NORTHWEST TERRITORIES

Despite facing similar challenges of distance, climate and isolation, the Yukon has a comfortable number of physicians for its residents, while the Northwest Territories faces a higher vacancy rate.

The Yukon has 69 physicians and specialists for its 36,000 population while the NWT has 44 doctors for a population of 43,550. When put into a doctor/resident ratio that equals 19/10,000 for Yukon and 10/10,000 for the NWT.

"We have one doctor for approximately 520 people, so we're quite comfortable," said Pat Living, a spokesperson for Yukon Health and Social Services. "It can change overnight, but we happen to be in a good position and don't have a large number of orphan patients."

Three or four years ago, the territory had a "significant number of orphans (patients without a doctor)," but a number of recent initiatives have increased the number of doctors to a sustainable number. While the Government of the Northwest Territories hires physicians and specialists on contract, Yukon doctors have private practices in Whitehorse and offer a few contracts in remote communities. If needed, the government will employ a number of initiatives to help doctors recruit staff.

Yukon also has three health bursaries for Yukon students in medical school, has purchased a seat in the medical school at Memorial University in Newfoundland and has contracts with the University of Calgary for medical students to complete their residency in the Yukon in the hopes of showing them an attractive lifestyle in the North.

The NWT has the same thoughts. If it can recruit people who want to live the lifestyle offered here, then the doctors will want to stay. Currently, 12 Northern medical students are supported on a bursary program paying $10,000 per year, that requires the students to return North to work. Of the three former medical students who went through the bursary program, only one returned.

The GNWT also offers mentorships and residencies tied to schools already with rural medicine programs.

"Instead of a shotgun approach and talking to 300 medical students, we're looking at those who already have an interest in Northern or rural medicine," said Shaleen Woodward, director of reform and innovation for the NWT Department of Health and Social Services. "We've found the best reference tool for recruiting is a physician who is already working in the community, a returning locum or another member of staff."

Even though private practices work well in the Yukon, the GNWT started offering contract and salaried positions in the early 2000s. The cost of running a private practice didn't prove feasible for doctors in the NWT, where costs are high and patient flow is not consistent.

"Comparisons between the two jurisdictions are very difficult with the Yukon," said Woodward. "In 2004 the GNWT took a team-based approach to health care, which is a good fit for the North where we have 33 communities over a huge distance."

The NWT has funding for 77 physicians and specialists

Both jurisdictions have few problems staffing physician positions in the capitals, but have difficulty with the rural locations. In the Yukon, 48 of the 69 doctors work from Whitehorse, while 40 of the 44 NWT physicians are based in Yellowknife.

Outside of Yellowknife, the Beaufort Delta is the only authority with permanent physicians on staff. The Sahtu, Fort Smith, Hay River and Deh Cho health authorities all suffer from a 100 per cent vacancy rate, with no permanent doctors in place to provide continuity of care. Locum doctors do visit the communities to ensure residents aren't without medical care. Neither the Yukon nor the NWT governments have a specific recruiter for physicians. While the Yukon government will help out the private practices by working together on recruitment campaigns, in the NWT each authority has responsibility for recruiting.

Yellowknife Health and Social Services Authority is the only authority that has a recruitment officer, and coincidentally or not, that authority has the lowest vacancy rate in the territory at 11.09 per cent. For other authorities, recruitment sits with the CEO's executive assistant.

"Authorities wanted to keep recruiting in the authority," Woodward said. "Authorities think they are the best place to do recruitment and represent the unique aspect of their authority."

With the lack of doctors in place, the GNWT will continue building a supportive work environment, with nurse practitioners, midwives, nutritionists and other health care staff as well as using technology to maximize the time and energy of physicians.

"Our goal is to make sure people have the right provider providing the right service at the right time," Woodward said. "We want to provide the most effective use of their time and make sure people have what they need."

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