As rural ERs close, doctors seek election promises for pan-Canadian licensing
Don't forget rural health care this federal election, Manitoba physicians and residents say
Doctors and residents in northern and rural Manitoba say health care in their communities must be a federal election priority this year, as emergency rooms continue to close and patients travel farther and longer for care.
The emergency room at Morris General Hospital, 60 kilometres south of Winnipeg, closed indefinitely in September 2023. It's one of several rural Manitoba ERs to shutter in recent years due to health-care worker shortages.
"You can go there with somebody half dying, and all it's got is a thing on the door: The emergency's closed," said Eileen Klassen, 78, who lives down the road from the hospital.
"It's not the doctors or the nurses. They work hard."
Klassen counts herself lucky because after the ER closed, she experienced a stroke and survived. Instead of being rushed to the local hospital down the street, she was transported to Boundary Trails Health Centre near Winkler, Man. — about 45 kilometres away.
The ER's closure also concerns Megan Adams, who lives with multiple sclerosis, and whose son had an allergic reaction to kiwi last summer.
"When your son's life is being threatened and you have no choice but to call an ambulance and take your son on a 45-minute drive to receive treatment ... it can be pretty problematic," Adams said.
Accessibility to health care is among Adams' top priorities this federal election.
National strategy needed, physicians say
Doctors Manitoba says this province falls second last in doctors per capita, at 219 physicians per 100,000 people, according to 2023 data from the Canadian Institute for Health Information.
For family doctors, Manitoba ranks last among the provinces at 107 doctors per 100,000 people. In northern and rural Manitoba, it's 94 physicians per 100,000 residents.
The increasing doctor and health-care worker shortage is why the Society of Rural Physicians of Canada is calling on all federal parties to create a national rural health workforce strategy, fund a skills training program and implement a national licensing system that would make it easier for physicians to practise across the country.
The NDP said in an emailed statement the party would bring more doctors to northern and rural areas by supporting pan-Canadian licensing. It would also create regional and remote medical schools, fully implement Jordan's Principle and provide grants to rural family doctors to help them stay in communities, a spokesperson said.
CBC did not hear back from the Conservative or Liberal parties before publication.
Long-term skills training program needed
Neepawa, Man., family doctor Nichelle Desilets knows patients are travelling farther and longer for health care.
"I think it, unfortunately, has been accepted as the new norm both in my community and surrounding areas," said Desilets, who is also the president-elect of Doctors Manitoba.
While she acknowledges provincial and municipal governments also have large roles to play in attracting rural doctors, she says health care is also a federal election issue.
"I know that there's a lot of people that are stressed over economic concerns, over tariffs from the United States … but we can't let health care fall too low on the priority list. That has to stay at the top," she said.
Last week, Desilets gave a presentation at the University of Manitoba's Health Sciences Centre medical school campus, hoping to convince about a dozen medical students to work in northern and rural areas.
Desilets explained how rural physicians are not only trained in family medicine but may also need expertise in emergency medicine, geriatrics, obstetrics, palliative care and surgery.
Society of Rural Physicians president Dr. Gavin Parker says that's one of the main reasons doctors in rural areas decide to leave: They're "feeling uncomfortable with the clinical scenarios they might come across."
He credits a recent national one-year pilot program with helping 342 doctors working in Indigenous and rural communities to upgrade their skills according to their needs.
The federal government contributed $7.4 million to the advanced skills training program, which Parker says covered training and travel costs and paid for locums — doctors who fill in for physicians while they're away.
"It was a hugely successful project," said Parker, who practises in Pincher Creek, Alta.
That nationally co-ordinated program was based on others offered in some provinces, including Alberta, Parker said. Over his career, he says it's helped him retrain in anesthesia and cardiac stress testing.
Doctors say rural health care 'in crisis'
Parker is advocating for a national skills training program to become permanent, along with the creation of a national rural health workforce strategy to make sure, in part, that medical schools support and train students for the jobs that are available and in the locations where they're needed.
He's also calling for pan-Canadian licensing, so doctors face fewer administrative and cost burdens to practise across different jurisdictions.
Dr. Sarah Newbery, a rural generalist family doctor in Marathon, Ont., agrees. She describes northern and rural health care as being "in crisis."
Part of the day-to-day challenges she experiences relate to the difficulties in finding locums when doctors get sick, go on vacation or retire.
Newbery urges the next federal government to make sure there's an end-to-end pathway for doctors, nurses, physiotherapists, social workers, laboratory technicians and more — from how they're educated to how they're recruited and retained — to work in northern and rural areas.
Without a strategy, Newbery and Parker say burnout and fatigue among rural doctors will accelerate, and patients will increasingly flood urban health-care facilities and lengthen emergency department wait times there.
"We have an opportunity to focus on how we support and stabilize rural health services, and that will make it more appealing for people to work here," said Newbery, who co-chairs the society's health human resources committee.
Klassen believes people in Morris and the surrounding areas deserve a better hospital with more services.
"It makes me very worried since I had that stroke," Klassen said.
Southern Health continues to face challenges recruiting rural family doctors, but efforts are ongoing, including to recruit internationally trained physicians, a spokesperson for the regional health authority said in an email.
The health authority is working to reopen the Morris hospital ER, the spokesperson said, although it's unclear when that will be.
At 78, Klassen says she isn't going to move now, and she hopes the conversation on health care doesn't forget rural towns like hers.
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