New incentives encouraging physicians to remain in rural British Columbia make the province “significantly more competitive” in Canada's ongoing physician recruiting war, the president of the British Columbia Medical Association (BCMA) says, “but it's still not a mecca.”
Dr. Lynn Doyle says the main problem facing BC is the combination of aging doctors and nurses with an aging population. A long-term solution that makes rural BC competitive with other provinces is needed, she says.
The measures negotiated with the BCMA include recruitment bonuses, retention premiums, CME benefits and locum programs. Unlike recent rural initiatives in BC, this program is part of a province-wide strategy.
Dr. Geoffrey Appleton, who has practised family medicine in Terrace for 30 years, helped negotiate the package. He says the incentives “will certainly help,” but points out that the province still relies heavily on countries such as South Africa — the source of the last 6 FPs to arrive in his town. He says one positive change, which might attract more Canadian-trained physicians, is that the number of doctors covered by the Northern Isolation Allowance has increased from about 300 to 1200 because medium-sized rural communities are now included.
Appleton says the availability of locums to spell off rural FPs is still “a major, major issue” that consistently ranks first on BCMA members' list of concerns. He says the new locum program will now pay a guaranteed daily rate of $750, plus a $600 honorarium for coverage provided while the regular doctor is away for vacation, education or health reasons. Only communities with fewer than 7 FPs are eligible: “There just are not enough bodies to go around, so we had to limit this to the really small communities,” says Appleton. Terrace, which has 16 FPs, will not benefit.
A new rural locum program for anesthetists, internists, general surgeons, orthopedic surgeons, pediatricians and obstetricians will pay a daily rate of $1000 plus fees-for-service, on-call payments and a $1000 per-trip travel honorarium; 14 communities are eligible for the program, which will cost $1 million annually. Appleton is cautiously optimistic, even though “we don't know if we can find any specialists who will want to do this.”
The government has also announced a $21-million program to recruit more nurses. In Terrace, says Appleton, “we are still really struggling. There are lots of times when our intensive care unit is closed because we just can't get nurses.”
Appleton thinks long-term relief for rural physicians may not come until the University of Northern British Columbia starts graduating nurses and doctors who may stay to practise in the north and/or rural communities.
“In BC we are still behind Alberta and Ontario in overall income terms. While that continues, we are not going to be the first choice, so we need to be constantly beefing up our incentive programs. These new programs are certainly helping to do that.” — Heather Kent, Vancouver