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Yahoo
14 hours ago
- Health
- Yahoo
Some Ontario hospitals offering hefty incentives for locums amid doctor shortage
As a travelling physician in northern Ontario, Dannica Switzer is acutely aware of the health-care crisis in underserved communities. 'It's sad to see how much worse things can get,' said Switzer, who works as a locum, filling roles on a temporary basis in rural or remote areas. Switzer has been in high demand since returning to locum work after quitting her family practice in Wawa, Ont., due to burnout more than two years ago. Rural and northern Ontario hospitals are competing to recruit locums by offering hefty financial incentives amid a severe shortage of doctors that has plagued the health-care system. The hospitals are vying for doctors from a relatively small pool of locums, often as a way to prevent emergency department closures that have become more common in recent years. 'But the reality is that most people are booked,' Switzer said in a recent interview. 'And even if you really want to go help that town out to prevent the closure, you can't because you're already working somewhere else.' Hospitals' fierce competition for locum recruitment has triggered concerns about equitable access to health care, with some doctors and experts saying it leaves smaller communities and hospitals vulnerable because they may not have the financial resources needed to entice physicians. While funding mainly comes from provincial programs, some hospitals top up the pay for locum shifts by tapping into their operating budgets or money that's available due to vacant staff positions. But Mike Cotterill, a physician in Wawa and one of Switzer's former colleagues, said that approach is not ideal. 'If you top up with X dollars, then the next town down the road will top up with X plus, you know, X plus Y," he said in an interview. 'So, it's a competition that is bad for hospitals and bad for towns. It really shouldn't have to happen." He said the Lady Dunn Health Centre, where he works, has so far avoided having to top up the pay for locums and its "excellent" recruiter has been able to ensure a steady supply of such physicians. But that's not the case at some other hospitals. Timmins and District Hospital is currently offering up to $18,500 for hospitalist medicine locums to work there for one week in August, according to an ad posted on the hospital's social media page. The North Bay Regional Health Centre pays up to $2,700 per eight-hour shift for emergency medicine locums, according to its website. Manitoulin Health Centre's Little Current site offers $250 per hour to physicians who take ER shifts in July and August. The hospital receives around $160 per hour from the Health Ministry for night and weekend shifts and tops up that amount so it can stay 'competitive," using funds from unfilled positions at the hospital, said lead physician Anne McDonald. The generous pay, flexible scheduling and less administrative work that comes with being a locum may impede some hospitals' recruitment and retention of full-time doctors, some experts say. The financial incentives for locums, which can also include accommodation, flights, car rentals and other expenses, are unaffordable in the long run, they add. The goal should be to make permanent positions more appealing so that doctors stay in communities, Switzer said. "We cannot recruit our way out of a retention crisis," she said. Still, doctors agree that locums play a vital role in rural and northern areas of the province. "We absolutely need the locum and the local program," said Dr. Anjali Oberai, who works in Wawa alongside Cotterill, her husband. 'We need to support locums but if the support is such that it de-incentivizes working and living in community, yeah, then we have a problem." Oberai and Cotterill worked for nearly two years as locum doctors to take advantage of the lifestyle before settling down in Wawa in 1998. But "the locum landscape was quite different back then,' Oberai said. They worked mainly during the summer, covering for doctors who were on vacation or other short-term leaves. But locums are now often used to fill vacant positions, and they've helped Wawa keep its hospital and primary care centre operational during a worsening physician shortage in the community in recent years. McDonald, the lead doctor at Manitoulin Health Centre's Little Current site, said rural doctors are under a lot of pressure, taking care of patients who are often their neighbours, friends or relatives due to physician shortages. Some cannot handle that workload and become locums instead. "I really think the locum lifestyle is less about the money exactly and more about the lack of burden of ongoing responsibilities that weighs physicians down," McDonald said. There are more than 350 physician vacancies in northern communities, according to the Ontario Medical Association. That shortage might get even worse as nearly half of the doctors there are expected to