Why are so many people in Steinbach and area without a family doctor?
There are between 6,000 to 10,000 people in Steinbach and the surrounding area without a family doctor.
Dr. Denis Fortier from Southern Health says there are many factors why, but one of the biggest reasons is that Steinbach is growing quickly.
“The first being that Steinbach is a rapidly growing city, and the supply of physicians is not keeping up with the demand of the increasing population.”
He says the other big reason is that we have also seen a significant change in the way physicians practice in Steinbach, which is increasingly like the way they practice in larger urban centers such as Winnipeg.
Typically in smaller communities, family physicians are also involved in other healthcare branches.
“Family physicians are involved in hospital care, emergency care, personal care homes and on and on,” he says. “Whereas in Steinbach, increasingly we've seen a shift, and almost a separation, between physicians who do uniquely primary care, and physicians who do uniquely hospital work.”
Dr. Fortier says this is a shift that has occurred fairly rapidly over the course of about 10-15 years.
“We just haven't been able to catch up on the primary care needs. A lot of our primary care physicians have moved, for instance, into purely hospital work. That has left a gap in the community,” he says. “So that movement away from primary care, combined with an increasing population, has further added to that gap in supply versus demand in Steinbach.”
He says one of the more recent variables is how COVID has impacted the health workforce, not just physicians, but pretty much every healthcare profession.
“People have decided that after three difficult years it's time to retire, move on, or reduce the days and hours that they would have worked historically, so that they have a better work life balance.”
He says there are many other variables, but those are three of the big ones that are playing a part in this.
What is the plan to get an adequate amount of family doctors back?
Southern Health has a long-term plan and a short-term plan to get a sufficient amount of family doctors in our communities.
One of the long-term strategies is to increase the spots available for med-students at the University of Manitoba's medical school.
“Historically, for many years it has been a steady 110 admissions. That hasn't deviated much in probably 15 to 20 years.”
The government has announced a plan to increase admissions from 110 to up to 150.
“Now that can't be done suddenly because there's a lot of things involved in training. So for this year, the proposal is to increase admissions by 15, so going from 110 to 125.”
He says that next year, the admissions will go from 125 to 140, and then they will reassess to what degree they increase.
This is a long-term strategy because the increase of physicians will not be seen for several years.
“If we admit 15 more people this year into medical school, we will not see them come out as family physicians until 2029, 2030, or 2031. So that's a long-term strategy, but it's a necessary strategy.”
He clarifies that the problem isn’t a lack of interest in medical school, but a lack of space and spots.
“For 110 spots, we've had on average 1000 applicants, so I think they (the spots) are always filled.”
Moving on to short-term strategies, they are currently recruiting internationally trained physicians, or physicians who have a medical degree from another country.
It needs to be confirmed that their training is appropriate for the Canadian health system, so they undergo a one-year training program.
“We have historically had 20 internationally trained medical graduates go through this program, and they're primarily earmarked to help in rural Manitoba.”
That number is set to increase this year from 20 to 25, and next year from 25 to 30.
“That will be a significant help. We'll see the results of that increase by next year and the year after, so it's not in the next couple of weeks, but it will be a welcome interim solution.”
He guesses their biggest recruitment tool is getting healthcare workers to experience life in rural communities.
“What we know for sure is that if we can encourage people, physicians, nurses, and other healthcare providers to come and experience work and life in rural Manitoba, many of them are actually quite surprised and are very happy to become part of a rural community.”
Dr. Fortier says there are a lot of really good things about practicing medicine and working in the health field in rural Manitoba. The problem is getting people here to actually experience it.
The university and other teaching programs have increasingly worked with communities such as Steinbach to offer clinical teaching units so they can experience life in the area.
"We actually train medical students, family practice residents, and other healthcare providers to come live, experience, and work as part of their training program in cities such as Steinbach.”
He says the challenge is getting them interested in Steinbach when the opportunities are endless.
“There are opportunities all over Manitoba, all over Canada, all over North America. So we're in a pretty stiff competition.”
Dr. Fortier notes there is a lot of work being done to find ways to get rural students interested in the health system, as people born and raised in rural Manitoba are more likely to stay in rural Manitoba.
He says there are a few other things they are doing as well, but those are some of the strategies that the university and the government has put in place.
Although there are long-term and short-term solutions, it will take time to fix the lack of family doctors in our area.
“We're probably in a very challenging 5 to 10 years ahead of us to try to correct the challenges that COVID has put on our table. And as well, keep up and even surpass the supply-demand gap that we've been experiencing for over 10 to 15 years.”