If you think it's hard to find a physician in Toronto, try recruiting
one for a small town outside the GTA

By PATRICIA LAUNT

Saturday, June 18, 2005 Page M1
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COMMENT:

LOL. An article about a town called Orangeville where the city budget
doesn't have enough money to pay a doctor an extra $20,000 or so a
year, as income incentive.  How many city jobs does the place have?
What's the city budget? Inquiring minds want to know.

The basic facts have been stated. Canadians have the same per capita
income as Americans. They pay HALF as much per capita for health care.
They say they can't afford more, and they refuse to pay more.  And
(surprise!) they have difficulty finding doctors for this price. So
they whine.  And whine.  But like the Scotsmen they are, they cannot
make their hands write out checks when it comes to medical care. They
have other priorities.

What are these priorities?  Well, it's not paying for a military.  The
Canadian doesn't have to pay nearly the per capita defense tax that the
average US citizen does. And yet the average Canadian pays just as much
total tax as the average American. It doesn't go for defense, and it
doesn't go for healthcare. Where does it go?  Well, there's a long list
of things, but suffice to say, these things are the Canadian TRUE
priorities. It's not that they're too poor to pay doctors. They have
the money. It's that they truely cannot make themselves pay it to a
doctor, no matter how badly they need one.

What can you say?

SBH

    its the non clinical managers who harass the physicians every
times so disgruntled patient makes a silly complaint .

If you think it's hard to find a physician in Toronto, try recruiting
one for a small town outside the GTA

By PATRICIA LAUNT

Saturday, June 18, 2005 Page M1

Special to The Globe and Mail

On a late September evening, the ballroom in the former Colony Hotel
--
now a University of Toronto residence -- is becoming crowded with
people eager to make a good first impression. This is where hearts are
won and dreams are realized. At least that's what many inside hope.
They're here for a job fair.

The pressure is on. But it's not the applicants who are sweating; it's
small towns from across Ontario that are feeling the heat.

Tonight is the last leg of the Health Professionals Recruitment Tour,
an annual opportunity for communities to showcase themselves to
medical
residents. For the past four days, the tour and representatives from
90
towns have visited Ontario's other medical schools in Ottawa,
Kingston,
Hamilton and London. Now it's U of T's turn.

Large, full-colour displays with recessed lighting and video
presentations compete with each other, promising state-of-the-art
hospitals and practice opportunities, quality schools and limitless
recreational activities. These towns only have four hours to get their
story across effectively, but first they have to grab the doctors'
attention.

A young man and woman, new physicians themselves, stand in front of
Orangeville's booth offering oranges to hundreds of visitors racing
through. Other towns offer chocolate bars with recruitment information
printed on the label, but most dole out the standard items: pens,
notepads and tote bags.

Trying to get urbanites to leave the city can be difficult, so the
Orangeville representatives emphasize that their town is rural but not
remote. Getting visitors to sign up to win a stay at the area's
renowned Millcroft Inn and Spa means they have the contact information
to follow up with prospective candidates later. This is one job fair
where it's the job seekers who call the shots.

But the recruitment game doesn't end there. What happens during the
months that follow is just as crucial.

This is the state of health care in Ontario: communities competing
with
one another for a limited supply of doctors.

The Ministry of Health reports that more than 800 family doctors are
currently needed to meet patient demand, while the Ontario Medical
Association estimates that one million Ontarians don't have doctors.
The shortage is so severe that there are now 142 communities
designated
underserviced, including mid-sized cities in the GTA area such as
Burlington, Ajax and Whitby, which is making it much more difficult
for
smaller rural communities to compete.

In many ways, Orangeville's quest is typical. An hour's drive
northwest
of the city, Orangeville prides itself on offering its 26,000 citizens
the best professional and recreational opportunities, highlighting the
short commute to Toronto-area jobs and easy access to golf courses,
ski
hills and hiking trails. But one thing it can't provide is family
doctors.

One in three people here is without a family physician. Currently, 17
doctors are needed to meet the needs of Orangeville and surrounding
Dufferin County, where the population is expected to increase by
two-thirds within 15 years.

Dr. David Scott, a retired surgeon, is trying to change all that. The
quintessential small-town doctor, Dr. Scott is one of a dying breed in
small-town Ontario. For 35 years, he has lived and worked in an old
Victorian house downtown, across the street from the Orangeville
General Hospital, just as his father did before him.

Now 73, he figures during his long career he has had about 24,000
patients. "I'm the only remaining doctor in Orangeville who is
originally from the town," Dr. Scott says, with both pride and
sadness.

His deep roots in the community make him a key member of a group of
area residents aiming to recruit physicians to Dufferin County and
nearby Caledon. It's a well-organized endeavour: three subcommittees
(the medical liaison committee led by Dr. Scott, the community liaison
committee and the marketing and communications committee) meet monthly
to work on recruitment strategies.

