Availability of services in rural areas
CMAJ 2000;162:1193
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Just 55% of rural physicians surveyed by the CMA in 1999 said their communities could provide cesarean sections if needed. (For the purposes of this study, rural physicians were defined as doctors living in communities with 10 000 or fewer residents.) Respondents reported that normal deliveries were handled in 70% of rural areas, but only 47% could provide epidural analgesia for labour. Tonsillectomies were done in 51% of communities, while hysterectomies could be performed in less than half (49%). Of the choices given in the survey, fracture management was the most common service handled locally, with 83% of rural physicians reporting that the service was available in their communities through family physicians or specialists.
Almost all physicians (97%) reported that they had access to ambulance services, and the vast majority had basic laboratory (94%) and x-ray (92%) services within the community. More than half (55%) could provide chemotherapy, but only 17% had dialysis services available locally.
While many communities did not have specialists living within their boundaries, many had access to regular visits from specialists. The majority of respondents (60%) reported having either a permanent or visiting radiologist. The proportion was slightly less for general surgeons (57%), internists (53%) and psychiatrists (51%), and substantially less for obstetricians/gynecologists (39%) and anesthetists (32%). — Lynda Buske, Chief, Physician Resources Information Planning, CMA (buskel@cma.ca).
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