No doctor shortages, but where are they?

A lot of doctors may be locating themselves in Rossland, which benefits the entire area, but the rest of Canada hasn’t been so lucky.

A lot of doctors may be locating themselves in Rossland, which benefits the entire area, but the rest of Canada hasn’t been so lucky.

According to a study by the Canadian Institute for Health Information, the number of physicians rose eight per cent between 2008 and 2009 That translates to 195 doctors per 100,000 population compared to 189 in 2004.

The number of family doctors practising clinical medicine in Canada is currently between 27,000 to 28,000.

The 176-page study, Supply, Migration and Distribution of Canadian Physicians, noted that provinces with medical schools showed a spike in the number of degrees awarded. In B.C., that number rose from 114 in 2003 to 197 in 2008.

The extension of the UBC medical school to Prince George and Kamloops helps.

In 2011, another 32 students were slated to enter medical school in those areas.

With many communities reporting difficulty finding family physicians and various specialists. where are all these medical graduates going?

Many who may have turned to family medicine in the past are entering a new field called hospitalists.

This relatively new movement was initiated in the late 1990s.

A hospitalist is a doctor who is specialized in caring for patients in hospitals. He or she does not have an office, hence does not run a family practice. They work exclusively at the hospital.

Many hospitalists are family practice doctors, medical-subspecialists or board-certified internists.

Hospitalists organize communication between doctors caring for a patient and serve as point of contact for other doctors, nurses and family members.

At Kootenay Boundary Regional Hospital, there are two hospitalists on full time but the work is split amongst 10 physicians in total, according to emergency room chief and emergency physician, Dr. Peter Krampl.

“Some work one week on, often,” he said. “We have quite a good group. Their job is to care for medical and surgical patients from out of town; help with patients whose conditions are too complicated for the primary physician; those who have no family doctor; and to assist with surgical patients.”

The downside is hospitalists may not know a patient’s detailed medical history as a primary doctor would.

Anesthesiology is another field where shortages are making the news of late.

Kootenay Boundary Regional Hospital has five anesthesiologists on staff and one anesthetist.

What is the difference?

“In most of the world, the two are synonymous,” said anesthesiologist Dr. Iain Reid.

“In the U.S., an anesthetist is a nurse.”

The confusion caused the Canadian medical society to make the term universal.

An anesthesiologist spends five years in this specialist study, Reid explained, whereas a general practitioner may take an extra year of study in anesthesiology.

The latter do not provide on-call work and are used for minor surgeries and C-sections.

“When I first came here, I did enough complicated (procedures) to be satisfied with the work according to my training – extensive care, neurology, thoracic, aortic aneurysms. . . I wanted a broad practice, complicated enough to practice my skills.

“Now, they’ve taken away the thoracic and vascular components and the intensive care has been morphed away into a separate group.”

Add to this the fact that anesthesiologists in rural areas don’t get paid as much as those in big centres makes Reid wonder who will replace him when he retires.

He says a lot of the new graduates don’t want to work as hard as the last generation of doctors.

“They don’t want to be tied down to a family practice. They may want to go on holiday for a month; so they just do lucums, walk-ins and hospitalist (services).”

Reid feels having a great hospital isn’t enough to attract new doctors to rural areas.

“Schools, lifestyle and so far, a good variety of medical specialists, will attract new doctors,” he added.

“I worry about what will happen if Rossland schools close. In five years, if you can’t get a family doctor, you’re sitting in emergency for hours and there’s no anesthesiologist, you begin to wonder.”

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