Society of Rural Physicians of Canada

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Society of Rural Physicians of Canada

WWW.SRPC.CA
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WWW.SRPC.CA

• The Society of Rural Physicians of Canada
• Bob Martel, MD
• Ken Babey, MD

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Society of Rural Physicians of Canada

• WHO ARE WE?
• WHAT CAN WE DO FOR YOU?
• WHAT CAN YOU DO FOR US?

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Society of Rural Physicians of Canada

• Every citizen in Canada should have equal
  access to health care regardless of where they
  live .
• Mr. Justice Emmet Hall
• l- Canada Health Act

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Society of Rural Physicians of Canada
Vicious Cycle of Rural Practice

Heavy workload and responsibility
New graduates stay in the city
Family financial disadvantages
Negative perceptions of rural practice
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Society of Rural Physicians of Canada

• Goals
• Sustainable working conditions for rural
  physicians
• Equitable treatment of rural communities
  and their populations

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Rural Issues Challenges

• Access
• Retention/Recruitment
• Technology
• Affordability/Accountability
• Political

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Rural Issues Challenges
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Rural Issues Challenges
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Rural Issues Challenges
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Rural Issues Challenges
Affordability/Accountability

• Many services not affordable due to low patient
  volumes high fixed operating costs vs. overall
  budget due to small size of health organizations.
• With downloading of services, economies of
  scale with running of provincial programs
  sacrificed.
• Limited evidence-based decision making
  capabilities.

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Rural Issues Challenges

• Political
• Changes in provincial/territorial health systems
  have impacted delivery of health care services in
  urban and rural settings.
• Restructuring (in some regions) has resulted in
  hospital closures, loss of community services,
  limited access to selected services.
• Status of primary health reform varies from
  location to location.

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Rural Issues Challenges
Recruitment /Retention
Affordability/Accountability

• Rural populations increasing (10) while number
  of physicians and other health professionals
  decreasing (10).
• Insufficient critical mass of physicians to
  provide sustainable working conditions sense of
  isolation.
• Retention difficulties insufficient incentives
  to set up practice and provide diverse
  medical/ER services.

• Many services not affordable due to low patient
  volumes high fixed operating costs vs. overall
  budget due to small size of health organizations.
• With downloading of services, economies of
  scale with running of provincial programs
  sacrificed.
• Limited evidence-based decision making
  capabilities.

• POLITICAL
• Changes in provincial/territorial health systems
  have impacted delivery of health care services in
  urban and rural settings.
• Restructuring (in some regions) has resulted in
  hospital closures, loss of community services,
  limited access to selected services.
• Status of primary health reform varies from
  location to location.

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THE PLAYERS
Rural Practitioners
Professional Groups
Rural-based patients
RuralHealth Services
Government
Technology Promoters
Educators
Regulatory Agencies
The Canadian Taxpayer
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Health System Directions
Past/Current State
Current/Future State
Episodic, Illness Orientation Individual
Provider/Facility Based
Patient Centered Wellness Orientation Enterprise/
Region Based
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Health System Directions
Current/Future State
Past/Current State
Community/Closer to Home-Rural Centres of
Excellence Financial Quality Outcomes
Measurement
Urban Centres of Excellence Financial
Measurement
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Health System Directions
Current/Future State
Past/Current State
Retrospective Decision Support Fee-For-Service
Billing
Concurrent Evidence-Based Alternative Funding
Models
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Health System Directions
Current/Future State
Past/Current State
Health Networks
Integrated
Fragmented
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Health System Directions
Past/Current State
Current/Future State

• Episodic, Illness Orientation
• Individual Provider/Facility Based
• Urban Centres of Excellence
• Financial Measurement
• Retrospective Decision Support
• Fee-For-Service Billing

Patient Centered Wellness Orientation Enterprise/R
egion Based Community/Closer to Home Rural
Centres of Excellence Financial Quality
Outcomes Measurement Concurrent
Evidence-Based Alternative Funding Models
Health Networks
Fragmented
Integrated
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Society of Rural Physicians of Canada
The Canadian Reality

• By area Canada is 99.8 rural
• 31.6 of the population live in rural regions
• 14.6 general practitioners (4,135 rural 24,848
  urban)
• 2.9 specialists ( 769 rural 26,144 urban)
• Stats Can defines predominently rural regions
  as those with over 50 of communities of
  population density under 150 persons per sq Km

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Society of Rural Physicians of Canada

• Who are we?
• National Voice of Rural Medicine
• Incorporated 1992 (Mount Forest, Ontario)
• RuralMED WWW.SRPC.CA
• Membership 1100 (and growing)
• Governing structure modeled on SOGC
• Canadian Journal of Rural Medicine(Peer reviewed)

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How can we realize our goals?
CMA
CFPC
ACMC
RCPSC
SRPC
CAS
CAIR
SOGC
CAGS
FMLAC
Through strategic partnerships
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Society of Rural Physicians of Canada

• A new approach to defining who is rural
• using the Canadian Practice Rurality Index
  (Leduc CJRM-Dec 1997)

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Society of Rural Physicians of Canada
Rurality Index

• distance from advanced referral centre
• distance from closest basic referral centre
• drawing population
• number of general practitioners
• number of specialists
• presence of acute care hospital

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Society of Rural Physicians of Canada

• What are we?
• Physicians serving rural communities
• Broad Skill Set
• Emergency Medicine, Internal Medicine,
• Psychiatry and Orthopedics and others.
• Advanced skills in Anesthesiology
• Obstetrics
• Surgery

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Society of Rural Physicians of Canada
WHY?

• BARRIERS TO RURAL PRACTICE
• attitudes towards the country
• learned helplessness
• lack of specific training
• heavy workload and long hours
• lack of infrastructure support
• relative professional isolation

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Society of Rural Physicians of Canada

• Approach
• Communications Links
• Community
• Professional Associations
• Governments
• Education

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Society of Rural Physicians of Canada

• Government
• Executive Director for Rural Health
• Lobby at national and provincial level

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Society of Rural Physicians of Canada

• Education
• Leading national deliverer of rural CME
• 11th National Conference on Rural Health
• Kelowna April 2002
• Rural Critical Care Course
• CME Locum Program
• REAP

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Society of Rural Physicians of Canada

• Community
• Canadian Federation of Agriculture
• Canadian Rural Restructuring Foundation
• Canadian Federation of Municipalities
• and your home community

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Society of Rural Physicians of Canada

• World Organization of Family Doctors
• World shortage of rural physicians
• Cost effectiveness of generalists vs specialists
• Policy on training for rural practice

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Rural Experience Access Program
Where would you rather do your next elective?
For an adventurous, busy, hands-on elective
consider . . .
RURAL MEDICINE

• combine family medicine, emergency, inpatients
  and obstetrics - why choose!!!!
• get lots of hands on experience - and without
  competition
• explore Canada - rural learning can happen
  anywhere from southern Ontario to the Northwest
  Territories
• meet some of the friendliest and most welcoming
  people around

www.srpc.ca/elective.html
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• Thank you

WWW.SRPC.CA