Rurality index changes will affect doctor recruitment

Jeff Green | Jan 14, 2010

The new Ontario “rurality index” grades community health care needs primarily on the basis of population density and their distance from hospitals and other medical services, and will likely put doctor recruitment campaigns in places like Verona at a disadvantage.

The new index is slated to streamline the system for determining what kinds of funding programs communities and clinics will be eligible for. It replaces a rurality index that was established in 2004, as well as the 40-year-old “under-serviced area” designation, which “does not make sense at all any more” according to Andrew Morrison, a spokesperson for the Ministry of Health.

According to a Ministry of Health media release, “The government is proposing a financial incentive program designed specifically to attract physicians to northern and rural communities. This program would combine existing physician recruitment and retention funding from the Incentive Grant and Free Tuition Programs into a single fund.”

In order to qualify for some provincially-funded incentive programs that can help communities pay bonuses to doctors and medical students they are trying to entice into their communities, a minimum score of 40 is required on the new index. Verona scores a 25 on the index, while Sharbot Lake scrapes through with a 40 and Northbrook scores 56.

John MacDougall, a member of the Verona Doctor Recruitment Committee, takes issue with the geographic boundaries that were used to come up with the designations. South Frontenac as a whole was considered.

“Sydenham might be 20 minutes from KGH, but Verona isn't,” he said, “and the Verona clinic serves patients from Godfrey and beyond who are not well served by the new index.”

Lynn Wilson, the administrator for the Rural Kingston Family Health Organisation, which includes clinics in Northbrook, Sharbot Lake, Tamworth, Verona, Newburgh and Sydenham, also takes issue with the new index, but she acknowledges that the system it is replacing was seriously flawed.

“When the rurality index popped up in 2004, it became clear that it was difficult to determine what a rural grading might be for any township. Some of the scores that were assigned made little sense. Sharbot Lake was only one point higher than Verona and Northbrook was lower. One good thing that has happened with the new designation is that Northbrook is corrected to where it should be,” she said.

The winners in Frontenac and Lennox and Addington County, Northbrook and Sharbot Lake, are also the communities whose clinics are or will become Family Health Teams, which carry a significant provincial investment, and an improved range of services, all of which are seen as helpful in doctor recruitment. This is all in addition to doctor recruitment funding that will likely flow from the rurality index.

The news is not as good for the clinics in Verona and Tamworth, both of which are staffed by doctors who would like to retire in the coming years.

“It's not going to be easy for Tamworth or Verona,” said Lynn Wilson, “but then again in Verona's case the clinic has never been eligible for many rural benefits because it has always been on the borderline of the designations. But now it will not be eligible for any at all.”

The other two rural clinics north of Kingston, in Sydenham and Newburgh, are in a better position because their doctor situation is more stable at the moment, according to Wilson. “It can become even more difficult when you consider that the majority of the family physicians coming into the field are mothers with children. They tend to want a practice with a roster of 1,200 to 1,300 patients, not the 2,400 patient rosters that retiring doctors often have. So it can take two doctors to replace one who is retiring.”

The New “Rurality Index” will be finalised soon and will be brought back to Queen's Park. The new incentive program for rural and northern doctors is slated to be in place in 2011, according to Andrew Morrison.

The Verona doctor recruitment committee is planning to announce a new phase in their campaign involving the Verona clinic in the coming weeks.