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Ong: ‘Medicine is politics’

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Published on Thursday, March 24, 2016

By Kate Jackman-Atkinson

Neepawa Banner/Neepawa Press

While other communities have struggled with service cutbacks and doctor shortages, Neepawa is one of the few rural communities that has been able to recruit doctors and retain its medical services. On March 10, long-time Neepawa physician Dr. George Ong spoke to the Neepawa Rotary Club about the town’s medical community. With many communities facing severe doctor shortages, Ong talked about some of the steps Neepawa has taken to be proactive about doctor recruitment and retention. 

Ong first came to the community 38 years ago and he said that a lot has changed since then.  He was recruited by existing physicians in the community and he actually had to pay those doctors. “I paid for the privilege of working here,” he said. Recruitment used to be done by a community’s existing physicians, but Ong said that over the years, “A lot of doctors have abandoned recruitment.” He explained that they work until they retire, without finding a new doctors to take over their practice. 

Ong also took the opportunity to rebut Banner publisher Ken Waddell’s Feb. 26 column, called “Neepawa, Minnedosa, we have a problem”. He said, “[Waddell] puts the blame on everybody else, but I think Neepawa has done extremely well.”  As other communities have struggled, Ong said, “The community, the region and the doctors work together as a team” to be proactive on recruitment.

“It’s getting harder and harder to recruit doctors to rural communities,” said Ong.  Adding that with recruitment and retention falling on the regional health authorities (RHAs), “They’ve done as best as they could”. It’s not only rural ˮ����Ƶ that’s facing challenges getting and keeping doctors, Ong explained that it’s a problem all over. “Most doctors want to stay in the city,” he said.  With that in mind, he explained that they have worked hard to find ways of attracting those physicians who want to practice in rural areas.

The RHA has relied heavily on international medical graduates (IMGs), which in recent years, Ong said, “has been a disaster”. Ong himself is an IMG, having trained in Britain.  He explained that after attracting UK trained doctors, ˮ����Ƶ RHAs turned to those trained in South Africa, some of whom can still be found in rural communities.  The newest source of recruits is the Middle East, but he said that very few of those doctors stay in rural areas once their initial three year contract is finished and they are accredited in Canada. Some even leave for larger centres before their contract is up, even though it means paying large penalties to the RHA that employs them. “They come, work three years and leave.  There’s a huge turn over,” Ong said.

Neepawa has a total of seven doctors, five of whom are Canadian.  “Doctors are very mobile, especially those who are Canadian trained. We have to make it good for them to stay,” said Ong. Neepawa has been the only smaller community in the region to maintain its level of service.  The Neepawa hospital continues to do some surgery and obstetrics, no other community of its size continues to offer these services.  Ong explained that the ability to do extra services is what has attracted and kept many doctors in Neepawa. 

While Neepawa has seven doctors, the community could still use more.  “We would like to service everyone, but we can’t,” said Ong, adding, “We need eight to 10 doctors to maintain service.” This is why they continue to actively recruit. He explained that newer doctors can’t handle the load for a variety of reasons, including increased time spent at the hospital, providing services such as surgery that reduce the amount of time a doctor has available to spend in the clinic, as well as a desire for a better work-life balance. 

Ong also spoke about the need for a regional hospital. A regional hospital would be served by more doctors, which reduces the on-call commitment from doctors. “The biggest problem is sustaining on call,” he explained.  The RHA has made a regional hospital, to be shared by Neepawa and Minnedosa, their number one priority. Ong added that the provincial government has been supportive, but doesn’t have the $100 million it will cost for a regional hospital.  Ong explained that a regional hospital would also be able to provide more services than currently available, such as CT scans. 

A regional hospital would be located between Neepawa and Minnedosa and many worry about the ability to reach it in inclement weather.  Ong pointed out that the Neepawa Hospital currently serves many people who don’t actually live in town and must already face bad roads to reach the hospital. “Medicine is politics and the final decision is a political one,” said Ong, noting that unless something changes dramatically in Minnedosa, the provincial government won’t make the decision to locate a regional hospital in Neepawa at the expense of Minnedosa.

A local hospital would be cheaper, costing about $50 million, but wouldn’t have as many services.  “A small hospital in a little community doesn’t work any more, it can’t often provide the services,” said Ong.