GO TO CMA Home
GO TO Inside CMA
GO TO Advocacy and Communications
GO TO Member Services
GO TO Publications
GO TO Professional Development
GO TO Clinical Resources

GO TO What's New
GO TO Contact CMA
GO TO Web Site Search
GO TO Web Site Map



Canadian Journal of Rural Medicine
../../../ 1998

Exploring working conditions

Jill D. Konkin, MD

CJRM 1999;4(3):164


Working conditions are a real issue for rural doctors, but how difficult are they and what can rural doctors do to improve them? These were the 2 main questions examined by members of a special interest group meeting at the recent SRPC conference in St. John's, Nfld. Originally intended to cover issues for women in rural medicine, the terms of reference for the workshop were expanded to cover working conditions for all rural doctors.

The working conditions of rural physicians are driven by many variables, including the expectations of governments and administrators, the public/our patients, our colleagues and ourselves. These expectations must be examined, our relationships and responsibilities to each of these groups must be explored and solutions must be forthcoming or others may seek to impose solutions on us.

We need a consensus among our members on some general principles. Are we looking for guidelines or options? Should national standards be developed for issues such as frequency of call and hours of work expected per week? Some participants in the workshop pointed to a need to design a system that supports individuals in defining their limits.

We must develop resources to help individuals and groups of physicians who are presently engaged in changing their working conditions. A national directory of physicians with expertise in negotiating working conditions, such as alternative payment programs and on-call arrangements among colleagues, would be a start.

Workshop participants felt that it was important to define what we're willing to do and what the value of our time is. Compensation is only a measure of the value of the time we spend on medicine. We need to factor in family time, continuing education time and holiday time.

Two other important areas for exploration are retirement, and maternity and parental obligations. Physicians nearing retirement need options. Too often physicians either work until they drop or else they leave town because there are no options in place to allow them to lessen the time spent on work, including their on-call responsibilities. Women in rural medicine often have more problems juggling family responsibilities with those of work than do their male counterparts. We need to work at developing better programs for maternity leave as well as creating realistic part-time work positions.

It is important to evaluate changes that have already been made. Has compensation for call done what we expected? What are its successes and failures? What working conditions are alternative payment programs improving? Are there new issues for those of our colleagues working under these programs? Have rural locum services been successful? There are many ideas for developing other programs, including sabbaticals, re-entry training positions for rural doctors and compensation for rural doctors with advanced skills.

The executive of the SRPC has decided that the policy day at our annual conference in Ottawa next year will be on rural working conditions. There is much work to be done. If you are interested in joining the working conditions committee or have ideas and suggestions for topics and speakers please email Dr. Jill Konkin at jillk@telusplanet.net or write to Box 2139, Jasper AB T0E E0.

© 1999 Society of Rural Physicians of Canada