retire in the next five years. The association always advocates for a system that encourages doctors to provide reliable and continuous care at a specific location, OMA president Zainab Abdurrahman said. But the doctor shortage is so acute that locums have become an essential part of the system. "It's not that having a locum means you're not hiring and you're not actively trying to recruit,' she said. Some new medical school graduates want to take time to explore their options as the financial cost and administrative burden of setting up a practice holds them back, she said, while others want to become locums to help underserved communities. While financial incentives offered by some hospitals do lead to inequities, they are just a symptom of a larger issue, Abdurrahman said. 'The utilization of these kind of extra incentives is really a reflection of the desperation in the health-care system,' she said. 'People are making choices to be competitive because they're feeling the constraint.' The Health Ministry says its Rural Emergency Medicine Coverage Investment Fund, which replaced the Temporary Locum Program in April, is helping hospitals improve access to emergency care throughout the year by offering them the flexibility to hire locums and improve their capacity to recruit permanent doctors. That commitment came out of negotiations between the government and the OMA for a new Physician Services Agreement. Ministry spokesperson Ema Popovic also pointed to the province's investments aimed at connecting every Ontarian with a primary care provider by 2029, and efforts to add hundreds of seats in medical schools. Many doctors say that other incentives, such as improving access to education, more vacation time and less administrative paperwork, are also needed to recruit and retain full-time physicians. For Switzer, being a locum gives her more control over her schedule but that comes with a cost. 'I have a house, I'm not at it. I have a garden. I'm not there ... I miss a lot of moments with my family," she said. This report by The Canadian Press was first published July 31, 2025. Sharif Hassan, The Canadian Press Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
CBC
3 days ago
- Health
- CBC
Can virtual care services solve the health-care staffing crisis in rural B.C.?
On Monday, a peer-reviewed study found that an initiative called the Real-Time Virtual Support network helped improve access to health care in rural B.C. Lead author Kendall Ho, a professor at the University of B.C.'s department of emergency medicine, said it was important to pair virtual care with an increase in in-person health facilities. Dr. Gavin Parker, president of the Society of Rural Physicians of Canada, argues that while virtual care programs are beneficial, there are also opportunities to increase funding to rural communities.
RNZ News
3 days ago
- Health
- RNZ News
Dargaville Hospital loses its only full-time doctor
Dargaville Hospital has lost its last full-time doctor. Photo: RNZ / Peter de Graaf Dargaville Hospital has lost its last full-time doctor, the latest setback in a staffing crisis affecting many rural hospitals around the country. Health New Zealand said the doctor's departure is unfortunate, but it has enough staff to keep the hospital running on the current roster, and there won't be any change to staffing levels in place since late last year. The 12-bed Northland hospital came close to shutting down last October when it could no longer find enough doctors to fill the 24-hour roster. The inpatient ward now runs without a doctor most nights. Instead, overnight care is provided by nurses backed up by a telehealth service, in which a doctor at another location offers advice via phone or video call when needed. Hopes of returning to 24-hour medical cover slipped further out of reach at the end of June with the loss of the hospital's only remaining full-time doctor. Rural medicine specialist Josh Griffiths, a member of the ASMS doctors' union, said the hospital now had two-and-a-half full-time-equivalent (FTE) doctors, when four were needed. "We were already not in a great place, staffing wise. When she was here, we were down to about two thirds of our job-sized FTEs. With her gone, that takes us down to about half." Dr Griffiths said the doctor's departure was a blow because she was committed to Dargaville - she had even bought a home in the town - and had specifically sought a position in rural Northland when she was recruited from the US about three years ago. Dr Griffiths said the remaining doctors were doing extra day shifts to fill the roster, but that was balanced by fewer night shifts now the hospital no longer had a doctor on duty 24 hours. They had, however, hoped to return to 24-hour cover at some point. "This just takes us a step further away from reinstating full services, which is really disheartening," he said. Dargaville Hospital serves about 27,000 people living in the town (pictured) and surrounding Kaipara District. Photo: Peter de Graaf/RNZ Mike