Faced with a shortage of rural medical professionals in an area with the highest birth, obesity, cancer and sexually transmitted disease rates in the province, the Northern Health Authority and its partners are recruiting staff, leading training programs, pushing for rapid hospital construction and leaning on groundbreaking technology to close the service gap.
“It is a challenging environment,” said Bill Clifford, chief medical information officer with Northern Health.
The smoking rate in northern B.C. is 22.8%, substantially higher than the provincial average of 15%, and the region has the highest rate of cancer in the province, according to the Canadian Cancer Society's B.C. and Yukon division.
As well, 58% of northerners are considered obese or overweight, compared with 45% in the rest of B.C.
A study done for the BC Medical Services Foundation found that sexually transmitted infections in northeast B.C. were 32% higher than the B.C. average, a reflection of the influx of young people into the booming resource economy.
The medical response is impressive.
This year $105 million is being spent to complete state-of-the-art hospitals at Haida Gwaii off the west coast and in Burns Lake in the central north.
The $308 million Fort St. John Hospital was completed just two years ago and, last year, the $91.5 million BC Cancer Agency Centre for the North opened on the University of Northern British Columbia (UNBC) campus.
The Northern Medical Program (NMP), part of the UNBC faculty of medicine, is ramping up efforts to train more doctors, nurses and medical technicians. Northern Health dangles incentives worth up to $100,000 for doctors who relocate to the north for at least five years and can offer signing bonuses of $10,000.
Working under a $724 million annual budget, Northern Health operates nearly two dozen hospitals and 14 long-term care facilities and, in the last year, handled 261,000 emergency department visits, performed 37,265 surgeries and delivered more than 3,200 babies for the youngest population in the province.
Still, some say it is not enough. In August, a group called Concerned Citizens for Health Care presented Northern Health with a 1,200-name petition calling for increased staff levels at the new Fort St. John Hospital.
“I don't have a family doctor and there are 24,000 people here [in the Peace River region] in the same situation,” said Fort St. John financial planner Brad Brain, a spokesman for the group.
Clifford said he is “not satisfied” with the overall northern staffing levels, though he said they have improved dramatically in the past five years. Prince George, for example, is seeking eight doctors or specialists, and Northern Health is advertising for 72 physicians across the north, which Clifford said is not unlike the shortages being seen in other parts of the country. “Fort St. John is where Prince George was five years ago,” he said.
The construction of modern facilities is part of the northern recruitment strategy, Clifford said, as is the development of primary care centres in every northern community. These facilities, often attached to the local hospital, use a team approach to address all aspects of medical care, including senior services, mental health and addiction issues. “The goal is longitudinal continuous care in a context of a multidisciplinary team,” Clifford said.
Northern staffing needs are being addressed locally, if slowly, said Paul Winwood, UNBC vice-provost of medicine, who noted that the 10-year old NMP admits 32 medical students every year, half of whom become family physicians.
Nearly 30% of NMP graduates who have settled into permanent practice are working in northern B.C., which Clifford said is “encouraging.”
“The data from Prince George Family Practice Residency program [part of the University of British Columbia faculty of medicine] are even more encouraging, with 43% [of graduates] working in northern B.C. since [the program] was established in 1995. These figures compare with a national average of approximately 10% of [medical] graduates who choose to practice in rural communities,” Winwood said.
“That's very promising.”
However, on average from the time they enter medical school, it takes 11 years for a family physician to settle into a practice and 15 years for a specialist. “It will not be until at least 2020 before we can really assess the impact of the NMP,” Winwood said.
Northern Health has boosted technology to help address the lack of medical staff. It runs the video conferencing Telehealth and Telepharmacy systems that link 25 of the 27 northern communities, allowing patients and northern doctors to meet remotely.
And, Clifford added, Northern Health is moving to expand the video links to allow patients and doctors access from their homes via personal computers. Private operators are also getting into medical teleconferencing.
Vancouver-based LifeCare Medical opened its first northern “telemedicine” clinic in Taylor this June. The private clinic has a nurse on staff and will have two doctors rotating through the facility beginning this September, said LifeCare CEO Mark Godley.
“It is very busy. We are seeing an average of 15 patients every day,” he said.
LifeCare is the second private telemedicine service in the north; the first was Medeo, which opened last year.
Godley said the Taylor clinic is unique as it can provide X-rays and other medical diagnostic tools that can then be relayed to doctors anywhere in the province. Doctors can then interact with patients in real time, he explained.
Northern Health has also concentrated on electronic storage of medical data and has digitized 90% of patients' records, compared to less than 60% in most of the province, noted Jeff Hunter, the agency's chief information officer.
Like all six health districts in B.C., Northern Health is restricted to a 2.6% budget increase for the next year, which will put further pressure on its ability to create a welcoming and contemporary environment for northern physicians.
“It is not enough to convince doctors that the north is a great place to live,” said Clifford, who was awarded the Order of BC this year for his 25 years of service in the north.
“It also has to be a great place to work.”
Two new hospitals are under construction in northern B.C.
The $50 million Queen Charlotte/Haida Gwaii General Hospital replaces a 60-year-old facility in the village of Queen Charlotte. Construction is underway and it will open in the fall of 2015. There will be eight acute-care beds, a labour, delivery and recovery suite, a home- and community-care wing with eight residential-care beds, a primary care centre and space for diagnostic imaging, laboratory and pharmacy services.
At Burns Lake, construction began on the $55 million Lakes District Hospital and Health Centre in June 2013 and will complete in 2015. The 16-bed complex will include acute-care and emergency services, diagnostic imaging, a laboratory and pharmacy. Space also is planned for a medical clinic along with the delivery of mental health and addictions services, public health, and home and community care.
