Mandryk: Sask. must find a way to keep our doctors

By Murray Mandryk

Perhaps the saddest story in Saskatchewan history is keeping our children at home — especially the best and brightest of our children.

Consider the ones who became doctors:

According to the Canadian Institute for Health Information (CIHI), of the 2,112 active practicing doctors in 2020 who graduated from the University of Saskatchewan medical graduates, only 931 or 44 per cent were practicing in Saskatchewan.

We are obviously not alone in this dilemma. All provinces lose doctors to the United States — especially at the surgical or specialist level.

In the highly competitive field of medicine, there is further penchant to lose doctors to places with larger urban centres where it may be easier to set up a thriving practice, practice with the support of more colleagues or practice a specialty in larger, more advanced hospital centres.

By comparison, Manitoba fares only slightly better, retaining slightly more than 50 per cent of the University of Manitoba’s medical school graduates. (However, it should be noted that the U of M medical school does have more seats.)

The reality is the problem of retaining doctors is more acute on the prairies — largely because of our sparse rural population and large northern area that present specific challenges when it comes to attracting doctors.

The CIHI numbers further underscore the problem:

In Saskatoon, a majority of 68 per cent of the current practicing physicians are Canadian medical school graduates compared with 32 per cent that are the International Medical Graduates (IMG).

However, this is the only place where this is the case. In Regina, 55 per cent of the doctors are IMGs while 45 per cent are Canadian medical school graduates. In the rest of the province, a whopping 76 per cent are IMGs, while only 24 per cent are Canadian medical school graduates.

These numbers come courtesy of Simon Fraser University professor and long-time health policy analyst Steven Lewis who wrote that Saskatchewan’s “health system would be sunk”.

Even as it is, Saskatchewan is further struggling to keep what doctors it has.

The NDP Opposition further noted last week that the 2,530 full-time doctors currently practice in this province worked out to 215 doctors per 100,000 residents.

That’s less than the national average of 242 doctors per 100,000 people. Logic dictates we need more doctors per capita because of our sparse population.

What has prevented the situation from being much worse is Saskatchewan benefits from Canadian government policy assigning newly arrived foreign doctors to areas of the country where they are needed.

Often, when those IMGs establish themselves in Canada, they, too, move on to other places.

“Don’t blame Canadian-trained doctors for not settling in rural Saskatchewan,” Lewis wrote in the article. “No one else does, either.”

The health policy analyst who grew up and spent much of his working life in Saskatchewan noted that doctors — like other professionals everywhere in the world who grow up in smaller communities — will always want to gravitate to places where there is a “population density to support a school, bank, theatre, supermarket and a hospital in every town.”

So we shouldn’t be surprised by now that Saskatchewan isn’t a preferred destination for doctors, Lewis said.

“I grew up in Saskatchewan, and the topography and emptiness are just features of home,” Lewis wrote. “But skies live elsewhere too.”

That observation drew condemnation from some Saskatchewan Party MLAs debating the issue.

But being upset at a frank assessment doesn’t solve the problem.

To the government’s credit, it re-emphasized doctor recruitment in the March budget, but Lewis suggested we look deeper than that.

He called for an “overhaul and expand primary care” creating clinics “where doctors, nurses, therapists, psychologists and pharmacists work in teams.”

It may not be a perfect solution, but the numbers tell us we may have to try something different.