Keeping Doctors in Communities — a Success Story in BC’s North

Train your doctors locally, give them lots of community support, and more often than not, they’ll stay – that seems to be a successful formula for attracting and keeping physicians in rural areas, according to the head of a program doing just that in Northern BC.

Back in 2000, thousands of residents rallied in Prince George over their concern with health services in the area. Out of that, the Northern Medical Program was born. It’s a partnership between the University of British Columbia, the University of Northern British Columbia, and the Northern Health Authority. A couple years later, communities around northern BC joined forces with UNBC to establish the Northern Medical Programs Trust (NMPT), which today, is a $9.5 million endowment fund. It was established with donations from individuals, corporations, municipalities and service organizations. About two dozen municipalities and regional districts have joined the NMPT and made financial commitments to support the education and retention of health professionals in northern and rural communities. 

“You hear physicians say that they wouldn’t be working here had they not had the experiencing of working in this kind of rural area,” says Dr. Paul Winwood, the regional associate dean for the University of British Columbia’s Northern Medical Program

Dr. Paul Winwood

The Northern Medical Program – just like the Southern Medical Program that provides clinical training at several locations, from Kelowna to Vernon, Kamloops, Penticton and in Cranbrook, is among the first of its kind in North America. A total of 32 students are accepted into both the NMP and the SMP every year. The programs are focused on training physicians from and for underserved and rural communities.

“The aim is to increase the healthcare profession in BC and support their education in BC, and what we’ve seen, is that our grads are coming back in numbers that are rewarding,” said Winwood of the northern program.

“There could be a variety of reasons for this, but there was a lot of work put into this program, so we would like to say it’s a success.”

Studies suggest doctors who train in these types of communities are more likely to return to practice there, once their education is complete, said Dr. Allan Jones, regional associate dean for the Interior region.

“The Southern Medical Program is helping to increase the supply of doctors for Interior communities, as we know that where our students train, they are more likely to stay on and practice,” he said. The inaugural SMP class graduated in 2015, before moving on to residency training.

Up in the northern part of the province, Dr. Winwood said the support of rural communities is hugely important.

“Because those relationships were built with the community, you see community leaders, such as municipal politicians, reach out to those graduates who are there – they’re part of the community.”

The program has been a long term investment, and in the early days the payoff was hard to see.

“The return is slow, but we are consistently seeing grads come back to these rural communities.”

And whether a physician is practicing up north, or here in the Okanagan, Winwood said the challenges of keeping doctors – especially ones who are willing to be medical directors – is the same.

“Aside from being a medical director in a fee-for-service structure, you’re dealing with overhead, administration and other responsibilities. Younger doctors are daunted by that, and the medical director role is really, a thankless job. It’s a lot of time, and you’re not renumerated very well. It’s quite a commitment.”

He says indirectly, the fee for service structure – a payment model where services are paid for separately, could be a factor in doctor retention.

“In some rural areas, you’ll see physicians on alternative payment plans, so they’re paid a salary. That way, they know what’s coming in, and they’re not pressured to see more patients to make more money. There are pros and cons to both systems, though.”

The key to success still lies in community, Winwood stresses.

“If you look at our program, it was led by community leaders. Back in 2000, there was a huge sense of ‘we need this medical school and we need the community to support it.’ What we have here is unique and a testament to the resourcefulness of the community and the desire to have a medical program here,” he said.

“If you select students who want to train and immerse themselves in the community, they will want to stay.”

 

This article by  Kristen Fiesen  was first published in the Peachland View.