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Doctor shortage in Clearwater grows acute

That the emergency room at Dr. Helmcken Memorial Hospital might not be able to offer 24/7 service is a real possibility

Clearwater and area will be down to one permanent physician as of May 15, according to Dr. John Soles.

Dr. Mathilde Stuart, who arrived here from South Africa about two years ago, plans to retire.

“Is it a crisis? Absolutely,” Soles said. “We’ve been in a crisis for a while but now it’s to a greater degree.”

Locums, or doctors on temporary placements, will be used to cover the shortfall but they tend to be more difficult to find during the summer months.

That the emergency room at Dr. Helmcken Memorial Hospital might not be able to offer 24/7 service is a real possibility, Soles said.

It has already happened in other small communities, such as Princeton, he pointed out.

“People can expect that they may have to wait longer to get an appointment,” said Soles.

He noted that, statistically, people in this community use the emergency room at the hospital less than in many other communities of similar size.

“That makes a huge difference in our ability to sustain our medical practice here,” he said. “In other communities, doctors can routinely spend half their nights in the hospital. People here don’t use the ER except in times of real need.”

The local longtime physician pointed out that only a few years ago Clearwater had five doctors.

That was a comfortable situation, in that if something happened to one of them or if someone wanted to take some time off, the others could cover without too much trouble.

“I think Clearwater still could support five doctors,” said Soles. “Four would work, but you have to consider that what brings people here is the lifestyle. If you have to work enormously hard, you aren’t enjoying the rural lifestyle.”

Having so few doctors to work with and to fall back on is a major disincentive for other doctors to move here, he pointed out.

Another disincentive is that many doctors lack confidence in their ability to handle critically ill patients without the facilities of a large hospital.

A few physicians from outside Canada have expressed interest and plan to visit the community in June, Soles said. However, even if they choose Clearwater the process means at least several months delay before they could start work here.

Most locums tend to be either semi-retired doctors who want to keep their hand in medicine, or recent graduates seeking to gain experience and pay off their student loans.

It isn’t a lifestyle that many pick as a career.

Clearwater formerly had a short list of locums who regularly visited the community, but that is no longer as true as it once was because some have retired or moved on.

South Africa used to be a major source of physicians for rural B.C. However, change in the rules done at the beginning of 2012 means that now only doctors trained in the U.K, the U.S., Australia and New Zealand can come to work in this province with relative ease. All others must go through an extensive evaluation process – a process for which there is no funding and no organization.

Stories about unemployed and under-employed physicians elsewhere in Canada are overblown, said Soles.

There are really not very many such physicians, he said, and those that do exist either don’t want to leave where they are located or often are trained in specialties that there is little demand for. He felt part of the blame for the surplus must be placed on medical schools, which have been slow to adjust.

Medical students in B.C. need to do at least a two-month rural rotation as part of their residency program. Clearwater has hosted a number of these students over the years as a result.

The number of family practice residencies in B.C. has expanded over the part few years and the program will start in Kamloops in 2014.

That could result in a number of second-year residents coming to Clearwater, Soles said.

Such students would be advanced enough in their training to need little supervision.

Having them here would increase the possibility that one or more will decide to stay in Clearwater once their training is done.