Recruitment of doctors in rural SK communities backfiring

Like hundreds of other places across Canada, the Saskatchewan town of Wakaw has gone all out to recruit doctors, recently luring two South African physicians to the community with free housing, car allowances and financial bonuses.

Barely six months later, though, the young husband-and-wife team is leaving, partly because of an unusual complaint: they say there are simply not enough patients in the supposedly under-serviced area to sustain their practices. They also charge the town essentially misled them about the nature of their roles, which include one or other of the physicians being on call in the hospital emergency department, 24 hours a day, 20 days out of 30.

Aggressive doctor recruitment has become an integral, if less than welcome, part of Canada’s MD-starved health care system. Dr. Paruk, 28, suggested his and his wife’s experience might serve as a cautionary tale for physicians tempted by generous incentives to make long-term commitments to particular jurisdictions.

He has heard of other Saskatchewan communities where the recruitment of doctors has backfired, too.

“A lot of towns will say “˜We’ll give you this, this and that if you commit to stay here for two or three years,’ “ he said. “We’ve learnt our lesson now … My best advice is don’t make any commitments until you work in a place, until you know.”

The town, though, has its own tale of woe, including other doctors officials had almost recruited in the past, only to have them stolen away by sweeter offers from competing municipalities.

Ed Kidd, Wakaw’s mayor, said Dr. Paruk and his wife, Dr. Tasnim Gafoor, were fully informed of the nature of their jobs, and would undoubtedly have built up a heavier patient roster in the town of 864 if they had simply stayed longer.

As it is, they lasted until just after they had gained their Saskatchewan medical licences, he said.

“It’s like any business, you have to attract people, you have to attract your clientele,” said Mr. Kidd. “Another doctor claims that there are enough patients for three doctors to keep very busy. It just takes a little patience and to get out there.”

Many people in town see family physicians in other communities, like Saskatoon, 90 kilometres to the southwest, and are loathe to leave them for a local doctor until they know for sure the Wakaw practitioner is staying for the long haul, he said.

The mayor said he realizes now the key for communities like his is to find doctors who are suited to a rural lifestyle.

Some researchers have estimated that as many as five million Canadians, many in small or isolated municipalities, are without a family doctor. Recruitment efforts – and the commitments asked of doctors – have escalated in recent years, with some places offering young doctors as much as $150,000 in exchange for a minimum five-year stint.

Drs. Paruk and Gafoor say they decided to emigrate to Saskatchewan in part to be close to family members who are also physicians and had moved to the province earlier. They talked to a number of communities before settling on Wakaw, which offered incentives partly funded by the Saskatoon Health Region and by the municipality itself.

Dr. Paruk says the town’s people welcomed them with open arms. Despite assurances they would have lots of patients, however, they rarely see more than 10 a day, when 25 or 30 a day would be more usual in a rural practice, he said. Meanwhile, he and his wife now constitute two-thirds of the on-call rotation for the local hospital’s newly re-opened emergency department, which he believes is the real reason they were brought to town.

The late-night phone calls disrupt both their lives, no matter who is on duty, he said. “It’s just become way too much for us. We don’t have a life, basically.”

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