Shepherd, acting deputy chief executive for Health NZ's northern region, said Kaipara residents continued to receive the same level of service from Dargaville Hospital as they had since November. "We have received the resignation of one of our doctors and clearly that's unfortunate, but we continue to have enough doctors to staff the roster without impacting the service for patients," he said. "We're continuing to actively recruit to further staff, as you'd expect, and we don't anticipate any change to service to the community." Shepherd said Health NZ had yet to decide whether to try to reinstate 24-hour cover. "We're having that conversation... Our priority at the moment is to continue to provide what we are providing. We think we're providing a good service during the day, and a safe service overnight using the range of treatment and staff that we have." Shepherd said the number of calls nurses were making to Emergency Consult, the hospital's telehealth provider, had decreased as they became more skilled at managing issues in the ward overnight. Meanwhile, Dr Griffiths said he had mixed views on telehealth. He believed it was safe and essential, because it was filling a gap that could have otherwise forced the hospital to close. "But it doesn't always work out great for patients. We now transfer anyone unstable to Whangārei but that means a massive increase in the use of ambulance transfers, which is a problem for St John who are also struggling with staffing in rural areas. It's also problematic for patients who want to be cared for close to home." Dr Griffiths said it also put extra strain on Whangārei Hospital, because patients that could have been treated in Dargaville were now sent there. Another problem was that patients who were not particularly ill could not be sent home because they could not be fully assessed overnight. "So they're either transferred to Whangārei or kept in Dargaville overnight where they can be monitored, and the next day the doctor has an increase in workload because stuff's been deferred from overnight... So, it's safe, but it's clearly sub-optimal, and a lot of patients tell me that they're dissatisfied because they can't really be dealt with by telehealth, they're just deferred or transferred." Dr Griffiths said he was "really proud" of the way Dargaville's nurses had stepped up. "It's resulted in a lot of upskilling, and nurse management has taken a proactive stance by trying to get people through courses to educate them more on managing emergencies in a way they wouldn't have had to previously, because the doctor would have taken the lead," he said. "Some of them have taken to it really well. Others are not really happy because it's different to what they signed up for. I'm also worried about our senior nurses, because they're compensating for the lack of doctor cover by being on call for critical issues 24/7, and sharing that amongst themselves." Dr Griffiths acknowledged that recruiting doctors was difficult worldwide, not just in Dargaville. "But I do think there are specific things that could be done better, which we've pushed for, and we've had a really lacklustre response." In particular, he said Health NZ should increase the rural recruitment and retention bonus paid to doctors who took up jobs in hard-to-staff places like Dargaville. As for the improved after-hours medical service promised in May by Health Minister Simeon Brown, Dr Griffiths said it was a positive move, but he was surprised no one at the hospital had heard about it before the announcement. He hoped officials would talk to locals and find out what was needed, rather than impose a top-down solution. Brown told RNZ the $164 million programme to expand and strengthen after-hours healthcare across the country would be rolled out during 2026 and 2027. He said Health NZ was currently considering the model and specific timing for the service. Within Northland, better after-hours access would be provided in Dargaville, Hokianga, Kaikohe, Kaitaia, Kawakawa, Mangawhai and Waipapa. Health NZ was also working on improved access to daytime urgent care in Dargaville, he said. Brown said he also expected Health NZ to continue recruiting clinical staff for Dargaville Hospital. "I have received assurances that Health NZ are doing so, and that existing services for patients will be maintained while this is underway," he said. Dargaville Hospital serves a population of about 27,000 people. The nearest secondary-level hospital is at Whangārei, about an hour's drive away on State Highway 14. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
CBC
3 days ago
- Health
- CBC
B.C.'s rural, First Nations communities find support in virtual care network: report
A new report in the Canadian Medical Association Journal describes how a real-time virtual support network in B.C. is shaping health-care access for rural and First Nations communities in the province. The network includes patient-facing services, as well as decision supports for health professionals in communities.
