Nelson needs four more family physicians to serve those who don’t have one, and the need will probably increase in the near future. In the Kootenay Boundary region, 25 new full time family doctors will be needed in the next four years.
That’s according to research collected by the Kootenay Boundary Division of Family Practice.
“There are about 4,500 people in the Kootenay Boundary region who are actively looking for a doctor,” says the organization’s Julius Halaschek-Wiener.
Aging population, more doctors retiring
The aging of the population will mean doctors will see fewer patients because the medical problems of older people are more complex and time-consuming. Also, there are many doctors retiring.
“Younger graduating physicians are emphasizing work-life balance over working 70 hours a week,” says Deryn Collier, the marketing manager for the family practice group, “while the older ones have very big practices so it takes more younger ones to replace them.”
Collier’s job is to figure out how to attract more physicians to the region. She goes to medical conferences, promotes the group’s website, helps local doctors with recruiting, and works with doctors who are thinking of moving here.
“Our marketing is about lifestyle, promoting what is attractive to physicians,” she says. “But it is more than what the tourism people would promote. Doctors want to know that there is hospital support, that they can do a full scope of family practice, that they are going into a collegial practice, whether there are good electronic medical records.”
Community involvement needed
She says community involvement is crucial. In Kaslo, Castlegar, and the Trail area there are volunteer groups that recruit doctors. In fact, Castlegar has a municipal employee dedicated to medical recruiting.
“In the Trail area and Kaslo, these are volunteer run programs,” says Collier. “They are retired health care professionals, for example — people that love their community. They know what health care professionals are looking for.”
Collier says community recruiting is important because doctors coming to town to check it out themselves will miss a lot.
“If a doctor is visiting the Trail area, they will have a community expert who will give them a tour of the lower Columbia. It is really specific to physicians. They will roll out the red carpet.”
Collier says Nelson does not have a program like that, but she says she intends to pitch the idea to the economic development groups here.
Spouses need work too
Another aspect of community recruiting, says Collier, is networking for spousal employment. If the recruiting group knows a specific doctor’s spouse is an engineer or a teacher, for example, they can help them network locally to find work.
“If the spouse is happy, the physician is more likely to stay.”
Collier is in contact with potential candidates, medical residents doing rotations in the area, and locums (temporary replacement doctors filling in for local doctors on vacation).
“It makes a huge difference to have one person making sure the right people are talking to each other,” she says of her role.
Collier says the group has been working on this recruitment program in the Kootenay Boundary for less than two years, so the results are as yet not clear. But she says the approach is based on accepted best practices for medical recruiting.
Working as a locum is cheaper
An additional issue is that it is cheaper and easier to work as a locum or in a walk-in clinic than to set up a practice, according to Dr. Lee MacKay, a Nelson native who has a family practice here. He says there are several doctors in Nelson who just do locums and have no practice of their own.
“Committing to a practice is challenging because if you decide to leave,” he says, “you feel you are abandoning your patients.”
MacKay is the chair of the Division of Family Practice. He says the way medicine is funded makes walk-in medicine more attractive because there are no morning rounds, no on call work, less responsibility, shorter hours, and perhaps more money.
Nelson won’t sell itself
Nelson residents are used to thinking that everyone in the outside world is just waiting for a chance to move here. That is not so when it comes to doctors, says MacKay.
“We really need to get over the idea that Nelson will sell itself,” he says. “Recruitment needs to be a community effort.”
Collier says appreciating the doctors we already have, including retaining new recruits, is also part of the strategy. Helping established doctors with succession planning is also important.
Several years ago, MacKay took over the practice of a senior physician here, who, he says, “spent six years trying to find someone to take over his practice so he could retire.”
“We have an executive coach who has developed a step by step plan over 12 to 18 months on what to plan for, and recruitment is one of those things.” says Collier. “We help them make sure they are ready to retire and hand over their practice.”