Rural communities in Saskatchewan have been facing difficulties recruiting and retaining physicians for a number of years. Saskatchewan is not the only place that has been hit by this reality. Places such as Nova Scotia for example have had difficulties in this field as well, which has led to changes to the ways they offer primary health care.
The current health care model is making it difficult to see a doctor and alternative practices are being sought. Included in these possible changes for Saskatchewan is the Nova Scotia Collaborative, the Distributive Learning Model, and changes to locum doctors.
The Nova Scotia Collaborative Emergency Centres (CEC) were developed as a way to offer both primary and emergency care. It strives to create a stable and reliable service. Open 24 hours a day for seven days a week the centres are run by doctors, nurse practitioners, registered nurses, and paramedics as a primary health care team. Usually the centre would have RN's and paramedics available to assess and treat patients or refer them to a larger hospital while in contact with a physician. This means it is important to have these people already in place before the centres can function properly.
The appeal is to lessen the onerous on-call schedule of doctors in areas where much is demanded from them. The Nova Scotia model is supposed to provide access to medical professionals after hours when people often are forced to go to the Emergency Room for non-emergencies. Overall it provides greater access to primary health care services. In the case of emergencies patients go to the most appropriate emergency centre. Ambulances and CEC's are able to assess and stabilize patients before continuing to the appropriate emergency facility.
"You'll be assessed, you'll be treated, but patients know that they can go there and they don't have to worry about the doors being closed or there's no doctor here or we can't do anything for you," Marga Cugnet, President and CEO of Sun Country, explained.
"How it's all going to work? We don't have all the answers yet, you know, we've got to have ties to where you're going to be transferring to and what impact does that have on the physicians and emergency rooms there. How are you going to manage that and you still need Human Resources to guarantee those hours of work, right. So, you need the docs, the nurse practitioners, paramedics, and until you have those... human resources is the main challenge."
Saskatchewan has decided to create centres such as these; but, regions are still discussing where these CEC's will be located. Sun Country has committed to discerning which areas would be best to offer this service.
Another model meant to help provide health care to the region is the application to become involved with the Distributive Learning Model. This model focuses on providing a residency to students just finishing their medical degree. Once they choose to enter family medicine they must fulfill two years of a residency, which is becoming difficult to be met in Saskatoon and Regina with the increase in seats within the College of Medicine. The College of Medicine has thusly expanded the areas to where these newly graduated physicians can practice.
"The Cypress Health Region, Swift Current, has been one of the sites. PA's been working under this for quite awhile, so we [put in] an application because we see this as an opportunity hopefully to bring in family medicine students..." Cugnet explained.
"They're going to live in a community, work with physicians in a practice, and get more comfortable with it [not being in a city]."
This is ultimately a new way to recruit and retain physicians for Sun Country, which will possibly be a way to alleviate the doctor shortage in rural areas by appealing to newly graduated physicians.
"And hopefully that will be a retention piece for us right. Recruit and retain some of these Saskatchewan graduates into these smaller regions," Cugnet said.
Another change being made to the system is the increase of locum doctors. Currently there are ten locum doctors for the entire province. These doctors are only defined as short term physicians, so in the case that a doctor is planning on being away for a short time a locum is found to work in their practice until they return. The change being made will increase the number of locums in the province making it easier for doctors to take time off from their practices. The province has committed to increasing this number and spreading them across the health regions in all of Saskatchewan. Having an available locum may make it easier to recruit and retain physicians to the area because doctors would have someone to rely on if in need of time off. The priority, however, is to recruit fulltime doctors to each position; but, increased numbers of locums may assist in this feat.
"There's no confirmed plan right now, but as a region we're always looking at different things, and different scenarios, and how they would work," Cugnet explained.
The people within Sun Country want to be able to have more access to and be able to rely on medical services in their area. People are discontent and want the health region and the province to find a way to fix the problem that is a lack of medical service in the area as they live in fear of serious emergencies being unable to be responded to. Therefore, these possible changes or new models may provide help; but, human resources are needed before the models are made a reality.
It is a difficult problem with no known solution that is guaranteed to work, thus, the region and province have been looking into these alternative practices which they hope will come to fruition soon in order to offer some services to the concerned people in the area.
