Ed Bedford says his small town isn’t giving up on its hospital — they’re spending their own money to find a second doctor after they were down to zero not long ago.
“We weren’t even sure if our hospital was going to stay open,” said Bedford, deputy mayor of the municipality of Glenboro-South Cypress.
“We were down to the nurse practitioner, and there are limits to what they can do.”
Glenboro-South Cypress, a municipality of just over 1,100 people about 160 kilometres west of Winnipeg, is one of several small communities in southwestern Manitoba spending tens of thousands of dollars on a recruiting firm in an effort to find doctors.
Officials in the municipalities of Hamiota and Killarney-Turtle Mountain also say they have hired Winnipeg-based recruiting firm Waterford Global. Prairie Mountain Health, their regional health authority, is splitting the cost, which can be anywhere from $90,000 to $150,000 per doctor.
The Glenboro Health Centre’s emergency department closed six times in 2023, with the total closure time adding up to more than 56 days, say documents obtained by CBC under a freedom of information request.
Glenboro does have one doctor again after the health authority assigned an international doctor to the community, but Bedford doesn’t think they’ll get a second that way, because other communities also need doctors.
The area has a health action committee that raised enough funds to cover half the cost of hiring the recruiting firm, Bedford said.
“It would have [been] way better if the provincial government or whoever put up the money and got the doctors in here, but it’s not happening,” he said.
Treena Slate, CEO of Prairie Mountain Health — the health authority in southwestern Manitoba — said the region is short approximately 80 doctors.
Hiring a recruiting firm is expensive and the process can take a full year, but the health region has had to explore every avenue possible to fill the gap, she said.
“We want to make sure that communities are going in this with a broad understanding of what they’re signing up for.”
Prairie Mountain Health has been assigned five international doctors a year, who work in the region for a minimum of four years after they complete a one-year training program at the University of Manitoba, Slate said. That program has expanded, so Slate hopes the region’s allocation of doctors will also increase.
Prairie Mountain has 18 operating emergency departments — a lot compared to other regions, Slate said, but only six are open 24/7.
The 18 operating emergency departments include Carberry’s, which closed indefinitely on Aug. 23.
Melita’s, which closed on Sept. 1, is no longer counted among the 18 operating emergency departments on the health authority’s website.
Also not on the list are Winnipegosis, which closed indefinitely in 2012, and Shoal Lake, which closed in 2015, although its emergency department is still classified as “temporarily suspended.”
On a list of 34 Manitoba hospitals that saw temporary emergency department closures last year — ranging from a few hours to, in effect, the entire year — 15 are in the Prairie Mountain Health region (a number that includes Melita).
‘Need to think a little differently’ about ERs
Historically, the area had even more emergency departments, but the health region is trying to provide alternatives in some small communities, Slate said.
“I think we need to think a little differently about how we have thought traditionally around the need for emergency care,” she said.
“For Melita … we are investigating ways to provide them better and primary care services as an alternative.”
In the past, some communities paired up to open their emergency departments on a rotating basis, which Glenboro did with Carberry at one time.
WATCH | Towns take hands-on approach to address doctor shortages:
Better access to primary care can also create less reliance on emergency rooms, said Slate.
“I think there’s definitely a need in the system in general, in our country, to examine that historical model of care … being the acute care hospital with the emergency room with the physician,” she said.
The health authority needs to make sure emergency departments are available throughout the region, not clustered together. Good ambulance service could then bridge the gaps, Slate said.
She also looks forward to seeing how the provincial government delivers on its promise to step up its efforts to recruit health-care workers.
Manitoba Health Minister Uzoma Asagwara said their government is working on it, pointing out the 2024-25 provincial budget increased the health-care recruitment fund to $32 million from $25 million.
“I didn’t become the health minister to close rural emergency rooms,” they said.
Recruitment success
Prairie Mountain isn’t the only Manitoba health region that’s worked with Waterford Global to find doctors. The Interlake-Eastern Regional Health Authority used the agency to recruit two doctors in 2014.
The Northern Health Authority said it has not hired the recruiting firm. Southern Health, the other rural Manitoba health authority, did not respond to questions about whether it’s used recruiting firms.
