Hurdles faced by Rural Doctors

[Guest Ian Wong]

Here's an interesting article by the Vancouver Sun commenting on the lifestyle of a rural doctor, as well as number of GP's and specialists in rural and urban areas, and how these numbers have changed in the last 6-7 years.

 

Ian

UBC, Med 3

 

www.canada.com/news/story.asp?id={50E9200D-127D-4310-A989-76C8D0951B0C}

 

<!--EZCODE BOLD START--> Rural doctors face many hurdles such as lack of money when retirement looms<!--EZCODE BOLD END-->

 

ERIC SHACKLETON

Tuesday, June 04, 2002

 

(CP) - Doctors in rural Canada who are thinking about retiring have a host of hurdles to get over before they can spend their days fishing or improving their golf scores.

 

Many fail to save enough money, others have problems selling their equipment or they find it difficult to stay in their communities because patients keep appearing on their doorsteps, some in the profession say.

 

Furthermore, rural doctors tend to be a breed apart. "You have to be pretty dedicated to become a rural doctor," says 53-year-old Dr. Keith MacLellan. "And those types of personalities don't easily retire."

 

Unlike in urban centres, where doctors have more choices such as working in drop-in clinics with set hours, rural physicians work long hours, in some cases up to 90 a week, and take on responsibilities that city doctors usually pass along to specialists.

 

Being a medical professional in a rural area "is a vocation," says MacLellan, who is vice-president of the Society of Rural Physicians of Canada and also has a practice in Shawville, Que., about 75 kilometres northwest of Ottawa.

 

When doctors retire, he says, depends a lot on whether they have saved any money, in RRSPs, for instance. Since most are on fee for service, they get paid for what they do and there's no pension plan.

 

But times are changing. About 10 per cent of rural doctors are now on salary and that usually incorporates some kind of pension plan, making retirement easier.

 

Selling the office and equipment is another major headache for many retiring rural doctors. "We're so short of doctors in rural areas that most of the time we're just happy that someone will come and take it over," says MacLellan.

 

MacLellan and Dr. Mary Johnston, 55, who lives in Revelstoke in southeastern B.C., are among about 5,000 general practitioners and specialists caring for about nine million people in rural areas. Some 55,000 doctors and specialists tend to the medical needs of about 31 million Canadians, according to rural physician society figures.

 

As only about 700 specialists work in rural settings, the local doctor must take on lots of specialty-type activities, such as caesarean sections.

 

"I've always had more work than I possibly could imagine doing, a lot of obstetrics, a lot of women's health problems," says Johnston, who began working in rural and remote communities 28 years ago.

 

In an effort to get out from under such a heavy workload, which often entailed working 90 hours a week while raising four kids, Johnston retired from her full-time practice last year. However, she hasn't left her profession behind.

 

Today Johnston does locums. During two to three week stints, which she hopes will take up about half the year, she relieves physicians who are ill, or want to spend time with their families or take a vacation.

 

Johnston, who had her first two kids while completing medical training, has always felt tied down. But now that the last child is in third year university, she says she wants to see how they do things in other places and doing locums "is an interesting way" to do it.

 

And how does her husband, also a full-time physician in Revelstoke, feel? "Oh, he misses me," she laughs. However, "we've done all this together."

 

As for MacLellan, who has five children, he has no retirement plan. "I'm just going to wing it," he says.

 

He once discussed setting up an RRSP with a financial planner, but was told to just spend his money after he asked the planner "to plan out my financial future as if I'm going to die when I'm 65."

 

"Well you know," he says, "doctors do tend to die earlier than the general population."

 

If he makes it over 65, MacLellan says, he'll have less expenses by then with his kids having grown up. "I'll probably be happy with a little cottage somewhere," he says.

 

Many doctors as they approach 65 slow down, and persuade their patients over time to move to a replacement GP.

 

"That would be the thing. . . slow down a little bit and spend less and not worry too much now that I don't have $2 million set aside in RRSPs," says MacLellan.

 

Some facts about doctors and specialists in Canada:

 

-In 1997/98 inner city doctors worked an average 48.6 hours a week.

 

-In 1997/98 physicians in rural areas put in an average 57 hours a week.

 

-In 1997/98 doctors who work on their own, as opposed to group practice, averaged 53.8 hours a week.

 

-In 2000, there were 4,089 general practitioners and 729 specialists in rural areas, a drop from 4,868 GPs and 972 specialists in 1994.

 

-In 2000, there were 25,278 GPs and 26,956 specialists in urban centres compared with 25,854 GPs and 25,571 specialists in 1994.

 

Sources:

 

Society of Rural Physicians of Canada: http://www.srpc.ca

 

National Family Physician Survey of the College of Family Physicians of Canada: http://www.cmaj.ca