ABC News
5 days ago
- Health
- ABC News
Expanded role for pharmacists in healthcare black spots to bridge GP gap
For the 600 residents of Milawa, a small town in north-eastern Victoria, there is no hospital, no local GP and no public transport, but there is a pharmacy. Sherwin Kashani has been the owner for more than a decade. "People come in to me needing all sorts of things," he said. "That's when I have to go beyond what I would normally be expected to do as a pharmacist." Mr Kashani said his pharmacy served a wide region, often making him the only easily accessible health professional for nearby towns, especially with his seven-day service. "Then southwards, there are no doctors at all between here and Mansfield, which is about 100km [away]. "Elderly people may not be able to drive that far and there is no public transport." According to the latest Australian Bureau of Statistics data, people living in regional and remote areas are more likely to delay or not see a GP when needed than those living in major cities. And they are 6.6 per cent more likely to visit a hospital emergency department. In October 2023, the Victorian government launched the Community Pharmacist Program (CPP) pilot, allowing participating pharmacists to treat conditions such as shingles, resupply certain contraceptive pills, and deliver a range of vaccinations, without a doctor's visit. According to a report by the Department of Health, during the 12-month pilot pharmacists provided more than 23,000 services and no serious safety concerns were reported. This year's Victorian budget confirmed the program would become permanent from July 1, with $40 million in funding. But not everyone is on board, with some medical professionals arguing pharmacists are not trained to diagnose complex conditions. Still, by 2026, pharmacists in Victoria will be able to offer 22 different health and wellbeing services. Of the more than 830 participating pharmacies, about 27 per cent are in rural or regional areas. "Local pharmacies play a valuable role in our health system, especially in regional Victoria," a Victorian Department of Health spokesperson said. One of the services planned to be added to the CPP is oral care, a healthcare gap that has recently been illuminated by a La Trobe University study. Researchers interviewed 11 rural pharmacists and found they were offering oral health advice up to three times a week on topics such as brushing habits, fluoridated toothpaste and dietary changes. Data from the 2021 National Pharmacy Survey showed while Australians visited community pharmacists 18 times a year on average, fewer than half had seen a dentist in the past 12 months. "In regions where dentists are absent, pharmacists are often the first and only line of health care," said professor Joseph Tucci, pharmacy discipline lead at La Trobe University's Rural Health School. Clunes pharmacist Kellie Saunders, who participated in the La Trobe study, said the CPP and its planned expansion to include oral care was "welcome news". "[The program] also recognises the trust communities place in pharmacists and ensures we can continue to serve our communities in a timely manner, helping also to ease the burden on our broader healthcare system." Royal Australian College of General Practitioners Victorian chair Anita Muñoz said she was critical of the program's expansion and suggested it could cause problems rather than solve them. "At best it ticks a box and allows for the announcement of some kind of solution," Dr Muñoz said. "At worst and in the long term, it's likely to cause more problems than it solves. "People want and need to be able to see a GP." Dr Muñoz said the only solution was making sure there were enough GPs in regional communities. "Studies show patients who see the same GP are healthier, live longer, and are more satisfied with their care," she said. The federal Department of Health, Disability and Ageing said the government would invest $662.6 million over four years from 2025–26 to grow the primary care workforce and deliver more Australian-trained doctors, including rural generalists. A Department of Health, Disability and Ageing spokesperson said pharmacists played an important role in Australia's healthcare system. "Pharmacists play a key role in the community in providing accessible health services to Australians, particularly those in regional, rural and remote areas," the spokesperson said. "The Australian government is progressing work to ensure all health professionals, including pharmacists, can work to their full scope of practice. "This is particularly relevant in rural areas where workforce shortages may be more acute."
