While attracting physicians to rural communities has its challenges, in Powell River’s case, keeping them here is more difficult.
Dr. Bruce Hobson, chair of the Powell River Division of Family Practice, outlined a GP for Me program at City of Powell River’s committee of the whole meeting on Tuesday, April 7. The Powell River division is actively engaged in helping patients wanting a family doctor to have access to one.
Hobson said the division is an organization of family physicians working toward improvement in health in the community of Powell River.
“One of the big issues that we know that’s presently in Powell River, and is going to be more of an issue in future, is the problem of unattached patients who don’t have a family physician,” Hobson said. “We’ve gone, in 2011, from having 620 hours of available appointments per week for patients to see their physicians, down to 500 in 2014. That’s a combination of physicians leaving town and physicians changing the way they are practicing.”
Hobson said there are 4,000 or 5,000 people in Powell River that do not have a family physician they can call their own that they can make an appointment to see.
“To address that we are looking at several different strategies,” he said. “We are not like some of the bigger communities that have a lot of resources and capacity to deal with these issues on our own. In Powell River we’ve had to build on some of the things we’ve already started doing and some of the things that are existing in the community.”
That includes recruitment and retention. Efforts are being made to attract new physicians to Powell River and for them to remain.
“We’ve been successful in being able to get some to Powell River in the last little while,” Hobson said. “The problem is keeping them.”
There are two significant issues. One is physicians may come to Powell River because they are foreign-trained doctors who are forced to come to a rural community. Hobson said these doctors might not want to stay in a rural community for a long period of time and eventually move away.
Hobson said, with females increasingly becoming family doctors, their spouses often can’t find jobs in this community.
“That’s a real problem here in Powell River,” he said.
The division is examining a strategy for recruiting physicians and a strategy for retention to keep the doctors in the community.
“The recruiting part is marketing, it’s going out and asking people to come to Powell River and it’s working on exposing people to what Powell River has to offer,” Hobson said. “The retention part is the part that will require community effort. When people come here to town, it’s not that we just incorporate them and make them comfortable as physicians in the community, but it’s figuring out how to make their families welcome. It’s figuring out how to find jobs for their significant others.”
Hobson said that’s the real challenge but he thinks if the community can roll out the red carpet and keep it rolled out, and keep people comfortable and welcome, that will make a big difference.
A supplementary initiative has been to make use of nurse practitioners. Hobson said that with an aging community, patients are beginning to present with more complex medical problems. He said there is now a nurse practitioner working with the Tla’amin (Sliammon) First Nation and one has been attached to Powell River General Hospital. He added that the hospital arrangement is not ideal so the family practitioners are examining the prospect of moving the nurse practitioner into an existing physician’s office.
“That will increase the number of hours she has to work and the number of patients she can take on,” Hobson said. “She can work with the physician in that office and be able to strengthen the attachment of the patients that the physician has already. In other words, she can be available to see patients and support the patients in that practice when the physician isn’t there.”
Hobson added that she could take patients who are complicated and complex who do not have a family doctor and “package” them.
“In other words, getting their medical history straight, getting their records straight, getting their medications straight, tests ordered and make them so they are attractive to a family physician to take on into their practice when they already have a full practice.”
Hobson said local physicians are hoping, through various programs, to attach about 27 per cent of the patients in town who are currently unattached.
“We are still left with a problem,” he said. “It’s not the total solution but it’s a start to providing an answer and making Powell River more attractive as a community that people want to move to comfortably without worrying about medical support for their health needs.”
Mayor Dave Formosa asked how many patients doctors currently have in their practices on average. Hobson said the average is 1,000 to 1,500 patients provincially.
“Powell River is a little unique in that we have a number of physicians [who] do two jobs,” he said. “Some do anesthesia, some just work part time. The panel size in Powell River is probably a little smaller.
“When we question the doctors, everyone is at the size they want to be. They don’t want to be taking on any more patients.”
