A boost in pay and the doctor will stay

Our take: It doesn’t take much to understand that doctors want to go where they will be treated well. Part of this is the compensation to not only cover the specialization, but to also cover what it took to get that medical degree.

MD Recruitment; Towns offering money, homes to lure physicians

Tom Blackwell, National Post
http://www.nationalpost.com

For years, Belleville suffered from a severe shortage of family doctors that left thousands of its citizens without a physician of their own.

Then, in less than 12 months, the eastern Ontario city suddenly recruited 10 medical students or residents, who will all but close Belleville’s gap in service as they finish their training and set up practice over the next four years.

Just down the highway, Hastings County has similarly beaten the odds in this time of doctor drought, convincing nine physicians-in-training to practice for at least five years in the community.

Both are pleasant spots with lots of recreational opportunities and the like, but their recruitment success seems tied to something more practical. Each municipality is offering physicians up to $150,000 for a promise to work there at least five years.

The two jurisdictions are among the most aggressive in the burgeoning MD-recruitment industry. Communities across the country, however, are competing with each other to offer inducements ranging from free housing to cars and enough money to pay off huge student debts.

“The physician recruitment area is an incredibly competitive market,” says Laurie Nash, who handles the job for southern Ontario’s Chatham-Kent. “Everyone is doing whatever they can to keep that competitive edgeÂ…. People are being very imaginative.”

Some local politicians say financial come-ons are a small price to pay for an essential service. Others worry the bidding war could create a new kind of health care disparity between places that can and cannot afford pricey inducements.

“I think it’s unethical,” said Bob Shepherd, Mayor of the Toronto-area township of Uxbridge, which eschews such tactics. “You get this endless spiral of one community trying to outdo the otherÂ…. You’re stealing doctors from communities that need them as well.”

What created the trend, of course, is Canada’s worsening shortfall of medical personnel. It is estimated that as many as five million Canadians are without a family physician, and some specialists are in even shorter supply.

Many provinces provide funds to help under-serviced communities recruit doctors. For the past six or seven years, though, individual municipalities have become increasingly sophisticated in their local recruitment attempts, which often include topping up the provincial incentives.

While the task was once handled exclusively by volunteers, there are so many professionals in the field they now have their own group– the Canadian Association of Staff Physician Recruiters — with a membership of about 100.

Many take part in recruitment tours that visit medical schools every year, and arrange visits by prospective physicians — usually medical students or residents nearing the end of their training– to potential new homes.

Financial incentives are increasingly becoming part of the picture, handed over after doctors sign a contract to practice in the community for a certain number of years. It seems to work, at least sometimes.

Manning, Alta., provides $10,000 a year to doctors, and managed to recruit two physicians — a married couple–in 2006. John Broderick, the town’s chief operating officer, feels the idea is not a raging success, however, noting that $10,000 is not much for someone earning a six-figure income, and might hold less sway than other factors.

“One doctor left because he couldn’t get a higher-class music teacher for his daughter,” he said. “If your wife likes opera or live theatre, you’re not going to find it in Manning or High Prairie.”

In Northern Ontario, Ignace, population 1,700, purchased a $185,000 home on picturesque Agimak Lake a couple of years ago to lure a physician to the village, though it has succeeded only in attracting part-time locums. “There’s a lot of competition out there,” said Lionel Cloutier, the Mayor.

The rural municipality of Brock, Sask., also bought a house to provide to doctors. In Manitoba, Boissevain agreed to fund the medical education in Hungary of a local young man in exchange for his working in the community for several years.

Hastings County was among the first in eastern Ontario to offer serious money: $25,000 a year to cover up to six years of medical training for a would-be family physician. The original goal two years ago was to find four doctors, but the program has twice been expanded, luring a total of nine family physicians so far, said Jim Pine, Hastings County’s chief administrative officer.

“People have been talking for a long time that we have to do something,” he said. “The need is urgent and immediate and our council decided to bite the bullet and take action.”

Neil Ellis, the Mayor of Belleville, was elected a couple of years ago on a promise to implement a similar program. He did and has signed up 10 physicians since, with another two on the verge of committing.

He emphasizes, however, that the city does not contract with doctors until they have visited the community and appear won over by its other attributes, an indication they will stay for the long haul. Still, he does not apologize for the head-hunting tactics.

“I come from the business world and in the business world if you want something, you have to have forward thinking to solve a problem,” Mr. Ellis said. “You have to have that little extra bit of retail sense in you to customer orient, and we have that here.”

Meanwhile, a local developer he will not name has offered to build — for free– a set of houses next to a golf course, with the aim of one day attracting older doctors who could ease toward retirement in Belleville.

The cash deals have pitfalls for the new doctors themselves, too, says the Canadian Association of Interns and Residents.

Students who sign up as family physicians when they are still in medical school, for instance, are committing themselves to work in a particular place and in a particular specialty years down the road, even though their personal lives and interests could change in the interim, said Jean-Pierre Martel, a radiology resident and the group’s president.

“Having these incentives come out of municipalities and governments is taking advantage of the fact that med students and residents have had to take on all this debt,” he said.
This originally appeared on the National Post. They have removed this story from their website, but we will keep it on our for archiving purposes.