A shortage of doctors across Lac La Biche County and many areas of the Lakeland region has been a challenge that has affected services for community members seeking medical attention. It has also forced local officials to “aggressively recruit” qualified candidates to fill the void, says Lac Lac Biche County Mayor Paul Reutov.
“We’re providing every incentive we can. We have a pretty aggressive attraction and retention program,” he tells Lakeland This Week.
The program includes generous relocation packages, salary bonuses and even a VIP pass to the communities facilities and amenities ... every possible option is being tabled, he said.
“We want to roll out the red carpet for these guys as they come in so they want to stay here” the mayor said, adding that at least three foreign doctors have been showing signs of interest in recent weeks. One, he said, is already past the application process and is now in actively pursuing a work visa to move to the area.
While physician shortages — some due to short-term vacation absences and others for long-term departures — across the Lakeland region over the last two years, have affected service levels, the Lac La Biche community had been relatively un-affected... until the start of the year. Last month’s abrupt exit of Dr. Richard Birkill, W. J. Cadzow Hospital’s Chief of Staff, and the same doctor who was an owner of the Associated Medical Clinic, along with the departure of several other community doctors and the pending departure of more local physicians due to staffing turnover, could see Lac La Biche residents facing even more healthcare hardships in the weeks to come.
Service cuts
Throughout the year, shortages in surgical staff at William J. Cadzow Hospital in Lac La Biche saw the obstetrics unit close on at least six separate occasions during the last four months with the longest closure in February for 10 days. The unit closures included not only a lack of doctors who could perform emergency cesarean sections for expectant mothers, but also at times a lack of anesthesia services.
The unit, which is often run by a single physician and two midwives throughout the year, is only one challenge. Multiple doctors have already left the community throughout the year with another anesthesiologist who provides the service in the unit leaving at the end of May, according to Alberta Health Services (AHS).
Additionally, on May 5, the hospital closed five of its 23 acute care beds. The bed closure will be in place for a month, said Gayleen Froese, the AHS senior communications officer.
The bed closures and physician shortages come as statistics show the Cadzow hospital at just over two-thirds capacity through the last year. Numbers tabulated by AHS for the month of March show the hospital at just over 50 per cent utilization. Those lower numbers help to reduce the impact of any healthcare challenges facing the region, Froese told Lakeland This Week.
“Impact on patients is expected to be minimal…this is due to a shortage in nursing staff and no services are expected to be impacted by this bed closure,” she explained.
Immigration applications
Lac La Biche County officials have been working behind the scenes to not only entice new healthcare professionals, but also to speed up any travel paperwork that could slow down the process. Reutov says County officials have been discussing their plans with Alberta Labour and Immigration Minister Kaycee Madu. The most recent meeting went well, said Reutov.
“Requesting and having that meeting with the immigration minister to expedite the visa process was a big win. We have direct contact with the immigration minister now on a provincial level and that will expedite the process,” the mayor said, admitting that there are a lot of moving parts and factors to consider when trying to find doctors.
It’s not just the doctor who will be recruited, said the mayor, it’s also the associated family unit, which may mean more paperwork and documentation requirements for children and spouses. Reutov says local supporters are hoping to create a “package deal” for doctors to make it a turn-key process.
“Were trying to get the application treated as a unit, so that if a doctor gets a work visa that the entire family would at least get a visitor's visa, so they can come together,” he said, admiting that so far, the package idea has been a challenge to create — but through more discussions, it holds some promise. "We’ve talked to the immigration minister and we’re getting some pretty good success on that so they treat the family as a unit.”
Local hires and staff
Work visas, travel planning, and other immigration obstacles would not be a concern if local people could be found to fill the vacancies, says the mayor. And while that remains a top priority, current roadblocks at Canadian medical schools have restricted available candidates. He says many universities are also feeling the effects of funding challenges and more than two years of pandemic measures. He says there aren’t enough available seats in medical school classrooms to accommodate a growing number of local medical students.
“There are local doctors and people from this community who have their degrees, but they cannot finish their medical studies because there is no space….they would love to come to Lac La Biche, (but) it’s a matter of paperwork and finishing their studies.”
As the educational institutions, the province and community officials in areas like Lac La Biche County work through the many questions, finding a timely answer — for residents and current healthcare workers — will be the best medicine, says the mayor.
“Right now we need a minimum of four doctors. You can imagine how much stress that puts on the staff so that burnout comes with the shortage. We’re absolutely aware of it and working on it. If I had a magic wand it would be a different story, but it’s the reality we’re in,” he says, explaining that conversations with neighbouring municipal leaders and elected officials across the province, especially the rural regions, paints a similar picture.
“We’re basically competing with our neighbours…at that’s the reality of the situation. It’s even worse the further north you go.”
The mayor said the challenges are compounded for municipalities like his because even with all the behind the scenes work being done, it’s the provincial officials who have the final say.
“The municipality has very little control of the health care system, it’s a provincial matter and anything we do has to go back to the province. It’s very limited how much authority council and the municipality have. We don’t fund them directly,” he said, hoping that the draw of the lakes, the culture ... and a VIP pass to local amenities like the Bold Center will be enough. “All we can do is provide them incentives, which we do.”
Provincial programs
Rural communities in the province dealing with doctor shortages have been a part of various provincial programs aiming to recruit and retain doctors. Last January, the provincial government announced a $2 million fund to the Rural Education Supplement and Integrated Doctor Experience (RESIDE) program to cover resettlement and education costs for 20 doctors in 15 rural communities (including Lac La Biche).
The RESIDE program is a part of the Rural Health Professions Action Plan (RhPAP) which has been operating for over three decades addressing health care needs with stakeholders, hospitals and medical professionals alike.
While the program is helping address part of the problem, it’s a long process that doesn’t address an immediate need, said Reutov.
“It’s going to help, but things move too slow; we need something immediate,” he says.
Next step
With the mounting challenges, closures and service disruptions while recruitment is underway, Reutov says he’s thankful that there aren’t serious health issues like the first few waves of the pandemic, however, but having a fully functioning health care system is the goal at all times.
“We’re fortunate we don’t have any major issues and the pandemic that are coming through right now, but that’s not always the case.”
As county officials work with the province and organizations, to bring doctors to the community, Reutov says residents can rest assured that municipal officials are utilizing every option.
To fill reoccurring gaps in regional healthcare services, AHS hasn’t only closed wards and programs, they have also implemented on-call services, and travelling medical staff to fill voids and staff shortages.
