Jackman-Atkinson: Healthier health care


By: Kate Jackman-Atkinson


Health care is one of the few issues that is of great concern to almost every Manitoban.Young or old, an actual or perceived shortage is cause for uneasiness.

Ensuring that their communities are adequately served by physicians is an ongoing worry for many rural communities and health authorities which face additional challenges compared to those located in urban centres.

Figuring out how to get and keep physicians in rural areas is an issue more and more people are paying attention to as older physicians retire and replacing them is proving to be a challenge.

Physicians who choose to practice in rural communities usually have some rural connection, such as a rural upbringing, and with most medical schools offering limited chances to learn about rural practice, many students without this background have little exposure to rural practice and instead embark on an urban career.

One idea which has been floated to counteract this problem is the creation of a rural focuses medical school in Brandon.Last year, the Brandon University Medical Education Study (BUMES) was created to look at three options; the potential for a stand-alone medical school in Brandon, the potential for a satellite program expansion of the University of Manitoba in partnership with Brandon University and the potential of continuing or expanding existing models of rotational and educational experiences.

In January, the study held a public consultation meeting in Neepawa where those in attendance spoke strongly in favour of expanding the clerkships and residencies offered by the University of Manitoba medical school in rural areas. These programs give students a chance to actually practice in a rural setting. They also spoke about possibly offering more medical school seats to students from rural communities.

When the study was released late last month, their recommendations focused on making better use of existing resources and opportunities, what could be called an enhanced status quo option. The study rejected the establishment of a new and independent medical school at Brandon University, however, they did consider the future establishment of a satellite school in Brandon.

The provincial government said that they would implement all 10 recommendations and one of them, creating more rural medical residencies, will start this year with six new family medicine residencies in Brandon, Steinbach and Morden/Winkler.

Research shows that there are three factors most strongly associated with a doctor entering rural practice: a rural upbringing, positive clinical experiences at the pre-vocational level and specific post-vocational training for rural practice.

We can do little to change an urban upbringing but I think that the recommended solutions and their rapid implementation are a good way to start addressing the other two factors. The problem, as noted in the report and by those at the Neepawa meeting, isn’t just a lack of opportunity or interest in rural practice.

There is a culture at medical schools that encourages students to specialize, as opposed to study family medicine, which further reduces the pool from which rural communities can pull their doctors.

Increasing the number of physicians choosing rural family practice is important for our communities today and in the future, but it will take a multi-pronged approach. We want to make the most efficient use of our scarce health care dollars to get the best result.

The province has pledged to ensure every Manitoban has access to a family doctor by 2015 and while physician shortages exist across the province, they are felt more acutely in rural and remote areas.

The government is at least saying they are interested in solving this problem, which makes it a good time to push for change.