Doctor recruitment in Lakeland perennial ‘treadmill’ as Elk Point and St. Paul look for a plan

A review of postings on the provincial doctor jobs website shows a posting for an Elk Point based general practitioner has been active since Aug. 20, but the town’s council wants Alberta Health Services to advertise for an additional doctor for the community.

“When you look at the workload of our current doctors, they work a tremendous amount of after-hours care. And compared to any of the towns around us: St. Paul, Bonnyville and so on, our doctors work an awful lot of shifts,” said Mayor Lorne Young.

“We rely as well on locum doctors to come in to provide some coverage for them on weekends. So we are trying to convince AHS and the ministry both that we really need to take a look at physician recruitment, not just to replace the one physician leaving but to add an additional position.”

Dr. Oyebode announced earlier this year that he is closing his practice and leaving Elk Point for Calgary.

“I’m not getting any younger. I’ve been here 16 years and all I’ve done is work hard. I need more time for my family,” said Oyebode, who came to Elk Point before he was married. “Our kids are young, they need more of my time now.”

According to Oyebode, an additional physician is absolutely needed in Elk Point because the current situation has the doctors on call for 24 hours at a time as compared to 12 hours at a time in St. Paul or eight hours at a time in Bonnyville.

“It’s a bigger centre and they see a higher volume of patients, but they don’t burn out because after eight hours your next shift is days away.”

According to a spokesperson for AHS, they have the ability to “bring in locum (or temporary) physicians and also to bring in physicians from other communities to ensure coverage at our site.”

Oyebode said in Elk Point, the locums come in for the weekends but the physicians still have to man the facility during the week.

“If you have two doctors they are working [on call] every other day. When the weekend comes you are just recuperating.

“It’s not easy to just say, well because I am on call tonight tomorrow I’m not working in the clinic. Then it would be too much for the other doctors in town,” said Oyebode.

Adding to the building crisis of care for the area is the loss of St. Paul-based Dr. Gordon who is also relocating at the end of 2020, and the resignation of Dr. Cardinal who will no longer be practicing at the St. Therese Health Centre but is continuing to operate her independent clinic in Saddle Lake.

Three other physicians including two anesthesiologists gave their notice to end leases at the St. Paul Wellness Centre last month after Dr. Ahmad, the general surgeon, announced he was moving to Cold Lake.

“We are working to ensure there is no gap of service in the St. Paul area as a result of these physicians withdrawing services. Our priority is the safe care of Albertans, and we will continue to work to support physicians and the community alike,” said a spokesperson for Alberta Health Services in an e-mail Wednesday.

“An AHS needs assessment will begin shortly to determine if recruitment for another full-time family medicine physician is needed in the community [St. Paul], to support the local emergency department.”

Mayor Young said Elk Point and St. Paul have lots of crossover use between the two facilities for surgery or for general issues, and wants to see a plan longterm from AHS for the Elk Point hospital, including staff projections for nurses,

“From the Elk Point area, we rely on the surgical services that are provided through St. Paul. On the other hand, we get a tremendous amount of St. Paul residents coming to Elk Point to see a general practitioner, because sometimes it’s easier to gain access in Elk Point than it is in St. Paul,” said Young.

“My understanding is that they go through a process regularly of determining what their workforce plan is for each hospital and as well as each region. We would like to see what this is. So we’ve requested it from them, and we haven’t heard back from them on that regard,” said Young.

‘Recruitment treadmill’

Asked for an update regarding the ongoing challenges to health care in the St. Paul area, Bonnyville–Cold Lake –St. Paul MLA David Hanson said he hasn’t had the opportunity to talk to Health Minister Tyler Shandro about the situation this week, but he is continuing to focus on making sure there is enough surgical capacity in St. Paul to keep the anesthesiologists.

He said he hopes to introduce changes that make it more desirable for doctors to practice in rural Alberta.

“That’s my ultimate goal. So that we don’t have to be constantly on this recruitment treadmill. Every one of our communities is the same thing. It doesn’t matter whether you’re in St. Paul, Bonnyville, Cold Lake or Elk Point. Everybody’s on that same treadmill trying to constantly recruit doctors.

“If we can make it more desirable to work in rural Alberta, I think that’ll make all of our situations better,” said Hanson.

He said the Rural Remote Northern Program, which allows doctors working in communities throughout the province to be paid a higher premium, will be going under review this fall.

According to the table, a doctor working in Elk Point receives an additional 7.76 per cent, in St. Paul 6.14 per cent, in Bonnyville 9.4 per cent, and in Cold Lake 9 per cent.

By comparison, a doctor in Lloydminster receives a 6.26 per cent premium and a doctor in Lac La Biche receives 21.4 per cent. The program was last changed in April 2020, following the resignation of ten doctors in Lac La Biche as part of an ongoing feud between Alberta doctors and the Ministry of Health.

“It just makes it a little bit harder when we’re trying to recruit up in northeastern Alberta, that our bonus structure is a little bit lower,” said Hanson.

A release from the provincial government dated Oct. 7 says there was a net gain of 246 doctors in the province between 2019 and 2020.

“This report shows that doctors continue to choose to live and practise in Alberta in impressive numbers – and for good reason. Alberta pays more than any other province, has lower taxes, and now has the most attractive compensation package available for rural and remote doctors in Canada,” said Tyler Shandro, the Minister of Health.

Letter writing campaign

Area politicians and doctors are both encouraging residents to reach out to the Ministry of Health and Alberta Health Services to express their concerns about healthcare in the region and create pressure to have the vacancies filled.

“We regularly have people coming in from the Bonnyville area, from Onion Lake, Frog Lake, Fishing Lake, St. Paul. It serves a very large area, and we want to make sure that we can continue to offer those services well into the future,” said Young.

“Part of our worry right now is, we know that provincially finances are going to be extremely tight moving forward. And we want to make sure that Elk Point still has a very strong role to play in health care in this region,” said Young.

He said he expects the issue to be discussed at the next meeting of the Lakeland Health Advisory Council, scheduled for next Wednesday.

Dr. Florence Akindele is an obstetrician working part-time in St. Paul. She said she hopes the community will push for accountability from AHS as to how they are addressing the issues.

“That’s what I would expect the community to keep doing. To say, ‘Can you be open? Can you be transparent? What are the real problems and how we solve it?’” said Akindele.

She said the conversations being had right now are productive because it’s the first time she’s been in a meeting where “the who’s who in AHS all show up.”

“I would encourage every member of the community to use this window of opportunity to let their experiences be known to the direct places. I believe we have an opportunity as a community right now to make a difference. If we would all keep talking,” said Akindele.

“With the current situation. I believe more voices are being heard. So we’re hopeful that that will really move things forward.”