The Rural Voice, 1996-11, Page 24of funds has not been seen, to date,
said Bell.
Already $170 million has been put
back in across the province, to
purchase such items as defibrillators,
Johns said. The health care budget is
presently $17.4 billion and is
expected to rise to $17.7 billion by
the end of the present term.
In the first year, Toronto
hospitals will have reductions of
six to eight per cent while
smaller facilities, such as Huron -
Perth and Grey -Bruce hospitals,
are likely to see 2.5 per cent
drop in funding. Rates for the
next two years have not been
calculated.
"It is hoped the health care
system will be seen as better
when we are through."
ith the provincial
government
"readjusting" health care
funding, they are taking other steps
which may help prepare graduating
doctors for rural practice.
New physicians often lack the
specific training required to operate
in a non -urban setting, particularly in
the far north, where support services
are even more difficult to obtain, due
to remoteness.
A medical training program has
been set up, based at the University
of Western Ontario, to give
prospective practitioners hands-on
training in rural medicine. The
program, headed by Dr. James
Rourke of Goderich, is for medical
residents training to be specialists.
The initiative received $150,000 in
government funding.
The Rural Ontario Medicine
Program will also see family
medicine residents given the
opportunity to train for six months in
Collingwood, rather than the usual
four to, six weeks allotted to rural and
northern needs.
Further funds have been designated
to train psychiatrists in northern
Ontario and to decentralize the
undergraduate and postgraduate
programs, expanding from the
present five city locations.
Successes have not yet been seen in
the rural education program, said
Johns, but it is still early. "This is a
step in the right direction" as more
doctors are attending rural recruiting
seminars and asking more probing
questions. "We are somewhat opti-
mistic."
In terms of remuneration, lengthy
debates and arguments have arisen
from the government's salary cap,
another method of reducing health
100 GPs are needed, as well as
specialists to cover a shortfall of 75,
in northern regions.
Twenty-one northern communities,
with populations of ugder 10,000,
have been included in a program
which would pay doctors under a
new agreement. Annual incomes,
under community -sponsored
contracts, could range up to
$194,000, with bonuses for the
completion of a two or three
year deal.
This plan was implemented in
areas where the population
could not sustain a practice.
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20 THE RURAL VOICE
care costs in specific areas and
allowing the funds to be moved to
other sectors.
This is an area where rural doctors
may have the advantage. Because of
their multi -discipline practices,
physicians are able to use the highest
cap for the services they provide. "It
is more than just the GP level,"
argues Johns.
If improved training opportunities
and emergency care compensations
are not enough to draw new doctors
from urban areas to rural facilities,
the provincial government has
another card they are willing to play
— the restriction on billing numbers.
Each new physician must obtain an
OHIP billing number in order to
receive their fee. The government has
brought forward a bill which would
deny requests for billing numbers for
areas already overserviced by physi-
cians. They would be required to
apply for an underserviced area such
as rural or northern sites.
"At present, Toronto has one
doctor for each 600 residents while
rural districts are one to 1,300," said
Johns. "The bill (restricting OHIP
numbers) is not yet implemented, but
it is there if needed."
The supply of physicians in rural
and northern areas has not improved
over the last six years. The number of
communities designated as
underserviced jumped from 43 to 68,
a 60 per cent increase. An additional
But are incentives or forced
placement the appropriate way
to get doctors into rural
communities? Physicians and
administrators at Seaforth
Community Hospital are using
another tactic to entice young
graduates to their facility.
A town of under 2,500, the
community has gone through trying
times in previous years. Left with
only three physicians for a period,
those three men worked as a team to
hold their group practice together,
said Woldnik.
Through considerable community
effort, a new medical clinic was built
next to the hospital. It was this
dedication and commitment to a
community health approach that has
seen Seaforth services flourish in
recent years.
It's often a joke amongst the nine
physicians who now call Seaforth
Medical Clinic home, that "build the
clinic and they (doctors) will come,"
said Woldnik.
Because there was a building
which could house several
practitioners, that led to recruitment.
The philosophy behind Seaforth's
success, (six new doctors over the
past three years), is a team practice.
"A group can buffer major
changes," said Woldnik. "If there is a
fluctuation in income, it is not as
important because overhead costs are
shared."
The clinic has also been changing
the thinking behind 'one patient has
one doctor'. People are learning they
don't have to see the same physician
on every visit, because the
knowledge is shared amongst the
team.