THE BATTLE FOR RURAL CARE
For the first time in more than 150 years, Crapaud, P.E.I. is without a family doctor.
In fall 2017, the only family physician, Dr. Joey Giordani, abruptly announced he would be relocating his practice to Cornall. Six months later he would close the practice completely. Patients were informed by a notice posted at his clinic.
Crapaud, located between Charlottetown and the Confederation Bridge, has long acted as a service and health care hub for towns on the island's south shore, including Victoria, Bonshaw, Albany, Tryon and even Borden-Carleton.
That fall, a meeting drew more than 200 from these communities to the Crapaud Community Hall. People were motivated. Some, such as Victoria-by-the-Sea councillor Pat Smith, felt the survival of their communities was at stake.
"Rural Prince Edward Island is under threat as it is right now, losing services and population,” Smith told CBC news.
“I think a healthy robust health-care system in the area is absolutely essential for a healthy, robust community.”
Crapaud's story is one of many examples of rural communities struggling to fill gaps caused by lack of physicians. With less than 10 per cent of Canadian family doctors practising in rural areas and tens of thousands from East Coast towns without a doc, communities are banding together to try and make something happen.
From the meeting in Crapaud, the South Shore Health and Wellness Committee was born. Its mandate included things one might expect a health authority to do.
"We decided we had to make a not-for-profit organization that could advocate for health care services and try and recruit," said secretary Lisa Gallant.
The group also committed to fundraising for supplies for a permanent clinic. It has generated $20,000. By January 2018, it opened a walk-in clinic at the pharmacy.
Gallant owns that dispensary. She decided, in a “leap of faith,” to donate the space. Her business later bankrolled a renovation so it could be used by a future physician. She and her employees have made do with a reduced workspace.
“My staff has given up their kitchen, my staff has given up their stockroom,” Gallant said.
“We can't go on like this.
We're building the facility hoping that government will come on board.”
Health P.E.I. has agreed to fund a nurse practitioner to staff the clinic. Recruitment of a doctor has proven elusive.
It's not for lack of trying. The group has canvassed local doctors, medical residents and posted notices at Dalhousie and Memorial Universities. It has offered free gym and curling club memberships, as well as a year of free rent in the clinic.
"The issue, as I see it, is that government recruitment and retention has us lumped in with Charlottetown,” Gallant suggested.
When given the choice, most physicians have opted for the bigger centre, she said.
Lewisporte, N.L., has a similar story. The town of 3,400 serves as a regional hub.
And like Crapaud, hundreds gathered to address a doctor shortage in 2011. Residents, from Lewisporte and surrounding towns, formed the Concerned Citizens Coalition, and have worked at establishing a new clinic for seven years.
As of now, it has been built, sharing a building with a local pharmacy. But there's still no doctor staffing it.
“Right now, we have a state-of-the art medical clinic with nobody in it. We succeeded in getting that land there. We succeeded in getting a private developer," said Walter Dawe of the Concerned Citizens Coalition.
“We don't know what's wrong.”
The Central Health Authority hasn't been able to recruit a doctor for the clinic, although general physician recruitment efforts in Lewisporte have been successful compared to some rural towns. Still, two physicians left last summer.
In Nova Scotia, communities have taken a different approach towards health care staffing shortages.
Digby is among the hardest hit of communities along Nova Scotia's south shore. Only one doctor serves the town of more than 2,000.
After the departure of three doctors in 2016, the Digby Area Health Coalition (DAHC) formed. It raised money for social science researchers to produce a report diagnosing local health care challenges. The researchers tracked down the departed doctors and asked why they left. The Nova Scotia Health Authority had not conducted exit interviews.
"They described a kind of switch and bait. You come here under certain offers and possibilities for your career when you land in a place like Digby. When you get here, what you thought you were getting into was not what you bargained for,” said Tony Kelly, coordinator for the DAHC.
Kelly said the departed physicians became burnt out due to a lack of support.
"At the end of the day they were all thoroughly exhausted as young people.”
It's the type of story Chris Parsons of the Nova Scotia Health Coalition hears a lot. He believes these stories are feeding a sense of regional alienation in rural communities.
"Everyone feels that somewhere else in the province is getting all the resources. There's a real sense in our communities that the battle for health care in a place like Shelburne or Digby is the battle for saving the community. If you can't fix the health care problem, then the town can't survive."