpatients, do minor procedures, and fill out insurance forms, go through test results, write referral letters, and document the patient visits they perform each day.
"We have to chart everything. This takes time," Bourgeois noted.
The workload means that each doctor can only handle so many patients as a family physician.
"You can only stretch yourself so thin," Bourgeois said.
Though local doctors are no longer taking on new patients as a family physician, they will provide care to anyone who walks into the clinic. Those people will see the doctor on call.
This isn't a new situation in Saskatchewan or across Canada; it's just new for Humboldt.
"Lots of people across Canada and Saskatchewan don't have family physicians... A solution is going to take years before we see any results," said Dr. Carrie Levick.
Humboldt is in a situation now that not only is the city growing, surrounding communities have lost a number of physicians, forcing people to drive here to see a doctor.
Wakaw's clinic closed, for instance, noted Levick. Lanigan has just one physician, and a number of doctors have left Watrous.
As for the city itself, the doctors have noticed an influx of new patients with people moving into Caleb Village, a new senior's assisted living facility in town.
Add to that the general growth of the city over the last few years, and a shortage of doctors, and you get this situation.
The Humboldt Clinic has been short of doctors since last year, when two doctors with large practices relocated elsewhere in the country.
Those two doctors looked after about 10,000 patients, it was noted, so that has an impact.
The remaining doctors at the clinic would like to recruit anywhere from two to four new doctors, because they would like to expand.
In the meantime, they remain short-staffed, which means people may have to wait between one to two weeks to see their family physicians. Those needing to get in sooner can go on the cancellation list and will see whatever doctor is available.
Working longer hours, as it has been suggested to at least one doctor, is not the answer to this issue, Levick believes. They simply need more doctors, and they won't attract any more if the hours for a physician here are that long.
The clinic is actively recruiting for Humboldt, the doctors noted.
"It's very, very hard to find someone who wants to come to rural (Saskatchewan)," said Bourgeois.
Other health regions subsidize rural physicians, and other communities have clinics that doctors don't have to buy into - they're owned by the communities themselves.
That stacks the odds against Humboldt when it comes to getting doctors here.
"If anyone has any ideas... any input about how to get more doctors, please share it," Bourgeois said. "It's frustrating (for us) hearing people's frustrations. It's hard for us, too."
Humboldt, she added, is a great place to work.
"We just need more people."
The Saskatoon Health Region (SHR) is working on that, too.
According to Kelvin Fisher of the SHR, they have made offers to two physicians - one from the United Kingdom and one from South Africa. They have yet to go through the new Physician Assessment Program, and immigrate here.
Fisher sees no problems ahead with either, but expects the earliest these "excellent recruits" would be here is in the new year.
In the meantime, they are continuing to pursue a few other leads, including Canadian-trained physicians, Fisher said.
Their ultimate goal is 12 physicians in Humboldt, and they are also currently recruiting for Rosthern, Wakaw, Watrous, Lanigan, Wadena and Wynyard.
"There isn't a community with a hospital (in the rural SHR) that has a full complement of physicians," he said.
Humboldt's doctors now say the community can help to get new physicians to stay here
First of all, if you book an appointment with a doctor, show up for it.
Between January 1 and May 19 of this year, there were 603 no-shows for appointments at the clinic, reported Gail Ewen, clinic manager.
From April 1 to May 19 alone, there were 200.
Those appointments mean wasted time for physicians, and denies those on the cancellation list a chance at an earlier appointment.
The clinic is adopting a new policy Ewen added, for those who habitually don't show up for their appointments.
After they miss two or three appointments, they will get a warning letter. After that, they will get billed $50 for missing the appointment.
It's what a lot of specialists do, the doctors noted.
"It's not about the money," Levick said. "We're not worried about lost income. We have people waiting two weeks for an appointment, and we have 600 people who don't show up."
Second, don't show up at the emergency room at 3 a.m. with something that's not urgent.
Doctors continue to get called to the emergency room at the hospital in the middle of the night for sore throats or belly aches.
The emergency room at the HDH is not staffed with doctors at all times of the day and night like nurses. They are called in when people come in, and nurses are obliged to call them in, no matter what people come in with.
And they are happy and more than willing to go to the hospital during the night to deal with an emergency, and people suspecting they may be having a heart attack or stroke or another serious matter should not wait.
But, the doctors noted, if you are experiencing something you think you should see a doctor for, but which doesn't seem urgent - like possible stitches in your finger - don't wait until the middle of the night, they urged. Come earlier in the evening, or if it is something that not urgent, go on the cancellation list at the clinic.
It's common sense stuff, the doctors noted.
"It's not about how much a doctor is making," Levick said. "Doctors don't care if they have to stay up all day (and night) long. Residents say the workload is too much and that's why they don't stay."
Every doctor in Humboldt takes a turn taking call, which means they are on-call for the emergency room, and to see patients on the cancellation list at the clinic.
Levick said that during her last on-call shift, after seeing patients at the hospital, she saw 26 patients from the cancellation list at the clinic.
"The cancellation board works," Levick said.
Third, if you put your name on the cancellation list, and are waiting for a phone call about an appointment, be at the number you left, and be willing to go when you're fit in.
"You may have to...adjust your schedule to come, if you really need to come," Ewen noted.
Their schedule is so tight right now, it's not very accommodating, she indicated, so people should be prepared to be flexible in their own schedules if they wish to see a doctor as soon as possible.
"Some people get a little abusive if it doesn't accommodate them," Ewen noted.
"We've gotten people in within two hours, and some (within) five days. The big thing is being able to reach them and that they are willing to come," Ewen said.
Fourth, try to keep your appointment limited to a few complaints.
Humboldt doctors see between 20 and 60 patients every day, and are scheduled to spend 10 minutes with each patient. If you have a long list of issues, it can put the doctor behind in seeing other patients.
The doctors are stuck between a rock and a hard place when it comes to patient appointments.
"People are saying 'book less people in so you spend more time with me'," Levick said, "but if you do that, people wait longer for appointments."
Fifth, if you do come to the emergency room, come armed with your personal medical information, including the dosages of any medications you are on. It will help the doctors with your care.
The Saskatoon Health Region has a list of family physicians who are taking new patients on their website.
