The rural health-care system in Canada is overextended and underfunded, said a report this week in the Canadian Medical Association Journal (CMAJ).
The article said no matter that rural medical practices are thriving in some parts of Canada, there is evidence that "as a whole, rural generalist physicians are poorly supported in their work, particularly by misaligned remuneration models. Physicians are increasingly leaving their rural posts seeking more favourable working conditions to avoid the burnout," said the article.
The article was authored by Aria Rezapour, Haedan Turner, Stefan Grzybowski, Paul Mackey and Sarah Newbury, a rural family physician in Marathon who is also an assistant dean of physician workforce strategy at Northern Ontario School of Medicine University.
Newbury spoke out during an Ontario Medical Association news conference last month about the need to establish a Northern Ontario physician workforce strategy,
The CMAJ article featured several key points which included that rural training is essential for medical students to gain adequate exposure to the field of rural medicine and develop a professional identity as future rural generalist clinicians.
The article further said that appropriate infrastructure, well-structured payment plans, and ample locum access are essential to supporting rural generalist clinicians who are also clinical teachers.
The article also said rural community members should be engaged in the physician recruitment process to ensure physicians feel welcome and connected.
"As the rural physician workforce becomes more unpredictable and dependent on locum coverage, not only do rural communities lose essential access to health care services, but medical students have increasingly limited opportunities to train in rural areas because of a lack of clinical preceptors," said the article.
The article also asked and answered the question of the importance of rural training for medical learners.
"Canadian medical schools have embraced the notion that career trajectory can be shaped by early, positive rural clinical experiences. Many medical students want a chance to work with and learn from experienced and satisfied rural clinicians," said the article.
"In rural communities, learners are exposed to a broad scope of practice, develop their procedural skills, and cultivate the resilience and clinical courage needed to manage uncertainty while building knowledge around rural health service delivery," said the article, adding that rural medical experience provides students with "crucial opportunities.”
The article concluded that more supports and positive training are required for Canadian medical students with rural interest and those in rural-entry streams.
"Students who currently aspire to be rural generalists are being exposed to numerous challenges in the path ahead and require system-level change to successfully transition into their role as rural care providers. Efforts must be focused on retaining and supporting committed rural clinicians in practice so that rural areas have a stable clinical faculty who can teach, support, and inspire the future of rural generalist family medicine,” said the article.
The article further called on medical schools, local health authorities and even provincial health ministries to share a broader commitment for prioritizing rural health care.
"This is the only way that rural and remote communities in Canada will have equitable and sustainable access to quality medical care that serves both patient and provider," said the article.
The full text version of the article with complete footnotes can be found online here.