Family doctors in rural areas: an up-and-coming profession
While there is a serious shortage of health care professionals throughout Canada, rural areas—which account for 21% of the Canadian population—are even harder hit, with only 9.4% of all the country's doctors practising there.1 These rural areas, where many primary industries such as mining, agriculture and fishing are located, require doctors just as much as urban areas. The provinces and territories are aware of this shortage, and programs have been in place for years to promote the recruiting of rural physicians. With the implementation of these measures and other factors, the practice of rural family medicine is currently very attractive.
A diversified practice
All studies tend to show a decrease in the number of procedures carried out by GPs in urban areas, with their rural counterparts offering a more diversified panel of care. In 2004, 33% of GPs in Canada's less-populated regions had delivered babies, vs 9% for GPs in cities.2
Along the same lines, rural GPs more often provide anesthetic, geriatric and surgical care. In 2004, 74% of them provided emergency room care vs only 15% of their urban counterparts.3
Rural GPs have more independence in their practices, because they have to make up for the shortage of specialists, just over 2% of whom work in rural areas. The role of GPs is therefore crucial, since without them, certain types of medical care would not be available. Rural residents must often travel over 100 km to see a specialist such as a pediatrician or a psychiatrist.
Community recognition
In addition to the diversified practice, rural doctors also value their quality of life. According to a 2001 rural practice survey, 76% of doctors polled felt appreciated by their community, and 70% also had a feeling of belonging. Rural GPs were well integrated in their community and 70% were satisfied with the recreational opportunities in their region.4
Of course, everything is not perfect in rural areas. Doctors' level of satisfaction with cultural activities and job/career opportunities for their spouses is mixed. Professionally, the independence of rural practices can also be accompanied by loneliness, and some doctors may be dissatisfied with the lack of professional advancement. Rural areas are aware of these concerns, and have increased their efforts to address them better for several years now.
Numerous incentives
With only 14% of its population living in rural areas, Ontario was nevertheless the first province to set up a program to promote these regions in 1969. The other provinces and territories followed suit. Despite these initiatives, however, rural areas are still currently experiencing a severe shortage of doctors.
Faced with this recurring problem, the federal government in 2005 granted the Society of Rural Physicians of Canada a budget of $153,895 over three years to enhance strategies to recruit and retain rural physicians and to develop appropriate educational programs.
This pan-Canadian strategy is in addition to efforts made by communities to attract GPs. As outlined in the Ontario Rural Council’s 2003 "Rural Health Strategy" information guide, there are many incentives throughout the country. These incentives include allowances, free or low-rent housing, executive vehicles, job assistance for spouses and school integration services.
And while the road to arrive at an ideal practise of rural medicine seems long, it offers interesting perspectives. The future reserves a prominent place for rural GPs, who are essential links for better accessibility to care in outlying regions.
1 2 3 Geographic Distribution of Physicians in Canada Report, Canadian Institute for Health Information, 2005.
4 Comments from the Canadian rural practice survey, 2001, Canadian Medical Association.