RM of Eldon No. 471 Spring Ratepayers Meeting

April 10, 2013

Agenda

• Current Situation • Students & Residents • Direct Recruitment • What the Doctors Say • Retention – We All Play a Role • Questions

• 2nd fastest physician growth (8.4%) in Canada • 2007 = 1,644 physicians • 2011 = 1,928*

• Rate more than twice Canadian average

• Rural physicians (family) 243 to 256

• “Canadian trained” increase of 14.3%

• IMG decrease of 4.7%

Source: CIHI Report Released November 16, 2012*

Current Situation Current Situation

saskdocs’ Role • Mission: Promote and support an environment that

attracts and retains the physicians Saskatchewan requires, by: – Promoting Saskatchewan as a province of choice – Coordinating and supporting organizations that recruit physicians – Serving as a point of contact for physicians seeking recruitment – Recruiting, screening, advising, assisting and matching potential

candidates – Creating a more effective recruitment environment that lessens

competition – Collaborating with regional health authorities, communities,

physicians and medical graduates to develop sustainable recruitment and retention

– Promoting and supporting effective policies – Helping medical graduates pursue careers in Saskatchewan

Recruitment Needs to 2020

Add: To keep up with population demand 79

Add: Equalize access 17

Add: Unmet need adjustment 45

Add: Projected retirements 74

Turnover from, less retirements 734

Total recruitment needed 949

Source: U of S medical residents 332

Out of province recruitment needed 617

Annual out of province recruitment needed 56

Family Physicians

Janessa Grosenick, PREP 2010 Sun Country Health Region

U of S Students and Residents • Board representation

• SMSS and PAIRS Executive meetings

• CORRP and SR&R Committees

• PREP – PRAS Rural Externship Program

• Student loan interest relief

• Rural and remote practice grant for recent graduates

• Retreat and event sponsorship

• Academic half-days

• Saskatchewan Career Fairs

Canadians Studying Abroad (CSA)

• 3/4 of highly qualified candidates are not accepted to Canadian medical schools

• 3,500 Canadians study medicine outside Canada

• 80 schools in 30 countries have Canadian students enrolled in medicine

• 90% want to return to Canada to practice … very few do!!

CSAs at Ross University, St, Maarten – “by show of hands, how many of you hope to practice medicine in Canada?”

Canadian Resident Matching Service (CaRMS) Top 10

Canadians Studying Abroad (CSA)

CSA Pilot Project Electives Coordination and rule change Family Medicine post grad seats opened to IMGs in 1st iteration College of Medicine Affiliation Agreements and Exchange Agreements

Recruitment

• Canadian conferences and events

• Select United States

• England

• Ireland

• SIPPA targeted recruitment

Arab Health Expo, Dubai – January 2013

Our New Contacts – 2012-13

0

200

400

600

800

1000

1200

1400

1600

1800

Q1 Q2 Q3 Q4

Public NewMedical Learners NewPhysicians New

SIPPA Pre-screening 2012-13

Sent to CPSS, 129

Provisional Ruling, 90

Upcoming SIPPA, 13

SIPPA Participant,

44

Ineligible, 103

In Progress, 318

• saskdocs pre-screening potential candidates

• Pre-screening developed by SIPPA working group

• Known IMGs in

Saskatchewan and Canada

• Growing international awareness

Family Physician Referrals

Year Total

2011-2012 39

2012-2013 151

Regional Health Authorities Hand Offs

RHA # of Doctors Handed Off Cypress 9

Five Hills 23

Heartland 24

Kelsey Trail 17

Prairie North 40

Prince Albert Parkland 31

Regina Qu’Appelle 55

Saskatchewan Medical Association 3

Saskatoon 60

Sun Country 28

Sunrise 37

Hand Off Statistics as of March 6, 2013

Rural & Remote Practice Grant

• $120,000 for recent medical graduates • Rural and remote communities (10,000 >)

Year 1 Year 2 Year 3 Year 4 Year 5 Total

Payment Amount

$15,000 $15,000 $20,000 $30,000 $40,000 $120,000

Eligibility • Available to physicians who:

– Recently trained in Family Medicine

– Hold full licensure

– FT, PT or visiting (locum) services to a rural/remote community in past 12 months

– Began practicing on or after April 1, 2012

– Sign an annual agreement with employer

Physician Surveys

• National Physician Survey – 2010

• saskdocs/Saskatchewan Medical Association (SMA) surveys

• Throughout 2012

• Three surveys: • Medical learners • Exit (Doctors who left the province) • Settlement survey (Doctors who recently arrived)

2010 National Physician Survey

0

5

10

15

20

25

30

35

40

45

50

Type

of p

ract

ice

envi

ronm

ent

Wor

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rson

al li

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alan

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Suffi

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ial c

ompe

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ng e

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nitie

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ieve

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Family Medicine Residents: Single most important factor