The physician search committee is led by Barry Stranks, a former
Rotarian and brand marketing manager turned semi-retired consultant
and
member of the hospital board. In discussing the shortage and its
impact, Mr. Stranks moves from hard-working hospital director spouting
facts and figures to frustrated citizen to tireless pitchman for the
town, pumping up its many offerings.

Of particular interest to him is the effect the shortage is having on
the area's economy. Mr. Stranks says each doctor represents an
infusion
of about $800,000 annually to a local economy, factoring in salaries
for the physician and office staff, lab tests, materials, office space
and other expenses. Based on those numbers, Orangeville is missing out
on more than $10-million.

Mr. Stranks also cites the physician shortage as a reason some
companies have decided against moving to Orangeville. "When they go to
a community, and they're thinking of relocating there, one of the
first
questions they ask is, 'If I bring 25 or 100 employees to the
community, will their families be able to find a doctor?' And if the
answer is no, they go elsewhere," Mr. Stranks says.

When 17 first- and second-year family medicine residents from Toronto
East General Hospital visited the town last October, the committee
went
to work, pitching the town and the practice opportunities. After the
hospital's CEO spoke about the hospital's state-of-the-art technology,
the group was led to the sparkling new family-medicine clinic.

Once the visiting students had been sufficiently impressed by the
facilities, Dr. Scott and another committee member treated the group
to
lunch at one the area's finer restaurants. And no visit to Headwaters
country would be complete without a hike in the region's conservation
area.

The residents are invited back to spend training time here or for a
more informal weekend stay with their partner. Hotel rooms and cars
are
donated by local businesses, and Mr. Stranks says that when they do
come, it's important to let them see what they want to see, not what
the town wants them to see.

If doctors ask about schools for their children, the committee sets to
work arranging a meeting with the head of the school board. Members
also offer real-estate advice about the area, and if a spouse needs
help finding a job, they have someone to assist with the search.

But the goal isn't just to get new doctors and medical students to
Orangeville: It's to keep them there.

So Dr. Scott recruits his colleagues to act as mentors to new doctors
and medical students. His approach is simple: "You get to know them,"
he says. "I'm having lunch with the new internist tomorrow just to see
if she's settled in. We had a new family doctor up in Shelburne and
she
needed a vet and I found her a vet. Another needed somebody to fix her
chimney. So you [help] in a variety of ways."

While lifestyle appeals to many, financial compensation is an even
bigger factor for doctors setting up a practice. The average student
debt load of starting family physicians is $100,000, and that's before
tuition deregulation. The government hopes that financially strapped
doctors can be lured to rural communities with the promise of repaid
tuition (up to $40,000), a $15,000 grant (paid out over three years)
and moving expenses.

Communities such as Orangeville that have received the Health
Ministry's underserviced designation are eligible for the incentives.
Still, towns that can afford it top them up with a range of other
opportunities, including free rent in a hospital-owned house for a
year, special banking status, interest-free loans, signing bonuses of
$10,000, a free one-year car lease and comprehensive medical and
dental
plans.

Orangeville's committee doesn't have the budget to offer these kinds
of
incentives, though it does plan to build a house that will serve as
temporary accommodation, on land donated by a local developer.

Other communities focus on training their own doctors. In Wallaceburg,
the Rotary Club and a Canadian Auto Workers unit joined forces to
create a program that pays for the tuition of those from the area who
attend medical school. In return, the student agrees to practise there
for four years after graduation. Other communities, such as Cobourg,
offer local students an opportunity to explore medical careers as part
of their Doc-for-a-Day program. And in Simcoe, some science classes
have been brought into the hospital so that students can be exposed to
career opportunities in health care.

Dr. Scott and the Orangeville committee hope that similar strategies
will work for them. Two years ago, he established a summer training
program for undergraduate science students interested in pursuing a
career in medicine. This summer, three students will spend two weeks
observing a physician at Headwaters Orangeville Hospital.

Dr. Scott acts as a mentor to the students, following up with them a
few times a year to see how they're doing. It's a long-term investment
in local young people they hope will pay off later for Orangeville or
some other small town.

Thanks to the efforts of the Dufferin-Caledon committee, Amy Horvat
was
sold on Orangeville. The 29-year-old, who recently finished her family
medicine residency at McMaster University, says there were a number of
factors that attracted her to the town, notably its tight-knit medical
community.

"People can really depend on each other both from a professional point
of view and in their personal lives. That was the sense that I got
when
I came here," says Dr. Horvat, who opened her practice this spring and
has now recruited another young female resident from McMaster to join
her.

Dr. Scott isn't concerned about the possibility that the two new
doctors may leave in a few years, after they have received their
incentives from the Ministry of Health. "They both bought houses and
have mortgages," he says. "That's always reassuring."

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