What's wrong with family practice in Rural Canada?

[DrIng]

This is actually a serious question. I've come acros several sites posting jobs working as a rural family physician in places like BC earning around $200,000p.a. & apparently to get licenced for these jobs you simply need two years of postgraduate experience, all of which raises the question, what is so objectionable that they have to pay people such huge amounts of money to work there?

Any information appreciated.

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[FungManX]

This is actually a serious question. I've come acros several sites posting jobs working as a rural family physician in places like BC earning around $200,000p.a. & apparently to get licenced for these jobs you simply need two years of postgraduate experience, all of which raises the question, what is so objectionable that they have to pay people such huge amounts of money to work there?

Any information appreciated.

I know in BC, nobody wants to work there because its boring there...
Nothing to do but fish all day.. or help with farming haha (alright I'm stereotyping a Bit..)

but yeah.. when major cities like Vancouver are just a few hours away from
family.. who wants to go to those places anyway

 

[firetown]

This is actually a serious question. I've come acros several sites posting jobs working as a rural family physician in places like BC earning around $200,000p.a. & apparently to get licenced for these jobs you simply need two years of postgraduate experience, all of which raises the question, what is so objectionable that they have to pay people such huge amounts of money to work there?

Any information appreciated.

I wonder why you say it is a huge amount of money. I would rather say that the amount might not even be enough to attract people in these days of doctor shortages in Canada. I have seen adverts in Ontario offering $330,000 (including benefits) for rural positions. The $200,000 probably includes benefits as well. It is not simply two years of postgraduate training. It is more of a 4 years of undergraduate study plus 4 years of medical school plus two years of residency.

 

[Mike59]

The fundamental problem in Canada is that they've been trying to lure physicians who were born/raised/educated/trained in the city to work in these hick towns that have huge catchment areas, low tech facilities and little access to specialists, all for a very sligtly increased pay scale. The credentials that are required (2 year residency) is not a perk because you can get a job ANYWHERE as a family doc in Canada once you've completed your residency.


The difference in pay scale is so minor that it's not going to appeal to those in the urban areas. The only way this will work is the Northern ontario approach, build a med school to train/serve in those areas and recruit rural people....As for living in these areas, it's like anywhere else in North America, if you are of colour or are used to living in cosmopolitan areas, you will be a serious outcast in these rural communities. They are very much hick towns with old world values and it's no wonder new grads hang around close to home base when they're done training.

 

[Nucana]

This is actually a serious question. I've come acros several sites posting jobs working as a rural family physician in places like BC earning around $200,000p.a. & apparently to get licenced for these jobs you simply need two years of postgraduate experience, all of which raises the question, what is so objectionable that they have to pay people such huge amounts of money to work there?

Any information appreciated.

In the smaller rural towns, if there are say three FPs you will be on call one in three. It is not really alot of money for working these sort of hours, and you and your wife have to like the rural life style.

 

[DrIng]

Compared with what you earn in Australia 2 years out $200,000 is a lot of money and it's true about the oncall but not everywhere has such extreme on call. I And if you're a foreign doctor looking to travel a bit before settling into training it looks pretty good to me... But obviously not to a lot of people...

 

[Nucana]

Compared with what you earn in Australia 2 years out $200,000 is a lot of money and it's true about the oncall but not everywhere has such extreme on call. I And if you're a foreign doctor looking to travel a bit before settling into training it looks pretty good to me... But obviously not to a lot of people...

In absolute terms, I do agree that C$200,000 is a lot, but in most things in life it is relative to what one is able to earn elsewhere and to consider opportunity cost/los involveds.
However, I do not understand when you say "travel a bit and before settling into training". As in US, Doctors have to complete their training before they are allowed to obtain license to practise, usually at age of 28. The system in Australia appears to be very different. How much does fully fledged GP/FP earns after overhead expenses in Australia?
The advertisement you posted in another tread for GP/FP in Prince George, BC showing remuneration $180k - $250k is based on fee for service. This amount assumes a full patient load which a new practice will take some time to achieve. The alternative is to purchase a full practice and capital payments will reduce potential cash flow before tax. The commitment must be a long term one, both for patients well being and GP/FP financial standing.