Glenboro’s plan to hire Waterford Global, which won’t get paid until the search is a success, was inspired by Killarney-Turtle Mountain. That municipality is using the firm for a second time, after hiring Waterford Global in 2016. With the company’s help, it found two doctors at that time.
“They came and they stayed,” Killarney-Turtle Mountain Mayor Janice Smith said. “It was great. It worked out really well.”
However, one of those doctors is heading back to Ireland for personal reasons after five years in Canada.
The community should have five doctors but is down to two, Smith said.
Locum doctors — short-term fill-ins who work in a number of communities — have been filling some of the gaps, but after the community’s earlier experience, they decided it was time to hire Waterford Global again, this time to recruit three doctors.
The firm vets doctors and gives them information about the job and the community. After that, there are Zoom meetings and a site visit to make sure the candidate and the community will be a successful match, Smith said.
If all goes well, the doctor signs a four-year agreement to practise in the community.
“We feel as a council that it was very important that we took the extra measures to ensure that we had the proper complement of doctors in our facility,” said Smith.
“We want to keep Killarney as vibrant and vital as it has been,” she said about the community, which is about 50 kilometres southwest of Glenboro.
The emergency department at its Tri-Lake Health Centre had 58 closures in 2023, adding up more than 56 days.
U.K. doctor stays
Rachelle Bemment is the wife of the doctor recruited in 2016 who stayed, and she now manages the health clinic in Killarney.
The adventure started nine years ago, when the Bemments were discussing the possibility of emigrating over dinner in the U.K. and a LinkedIn message from Waterford Global arrived on Dr. Bemment’s phone, asking if he’d be interested in becoming a rural physician in Canada.
It took 18 months before they arrived in Killarney, where they’ve stayed because they found what they were looking for, she said.
She grew up in a community where everybody knew everyone else and people looked out for each other, and that’s what Killarney’s like, she said.
“We’ve made some lovely friends here in Killarney.”
The work-life balance is also better, although the number of on-call hours her husband has is high right now because of the doctor shortage.
In England, he worked from 6:30 a.m. to 8:30 p.m., in part because of the required paperwork, she said.
“I’m not sure we’d ever cope now, going back.”
Retention of doctors is also important, and making sure there’s enough staff helps with that, Bemment said.
“It’s very difficult for a physician … having worked all week and then be expected to be on call for 72 hours in the hospital,” she said.
Hamiota, where the emergency department logged 65 separate closures that totalled 130 days worth of time in 2023, is working on both recruitment and retention, Mayor Randy Lints said.
The municipality is hiring Waterford Global because it wants to get the Hamiota Health Centre emergency department open full-time again, which will also help nearby communities that have lost their emergency departments, Lints said.
Birtle, Shoal Lake and Rivers, which surround Hamiota, all had operating ER services at one time, he said.
“What we were thinking is that, since we still had a fairly vibrant health centre, that maybe this would become more of a regional health centre,” he said.
The Hamiota Health Centre Foundation, which has traditionally raised funds for equipment, is now helping to fund the recruitment effort, Lints said.
Hamiota, about 130 kilometres northwest of Killarney, was down to two full-time doctors and one part-time doctor, but was also assigned an international medical graduate, which has given the community the equivalent of 3.25 full-time doctors, Lints said.
He’d like to have five or six.
‘The province is struggling’
The foundation also has what’s called a return of service agreement with a lab technology student at Red River College Polytechnic in Winnipeg. The foundation is helping fund the student’s education in return for a promise the student will work in Hamiota after graduation.
The community is also trying to make sure its health-care workers feel appreciated, including hosting a thank-you dinner with entertainment for medical and emergency service workers in April.
“You can bring in as many doctors as you want, but if they don’t stay, well, you’re constantly redoing that,” Lints said.
Health care is a provincial responsibility, but Hamiota is done waiting for help, he said.
“The province is struggling,” said Lints.
“We’re wanting to work with the province and wanting to work with the RHA, and hopefully together, we can solve all these issues and make communities safer again.”