Marathon's success
CMAJ 1998;159:445
One objective of a small group within Ontario's Ministry of Health in the 1970s was to develop a type of group practice for Northern Ontario communities that would not wither and die after a few years. The underserviced-area program of the time did not venture into a long-term plan for Northern health care, so the article "A Marathon session: A town's MDs develop a philosophy to call their own" (CMAJ 1998;158(11):1516-7 [full text]), by Michael OReilly, about the family physicians in Marathon, Ont., cheered me immensely.
Their success has been made possible, in part, by the local hospital. Doctors in another Northern paper town had an opportunity in the 1970s to integrate doctors, hospital and community care in a single organization to provide coordinated service. It was too radical a move for the doctors — the Ontario Medical Association nearly had a seizure!
The use of small-town hospitals as walk-in clinics is not confined to Northern communities, as I noted recently.1 In places like Marathon the doctors' offices belong in the hospital unless there are specific distances to overcome. The duplication of facilities wastes money and effort, and so does the separation of medical and hospital services. Night phone calls need go only to the duty doctor in the hospital, since all doctors would be familiar with most patients in a small town (aided by computerized records, of course).
Seven doctors may be a little much for the 5500 would-be patients in Marathon, but I agree that a major cause of failure of previous efforts to provide care in the North has been a shortage of doctors. An underserviced, isolated community does not need a doctor: it needs doctors. Any medical group in the North must be able to function effectively with one doctor away consistently.
My praise for Dr. Gordon Hollway and all the family physicians in his group, and to Dr. George Macey and the entire community of Marathon — your creativity and energy are heartening.
John S.W. Aldis, MD
Port Hope, Ont.
draldis@eagle.ca
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Reference
- Aldis JSW. The disorganized state of primary care [letter]. CMAJ 1998;158[7]:865.