 

[richmond_repn]

Making that much money in Prince George would be worth it considering its not a rural town. Prince George has a population of 80 000 people, they have an up and coming university which has medical students (24). I mean if your an IMG and you really want to practice in Canada, and you have the chance to go to PG you should do it for sure.

 

[Mike59]

This amount assumes a full patient load which a new practice will take some time to achieve. The alternative is to purchase a full practice and capital payments will reduce potential cash flow before tax. The commitment must be a long term one, both for patients well being and GP/FP financial standing.

Doesn't sound like you live/work in Canada.....New GPs can fill a roster in a matter of weeks before they even open the door to their practice. Purchasing a full practice is also a breeze although there's really not much of an incentive to do so in the current market, retiring physicians are almost at the point of "giving away" their practices since nobody is taking new patients.

I see absolutely no reason why someone can't apply for that position and be making the monthly equivalent of that salary right off the bat.

 

[Nucana]

Making that much money in Prince George would be worth it considering its not a rural town. Prince George has a population of 80 000 people, they have an up and coming university which has medical students (24). I mean if your an IMG and you really want to practice in Canada, and you have the chance to go to PG you should do it for sure.

But why do most IMGs move to the bigger cities after a few years? Governments have realized that this is a short term measure. Ontario, Alberta and BC have started to aggressively deal with the severe shortages by accepting from and training more students/residents in Northern communities..

 

[Nucana]

Doesn't sound like you live/work in Canada.....New GPs can fill a roster in a matter of weeks before they even open the door to their practice. Purchasing a full practice is also a breeze although there's really not much of an incentive to do so in the current market, retiring physicians are almost at the point of "giving away" their practices since nobody is taking new patients.

I see absolutely no reason why someone can't apply for that position and be making the monthly equivalent of that salary right off the bat.

Refer to extract of last para of advertisement which is shown below where practice for sale is specifically stated. BC is very different from Ontario.

From DrIng
[Default.]
For info I found this recently...
Physician Vacancy #100-0006 return to vacancy list
Specialty: Family Practitioner/General Medicine

Qualifications: CMPA Membership (Mandatory)
Comments: Prince George is a growing, thriving community requiring additional family practitioners to serve its population. There are several vacancies; some existing practices are for sale and opportunities are available to establish new practices. Will have the opportunity for clinical and/or academic affiliation to the Northern Medical Program beginning fall 2004.

 

[Nucana]

In the above posting, I was asked by MIKE59 whether I livework in Canada. I have been in the Greater Vancouver Area for several years.

Due to public outcry and government response, Ontario's present severe shortage of GP/Fp should be a medium term one.. The Province has acted by increasing FP residency positions by 141 to 337 per year in 2006 compared to two years ago. Ontario has also started setting up Family Health Teams which consist of Nurse Practitioners, Nurses and other health professionals working with FP/GP. As a result GP/FP are able to attend to many more patients, and over 100 FHTs is to be formed in Ontario.

BC has also increased new med school spots from 128 in 2001 to projected 256 each year by 2008. Like the other provinces most of the increase will be channeled to FM. It is not uncommon for FP/GP practices to be soldin GVA andVictoria..

 

[DrFrankenstein]

I hate to over simplify the issue but it's primarily about lifestyle. I grew up in a small town and living even an hour from the city feels like living on Mars if you're not into outdoors activities. By the time I left I was ready to snap if I had to listen to one more conversation about how the crops were doing.

I really don't think I would want to pursue Family Medicine by the time I'm done. Right now I find many other fields much more engaging and the only option to practice is in a major center. And while to money can be good, a GP and a Specialist have gone through a majority of the same training and if you pick the right field you can almost name your price in some areas. And after 20 years of school, the difference of an extra two to four years of education seem quite insignificant.

The point raised about having limited additional staff and resources is valid. While it's nice to have no shortage of work, being one of too few doctors in a community can quickly lead to burnout, especially if one is on vacation or extended leave. Everyone comes to you with their problems and you have to be "a jack of all trades" to satisfy the wide range of needs.

For some the idea of being a big fish in a small pond is appealing. Being a doctor in any medium or larger sized city isn't all that impressive but in almost any small town you're well known and a pillar of the community.

 

[Giemsa]

It's alive!