2010 National Physician Survey

Source: National Physician Survey. www.nationalphysiciansurvey.ca

Solo, 1.5

Group/Association 27.2

Group/partnership10.5 Interprofessional

30.5

Other, 2.7

Unsure, 27

Family Medicine Residents preferred practice type

2010 National Physician Survey

Very Satisfied,

16.6

Somewhat Satisfied, 37 Neutral, 9.5

Somewhat Dissatisfied,

19.7

Very Dissatisfied,

9.8

SK Family Physician Satisfaction with Work - Personal Life Balance (%)

Very Satisfied,

19.1

Somewhat Satisfied,

27.6 Neutral,

11.1

Somewhat Dissatisfied,

19.3

Very Dissatisfied,

10.1

SK Specialist Satisfaction with Work - Personal Life Balance (%)

Saskatchewan Specialist Physicians

Saskatchewan Family Physicians

Source: National Physician Survey.

www.nationalphysiciansurvey.ca.

45 %

13 %

10 %

8 %

6 %

4 %

4 %

3 %

2 %

2 %

1 %

1 %

1 %

1 %

0 % 10 % 20 % 30 % 40 % 50 %

Work-life balance

Career opportunities for spouse/partner

The community as a whole

Adequate support to do your job

Proximity to family and friends

Income (including benefits)

Professional development opportunities

Commute time

Financial incentives

Availability of training

Ability to access appropriate care facilities for patients

Electronic Medical Records

Flexible work hours

Proximity to an international airport

Medical Learner Survey Single Most Important Factor

Source: saskdocs - SMA (Insightrix) Medical Learner Survey, April 2012.

Medical Learners Survey Preferences

47%

19%

34% Four-Five

Two-Three

Six and Up

Group Practice

Source: saskdocs - SMA (Insightrix) Medical Learners Survey, April 2012.

Medical Learners Survey Call Preferences

Zero 3%

One 33%

Two 50%

Three 8%

Four 6%

Saskatchewan Residents/Medical Students Evenings

Source: saskdocs - SMA (Insightrix) Medical Learner Survey, April 2012.

Exit Survey Primary Reasons for Leaving

14 %

16 %

24 %

28 %

32 %

32 %

48 %

0 % 10 % 20 % 30 % 40 % 50 % 60 %

Other

Compensation not competitive

Not enough support

Weather

Workload too much

Location/lack of amenities

Be closer to family

Family

Family

Source: saskdocs - SMA (Insightrix) Physician Exit Survey, April 2012.

saskdocs Satisfaction Survey

44 %

46 %

37 %

35 %

33 %

48 %

33 %

42 %

27 %

10 %

92 %

79 %

79 %

62 %

42 %

Specific community thatyou practiced in

Specific facility that youpracticed in

Specific practice/clinic thatyou were a part of

Proximity to aninternational airport

Weather

Location Specific

35 %

39 %

40 %

40 %

48 %

52 %

27 %

50 %

40 %

44 %

46 %

27 %

23 %

25 %

25 %

23 %

27 %

54 %

31 %

44 %

40 %

42 %

62 %

62 %

65 %

65 %

71 %

79 %

81 %

81 %

85 %

85 %

89 %

Call rotation

Work-life balance

Mentorship available in your workplace

Opportunities for advancement

Availability of training

Adequate support to do your job

Relationship with colleagues/otherhealthcare providers

Access to specialists/therapists on behalf ofyour patient

Compensation method

Professional development opportunities

Income (including benefits)

Working Conditions Specific

Settlement Survey “Soft Landing”

39 %

29 %

24 %

22 %

20 %

12 %

12 %

10 %

10 %

7 %

2 %

54 %

0 % 10 % 20 % 30 % 40 % 50 % 60 %

Assistance to obtain documentation to begin…

Practice orientation

Picked up at the airport

Orientation to the community

Orientation to facilities and services

Securing housing

Orientation to other facilities and services in the community

Securing transportation

Assistance to connect with other members of the community

Educational assistance for your family

Assistance to secure spousal employment

None of the above

Source: saskdocs - SMA (Insightrix) Physician Settlement Survey, April 2012.

Recruitment and Retention Incentives – Consultation

• Consultations in 2011 – RHAs, NMS – Municipal officials, SUMA, SARM – Ministry of Health – Saskatchewan Medical Association (SMA) – Student Medical Society of Saskatchewan (SMSS) – Professional Association of Internes and Residents of

Saskatchewan (PAIRS) • Approximately 180 participants • Results analyzed and synthesized

Highlights Recruitment Retention

Financial Incentives Practice Establishment/Relocation Assistance Student / Resident Bursaries Rural Experience Work – Life Balance Family Engagement Collegial Relationships

• Work life balance is a common theme

• Family is a large driver

• Money appears to have a “minor” role

• Development of Best Practice Handbooks

Summary

• Saskatchewan is not alone • Physician shortages in every province • Around the world • “Quick Fix” solutions don’t work • Multi-faceted solution required • Each partner (communities, municipalities,

government, doctors) all play a role

www.saskdocs.ca

http://www.saskdocs.ca/