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Endless circle of rural medicine struggles

A column on the challanges the Saskatchewan healthcare system faces
Filling Medical Form, document, stethoscope
An opinion piece on endless circle of the healthcare system's struggles in Sask.

One of the readers submitted a tip to the Mercury recently.

"Maybe we should have a story about all these service disruptions lately. Can they not run a hospital? People of Estevan deserve better," they suggested.

At that point, we'd already spoken to St. Joseph's Hospital about disruptions. It'd be much easier to have a scapegoat to blame for the problem, but unfortunately, it's not really the case, as the problem is traditionally more complicated than this. This issue resonates with the rest of the province – there is just not enough qualified medical staff.

To my knowledge, rural healthcare systems from all eternity have struggled with the recruitment and retention of specialists all over the world. And even if on rare occasions some communities were lucky to get a brilliant, dedicated and loyal doctor like Dr. Mainprize from Midale, it still didn't mean that they were fully staffed at all times.

A quick search came back with articles from the late 2000s, talking about the rural medicine crisis with severely understaffed hospitals in Saskatchewan. One gave an example of a doctor who agreed to cover a shift in Meadow Lake and ended up working 72 hours straight.

My brother chose a medical path in Russia, and when he was looking into starting his career, a good friend who is also a doctor suggested that the toughest but also the fastest way to do so is to go to a rural hospital. They've always struggled with a lack of specialists, and there my brother would become a go-to professional of all fields, from delivering babies to surgeries, to handling viruses and infections, to probably even dealing with cancer, etc.

Of course, my brother, a doctor with all required degrees and qualifications from a big city university, refused to do so, as he didn't feel confident that he simply would have enough knowledge to be able to handle all of it. But even if he'd go, the plan never was to stay there longer than a couple of years necessary to acquire experience and start building a competitive resume.

Why? Long hours, enormous pressure and responsibility, often lack of necessary supplies, not that much money and no real perspectives in sense of career or research. Besides, life outside the big centres traditionally has less to offer than what a doctor would get in a city. So again, why go rural unless you are a masochist, a hero or have strong personal ties to the area?

The solution we heard back in the 2000s was to give up on the idea of having a doctor close by and get used to driving for an appointment. I don't think we are there yet. And the pandemic closed that gap with the mass spread of online consultations, which often work just as well, but it also once again proved that people still need a hospital they trust and rely on.

I feel that these issues are relevant to rural communities in many countries, and I'm not sure if anyone has found a solution to that.

But outside of the rural challenges, we are also facing some issues on a provincial level.

My original point of entry to Canada was Manitoba. Back in the early 2010s, I was researching immigration programs offered by that province and neighbouring Saskatchewan, as right away I was told that those two provinces have the most options. The first thing I noticed was how many variants they had for medical staff.

Yes, specialists would need to confirm their degrees here, which is a hell of a job, but it seemed that everything was done for them to come here. So my first thought was that these two provinces are so focused on health that they want to have the most doctors per capita. Pretty soon someone pointed out that in these two "flyover" provinces (that's how they were described to me about 10 years ago), doctors usually land, spend a few years necessary for immigration and then move on to more attractive parts of Canada. So the provinces were actually rather desperate for medical staff.

With that said, I don't think I've ever had a doctor here who was born and received their degree in Canada (which I usually learned from either the research on the doctor or from conversations with them), so better or worse, but the immigration programs must work. However, another question I had was where Canadians choose to go.

I've never needed healthcare in cities bigger than Winnipeg, so my guess was they either mainly choose to establish their practice in communities with a million people, or, as someone assumed, they move to the States, as there they have way more opportunities.

I think in the last 10 years a lot was done to promote Saskatchewan as a place to live, rather than to leave, and the image of the province has changed a lot. The pandemic also added an attractive spark to less populated areas, as they proved to be safer and allow for more freedom and comfort these days. And while the work isn't done yet, there is potential for us to be a destination, not a transit point for both newcomers and our own specialists. But to work, that needs to be transmitted through the people living in this province and also through the system, responding to the needs of rural communities in a timely manner.

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