A new venture: CJRM, a voice for rural medicine

John Wootton, MD, CM, CCFP, FCFP
Shawville, Que.

Can J Rural Med 1996; 1 (1): 5

In 1979, as a newly minted GP, I stepped somewhat anxiously off an amphibian Grumman Goose to begin 3 months as the only physician in Ocean Falls, BC, an isolated paper-mill town a long way up a very long and lonely coast at the extreme western edge of Canada. I didn't know it then, but I had begun a career in rural medicine.

So impressed was I by that experience that I wrote an editorial in the Canadian Family Physician[1] about the problems that, even as a newcomer, I could see were endemic. Problems such as professional isolation, lack of backup and support, difficulties in recruitment and retention, and insufficient or inappropriate training were all evident.

The hospital in Ocean Falls is long gone, but the problems faced by rural medicine remain very much alive across the country. The Canadian Journal of Rural Medicine (CJRM) is one manifestation of a new determination by rural physicians in every province to address these issues. The CJRM will attempt to keep the rural agenda in the public eye and help promote discussion within the medical community. It is dedicated to the proposition that rural medicine is a distinct discipline, that its practitioners require distinct skills and that they face problems different from those faced by practitioners in non-rural settings. A hard look reveals the multitude of questions to be examined:

What level of care can/should be provided in rural areas?
What are appropriate ways to organize that care?
What training is required for the practice of rural medicine, and who should provide it, and where, and how?
What factors attract physicians to rural areas?
What strategies keep them there? What causes them to leave?

Ultimately rural medicine is about the care and services delivered to people in rural areas. If you have any doubt about the rural nature of Canada, browse through Statistics Canada's Internet site (URL: http://www.statcan.ca) and you'll find that our current population stands at 29 413 100. Depending on the definition, at least a quarter, perhaps closer to a third of that, is rural. That's somewhere between 7 and 10 million people cared for by rural physicians! The CJRM is a new venue to articulate rural doctors' concerns, diffuse their ideas, provide them with educational material tailored to their needs and introduce them to each other.

The rural community is dispersed, both within Canada and internationally. This publication, in its paper version and by publishing simultaneously on the Internet, can help bring the rural community closer together. Your input is important to us. Answering the enclosed survey is one way to respond. We can also be reached by mail, phone and fax, and on the Internet (email: cjrm@fox.nstn.ca). Don't hold back! The way forward promises to be interesting. I hope you come along for the ride.

Reference

1. Wootton JC: Rural medicine: implications for the future. [editorial] Can Fam Physician 1980; 26: 622, 624

Table of contents: Can J Rural Med 1 (1)