| The situation varies greatly across Ontario, with the Southwest the worst-off with 1,358 persons per family doctor. The number of people per doctor in other regions includes Central West, 1,286; North East, 1,206; North West, 1,130; Central East, 1,042; and East, 1,011. The average ratio is one doctor per 1,124 people. | By David Dauphinee --
Free Press Reporter A $36-million pot to cure acute shortages of rural doctors is
gathering dust even as the problem worsens in Southwestern Ontario. In a report sent yesterday to area MPPs, medical educator Dr. James Rourke outlined a crippling shortage and says at least 330 doctors are needed in the Southwest just to offer its residents coverage similar to the Ontario average. The shortage of family doctors is most critical in Lambton County, followed closely by Oxford, Elgin, Kent and Essex counties. Perth, Huron, Bruce and Grey counties are slightly better off but still worse than Ontario's average. Middlesex County, with London as a medical teaching centre, is the only better-than-average area. "The needs are enormous," said Rourke, a Goderich physician and director of the Southwestern Ontario Rural Medicine (SORM) unit at University of Western Ontario. "The smaller communities are desperate." Rourke will meet with area MPPs next week and seek support for an action plan. Forty per cent of Southwestern Ontario's 1.4 million residents live in rural areas. Ironically, Ontario's Health Ministry and the Ontario Medical Association had worked out a plan to spend $36 million a year on rural and Northern medicine. But in the first year, none of the money was spent and it was absorbed into general health care. This year, some money was spent -- but none in the Southwest. "So much of the decision-making is by people who live in the central area and it is hard when they live in an area over-doctored to see beyond the confines of their area," Rourke told The Free Press. "This shortage puts people's health at serious risk and I would say it is worsening. It is time for action now." Few family doctors outside London will accept new patients. Barb Lubell, a SORM spokesperson, said the public clamour is so great it's not unusual for a doctor opening a new rural practice to find 200 people lined up the first day. Some caseloads are filled even before doctors arrive in town. The situation varies greatly across Ontario, with the Southwest the worst-off with 1,358 persons per family doctor. The number of people per doctor in other regions includes Central West, 1,286; North East, 1,206; North West, 1,130; Central East, 1,042; and East, 1,011. The average ratio is one doctor per 1,124 people. Robin Ouellette of Rodney, in Elgin County, who has two sons -- Nathan, 16 and Zachary, 6 -- has serious health problems. She had a family doctor until a year ago, when her physician moved to Kitchener. Now she's on waiting lists for more than 10 doctors. "My doctor knew me, he knew what was going. I would call him and say 'Zackary's not breathing good, his colour isn't good' and we would talk and he would say `get him to London.'" Near Thamesville, in Chatham-Kent, Reginald and Alma Dickerson are facing a similar situation. Alma, 65, has cracked ribs from a skating accident. Reginald, 73, has had a triple heart bypass and takes pills for a heart condition. Nine months ago, they were left without a family doctor for the first time in their lives. "Now we wait until maybe it is too late because all we have is the (hospital) emergency department (to rely on) " said Alma. Reginald suggests graduating doctors be told where to practice. "If a guy wants to go in for a doctor, tell him he has got to go to a place like Newbury. "They have rights," said Alma. To which Reginald replied, "well so have we." Rourke summed up the problem in a sentence: "We need to educate more doctors in Southwestern Ontario, recruit more doctors to rural Southwestern Ontario and support and retain doctors in rural Southwestern Ontario." The only area where much action is happening is in education. UWO's medical school has refocused to better serve the Southwest. A recent study showed more graduating UWO doctors go to underserviced areas than graduates of any other medical school. Still, Rourke would boost UWO enrolment by 20 per cent. After graduation, he said, there are too many rural barriers. Financially, many rural activities -- such as night calls, delivering babies and handling emergencies -- are paid less than regular office work. Obstetrics and anesthesia are in serious need of extra support in rural areas, he said. Today's doctors prefer clinics "that allow them to be a doctor rather than manage issues such as who shovels the snow and fixes the lights." Doctors also prefer salary options. Many young doctors were attracted to the North by salaries rather than fee-for-service pay. Time off for vacations and maternity leaves is also critical, said Rourke, plus that many doctors go to a small town with a spouse who who has a career of their own. |
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