Doctors rolling up their sleeves
Lack of physicians leaves doctors burned out

Scott Crabbe
Northern News Services

Yellowknife (Feb 04/00) - Doctors in Yellowknife have been "rolling up their sleeves" far too often in an attempt to make up for the serious shortage of general practitioners in the city, says the head of the NWT Medical Association.

In order to deal with this the medical association and the Department of Health and Social Services has launched a new strategy to recruit, retain and compensate physicians in the NWT.

All in all, an effort the medical association's president, Dr. David King, said will be far from easy.

King said according to a 1996 study done, there is a need for up to 26 full-time physicians in the city.

Presently there are 14 physicians (excluding specialists) preforming various tasks such as family health duties, assisted surgical procedures and deliveries.

Over the past year, a significant number of physicians have left Yellowknife to practice elsewhere, King said, adding it is becoming increasingly difficult to recruit permanent replacements.

One only need look to the national scene to further illustrate the local physician shortage.

Currently, the 1,700 students graduating from Canadian medical schools cannot possibly meet the demand of 2,000 doctors needed on an annual basis.

"It takes eight to nine years to graduate from medical school," King said, adding, "Following that, a heavy recruitment of doctors head to the U.S."

A further blow, King said, is that recently several long-term physicians have left.

"Over the past two years we've lost 12 long-term (two years or more) serving positions. Some of the doctors were up here for nine or 10 years."

Many leave because the overhead costs to run a clinic in Yellowknife are higher than in the south.

"Locum physicians (temporary relief staff sent in, allowing regular physicians time off) are able to negotiate a better overhead expense arrangement in southern clinics as compared to Yellowknife," King said.

Typically with all private clinics, a certain per cent of a doctor's pay must cover costs the cost of the clinic's operation.

In Yellowknife that comes to approximately 35-40 per cent. The difference being that any operation preformed outside of the clinic, or within the hospital, is still included in overhead for the clinic.

With such a lack of incentives for locums, regular physicians are left working double shifts at peak vacation times such as summer and Christmas holidays.

"We did a poll. Doctors reported working on average between 60 and 70 hours a week. Some of that is on on-call time, half the shifts are night shifts and emergency shifts are 12-hours at a time," King said.

"I am proud of our doctors, they're rolling up their sleeves, some take in that extra patient, some make that extra call."

The new plan includes implementing initiatives that include negotiating new fee schedule agreements with a favourable increase to physicians, hiring a doctor to work as a part-time physician recruiter and obtaining an agreement with the Alberta Medical Association's Rural Locum Physician Program.

The Stanton Regional Health Board has also been included in discussions with Yellowknife practitioners concerning alternate payment mechanisms.

"We must act now to ensure that our roaming physicians stay in the North," said Penny Ballantyne, deputy minister of Health and Social Services.

"We are very pleased to be working with the NWT Medical Association on this initiative and are exploring ways to develop physician compensation that may result in improved working conditions."