Why have a society of rural physicians?

Keith MacLellan, MD
President, Society of Rural Physicians of Canada
Shawville, Que.

Can J Rural Med 1996; 1(1): 11

As rural doctors we practise a distinct form of medicine and have many challenges in common. We are placed in difficult situations without extensive specialist back-up; we are understaffed and cope with crippling emergency room coverage; we are underequipped and deal with patients with severe pathology; we are underpaid and see cutbacks looming; we are undertrained and face disincentives for continuing medical education (CME), and we are underrepresented in our professional organizations and universities. Yet we are true generalists, who provide excellent care to the one-third of Canadians who live in rural areas. We have chosen our careers for the challenges and pleasures that rural practice and rural living provide.

It has been difficult to bring the interests and concerns of rural medicine to the attention of Canadian decision-makers. Provincial and national professional associations are dominated by their urban majorities. University and standard-setting bodies such as the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada have pursued training policies that are well suited to centralized medical models but ignore the geographic, demographic and economic facts of Canada. Provincial and federal governments have tried to help their rural constituents with a hodgepodge of rural medicine programs, but they must rely on the existing urban medical organizations for advice and have never produced a workable plan.

With all this in mind, the Society of Rural Physicians of Canada (SRPC) was formed in 1992 by a group of physicians from Mount Forest, Ont. In just four years we have registered solid achievements, all of which would not likely have happened without our organization.

Because CME pertinent to rural medicine was not available from the usual sources, we initiated a creative cooperation with the universities to set up courses designed by rural doctors for those in the field.
Our fourth annual national conference and course on rural and remote area medicine took place in Banff in April 1996. We are also setting up a rural CME hour for weekly broadcast on the upcoming digital satellite network. It promises to be useful and interesting.
With this issue we are launching the Canadian Journal of Rural Medicine, which will be an independent forum for rural medicine topics and research.
We have created RuralMed, an internet discussion group, which is active nationally and internationally and available to all interested persons.
We have developed a series of creative and pertinent rural medicine policy issues.
We have made representations to national and provincial governments and medical bodies, including Health Canada, many of the provincial ministries of health, and the Canadian Medical Association.
We hosted a national meeting this past April on recruitment and retention issues.
We are initiating and coordinating local and provincial pressure tactics to bring about change. The SRPC played a large part in Ontario emergency room actions from 1991 to 1995 (and the subsequent Scott Report1) and in the Ontario government's recent plan to address some of the fee-schedule problems of Ontario's rural doctors.
We are providing political support to rural doctors across Canada and are planning a video to help them explain their difficulties to community organizations and representatives.
We are bringing social and psychological support to rural doctors and their spouses and families, and setting up lectures on financial planning, sleep deprivation and physician well-being.

All of this and more is the result of years of behind-the-scenes hard work done by our executive members. Unpaid and without charging expenses they have fielded calls and letters from all over the country; handled, or been handled, by the media; written letters and briefs; coordinated conferences and conference calls; helped various groups to communicate; fostered connections; put out newsletters; made international contacts; formed policies and, most importantly, have given moral support and useful advice to rural doctors across the country. This has all been done on a shoestring budget based on membership dues alone and without the support of grants, advertising or other sources of income. If you would like to help keep the SRPC going, please give us your support by filling out and mailing a copy of the membership form found on the inside back cover.

Your support will help keep the concerns of rural medicine on the front burner and will help us to improve the lives of rural doctors and the people they serve.

Reference

1. Scott GWS: Report of the Fact Finder on the Issue of Small/Rural Hospital Emergency Department Physician Service, Ontario Ministry of Health, Ontario Hospital Association, Ontario Medical Association, Toronto, 1995: Mar 22

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