Rural Canadians travel far for specialists: study

Canadians living in rural areas have to undertake long treks to receive medical treatment from specialized physicians, a new study says.

Nine per cent of all physicians in Canada worked in rural areas in 2004, home to about 20 per cent of the population, according to a report issued by the Canadian Institute for Health Information.

That's unchanged from the mid-1990s, despite a wide variety of strategies implemented by provinces and territories.

The report shows that the distances between rural populations and specialist physicians such as obstetricians, pediatricians and general surgeons can be more than 100 km, and even several hundred kilometers for the territories.

While the average distance for an urbanite seeking treatment a pediatrician in the most populated urban centre was 3 km, the average distance was 149 km in the least populated towns and 846 km in the territories.

Also, the average traveling distance to a psychiatrist was 2 km in big cities, compared to 144 km in the most rural communities and 957 km in the remote communities of the territories.

When broken down by category, the study shows that nearly 16 per cent of family physicians and slightly more than 2 per cent of specialists worked in rural areas.

Report co-author Dr. Raymond Pong of the Centre for Rural and Northern Health Research says it is not surprising to see fewer specialist physicians in rural areas because they are "fewer in number and often need specific facilities, equipment and support staff to practice."

The study also suggests that the scarcity of specialists is driving rural general practitioners to adapt in an effort to meet the need of their patients.

Rural family doctors do not work the same way their urban counterparts do. They generally offer a wider range of services because in many small towns a specialist may be hundreds of kilometers away.

For instance, 74 per cent of family doctors in the least populated areas provided emergency room care, compared to 15 per cent of their urban counterparts. Also, 33 per cent of family doctors in Canada's rural areas delivered babies in 2004, compared to 9 per cent of family doctors in the biggest cities.

The report also suggests that rural doctors are increasingly following the general trend of narrowing the scope of their practices, indicating the situation may be about to shift. "If rural family doctors didn't provide some specialty services, many people would be forced to travel even greater distances to get medical care-or they would simply go without," says co-author, Dr. Roger Pitblado of the Centre for Rural and Northern Health Research.

"In some parts of Canada, health care delivery programs—such as telemedicine, rural travel allowances, visiting specialists and air ambulance services-assist in bridging distances between urban doctors and rural Canadians," CIHI says in the report.