SOMBA K'E/YELLOWKNIFE - The NWT has the third worst doctor-to-patient ratio in the country.

A report released in early December by the Canadian Medical Health Association and the College of Family Physicians of Canada is recommending ways to improve the number of family doctors across the country. The report suggests that by 2012, 95 per cent of Canadians in each community should have a family doctor but that might be wishful thinking in the North.

Titled The Wait Starts Here, the report is based on survey results showing one in 10 Canadians don't have a family doctor. The report recommends governments encourage more students to specialize in family medicine, help foreign doctors gain the credentials necessary to practise family medicine in Canada, and provide incentives for existing family doctors to take on more patients.

But those survey results didn't include data from Canada's three territories.

Last year there were 33 family doctors in NWT, according to statistics from the Canadian Institute for Health Information. That's approximately one family doctor for every 1,300 NWT residents - the third worst doctor-patient ratio in the country after Nunavut and Manitoba.

Yukon had the best ratio with roughly one family doctor per 500 residents.

Unless the NWT can recruit more permanent family doctors, patient care in the territory isn't likely to improve.

Dr. Leah Seaman, medical health officer for the Beaufort Delta, said smaller communities are seeing more turnover among doctors. She said Yellowknife currently has about 25 doctors - including family physicians and specialists - while about 19 more are supposed to be divided among the next largest communities: Inuvik, Hay River, Fort Smith and Fort Simpson.

But Inuvik has only four permanent doctors and more remote communities depend on temporary doctors - locums - who fly in about every five weeks.

"We've lost three permanent physicians in the last three or four years here in Inuvik and none of them have been replaced. We can't recruit anybody to come and sign on," Seaman said. "We can recruit people to come for a few weeks or sometimes a few months but not to sign on and commit for, say, three years or more."

She said even though the doctors work as a team and do their best to provide continuous care, mistakes can happen when a patient's file is transferred from one doctor to another.

"We try to minimize the negative effects (on patients), but in places where they're only running on temporary physicians, there are times when something might not get followed up on properly, that kind of thing, because people are coming and going all the time and there's not enough of a smooth continuity."

Isolation, financial concerns and a lack of backup services are all reasons why doctors leave the territory, Seaman said.

"Until you've come and worked in a place like this you can feel nervous about working a long way from specialists and fancy equipment. Once you do it (you) realize that the folks here are part of a real team," she said.

"Some other recognition for the fact that you do work in a very remote location without a lot of extra help needs to happen in various ways, either some benefits, pay," or more opportunities to upgrade medical skills, she added.

Dr. Anne Doig, president of the Canadian Medical Association and a family doctor in Saskatchewan, said the report's suggestion that 95 per cent of Canadians should have a family doctor by 2012 was meant to be a target and is not necessarily achievable.

"The report is intended to be inclusive of the whole of Canada, recognizing that there are unique regional challenges, especially in the far North," Doig said, adding there simply are not enough family doctors to go around.

"This is universal across the country. There are challenges in the far south of Saskatchewan just as there are in the far north of Northwest Territories or in Nunavut."

Doig said she hopes the report will prompt the federal government to follow through with funding to train more medical students and immigrant doctors, as well as "help existing doctors do their jobs more effectively."

"It's out there now for people to see so that we can say to government, 'look, here are the facts. We're not just making this up. Here's the information that you need. Help us.'"