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SERVICE NEEDS: It’s time to change the old mantra that every town and hamlet needs a physician. Too much time, effort and money are spent trying to attract physicians to rural and remote locations when physicians have little or no interest in relocating to these places. Almost the entire training of physicians is hospital-based and located in secondary and tertiary facilities. With few exceptions, little attention is paid to primary care. The specialists involved in training physicians often have scant regard for primary care and actively encourage specialization.
It’s time to ask what services are needed by the population seeking a physician? This should be readily answerable by examining the billings of a physician’s office to Alberta Health. I would suggest that most of the services provided by general practitioners could well be provided by alternative practitioners. Such things as blood pressure control, diabetes management, depression, fevers, coughs and colds could well be managed by nurse practitioners, pharmacists and others.
The COVID pandemic has demonstrated that remote medicine is practical, useful, accessible and acceptable to both patients and practitioners. Even the follow up of patients with serious illness, such as cancer, can be effectively managed remotely.
Let’s forget about money and start a meaningful discussion about the needs of the population and how best to effectively, efficiently and safely meet those needs. It’s time for Alberta’s physicians to ask what can we do to help the province rather than asking what more can we extract from the province. Alberta’s physicians have enjoyed and continue to enjoy some of the highest payment schedules in the world. Alberta’s physicians enjoy the respect of the community. It’s time for them to pay back some of that respect.
Colum Smith is a former dean of medicine at the University of Saskatchewan and an executive fellow at the School of Public Policy, University of Calgary.