One of our readers made some thoughtful suggestions. SOHC’s replies are in bold.
Before we can figure out how to attract doctors to the rural Princeton area we need to address why they don’t want to be here. A Nova Scotia study done in 1998 found the following reasons doctors don’t like to practice in rural communities:
– Excessive work hours This is still a problem, however we currently have 3 physicians and a nurse practitioner and are hoping to be able to attract two more physicians
– Lack of specialists which means less opportunity for interaction with specialists We now have a visiting specialist program (11 different specialists) who love coming to Princeton, our docs love having the interaction and the patients like it because it cuts down on traveling
– Unreliable access to locums It seems that the docs have been able to attract more locums; they like coming here now. IH pays for accommodation and SOHC has started a ‘Love a Locum’ program (a basket of goodies, home made canning etc. for new locums)
– Rural doctors have to deal with psychological and psychiatric problems beyond their skills Very true, at the moment SOHC is working with UBC Okanagan to organize an evaluation, interviews with people suffering from depression and other problems. Hopefully after that we may be able to come up with some solutions.
– Less interaction with colleagues for support, training and recommendations and limited access to specialized information This problem seems to have been solved by having everyone under one roof and the visiting specialist program.
– They feel they don’t have community support It seems that this is changing, very slowly, but nevertheless I think that the community is starting to understand that health care problems such as wait lists, no access to a doctor etc. are a country wide problem.
– “Fee for service” is not appropriate for rural areas No change there yet.
– Rural doctors are treated as second rate by their urban peers Is this your opinion or is this supported by fact. If this is a problem, it may be remedied in the future by promoting rural practice for medical students and by having visiting medical student to PGH .
– The availability of hospital resources affects retention of rural doctors. Not sure what you mean by “hospital resources”. However, most general practitioners who choose rural practice probably know what to expect. If they don’t, then it may be true that limited resources would affect retention.
What Can Be Provided For Incentives:
– Reliable locums!! This will allow physicians time off for vacations or continuing education – Offer a MINIMUM annual salary (in Nova Scotia in 1998 it was $138,000 with a $50,000 moving bonus and other incentives) – Provide extra on-call payment (Nova Scotia in 1998 said $51 – $75 per hour was desired) – Offer four weeks holiday pay per year. – Offer loan repayments in exchange for a given time period of work or as was suggested in the past, offer a home incentive (Princeton buys a house. Give the doctor a 10% ownership in a house for every year they work. After 10 years they own it.) SOHC feels it is not right if rural towns compete with each other, i.e. whoever has the most money and thus incentives, gets a doctor. However a fund has now been established, where doctors can access money to be used to attend conferences, prepare recruitment materials, make improvements at the clinic, etc.
– Provide subsidized telemedicine to allow rural doctors to communicate with colleagues and specialists. Program has now been established.
– Doctors want to practice medicine not run an office. Have someone run their office for them. That certainly would help. Our doctors are willing to pay for the salary of a Physician Assistant (PA). However, this kind of program has not been established in B.C. yet.
– Provide nurse practitioners to help lessen the load of physicians. Currently we have one nurse practitioner .
– Offer incentives to medical students who agree to serve in Princeton. If they agree to practice for a given number of years here, their tuition will be covered. I believe there is a program for this.
– Show the existing physicians they are appreciated by celebrating National Doctors’ Day. Great idea, will do that for coming year￼!