Chester Gillan, Minister of Health today announced that the province is launching an enhanced Physician Recruitment/Retention and Medical Education Strategy.
In the recent spring budget speech, government announced 2.7 million dollars for new physician positions and recruitment and retention initiatives. The new enhanced strategy allocates approximately 500,000 additional dollars from that allocation, resulting in the recruitment, retention and medical education budget increasing from 1.5 million to approximately two million dollars, a 33 percent increase. This leaves approximately 2.2 million dollars for new physician positions.
The new strategy will offer initiatives which address the financial, professional and lifestyle concerns by targeting three distinct groups including physicians in training, physicians being recruited to the Island and physicians currently in practice on PEI.
Minister Gillan said, “The new strategy is an integrated and comprehensive approach to the education, recruitment and retention of physicians for practice on PEI. The mission is to provide appropriate healthcare in all communities in PEI and to promote, maintain and improve the health of its residents. We also aim to enhance the career, educational opportunities and personal life of our physicians.”
During this past winter, staff in the Department of Health renewed discussions with the Dalhousie Medical School to explore options for an on-Island Medical Residency Program. In conjunction with Dalhousie and Memorial University Medical Schools, the Department of Health will be considering options for expansion. Options may include the development of Centres of Excellence for family medicine residents, a new Island-based Family Residency Training Program, or creation of a third-year extended Family Medicine Training Program in areas such as Geriatrics, Palliative Care and Emergency Medicine.
In April 2000, the Prince Edward Island Physician Recruitment Program was implemented to address a shortage of both family and specialty physicians in the province. Since that time, more than 90 new doctors have been recruited to PEI. During this time, some doctors have chosen to leave. However, there has been a significant net gain in the numbers of doctors currently practicing on PEI.
Physician numbers have increased from 149 in 1996 to the current level of 182 active full-time physicians. With the latest spring budget, the physician complement on PEI has been expanded to 202 available full-time positions and the strategy aims to fill those positions. The Island’s base of physicians continues to expand in small increments each year.
Minister Gillan said, “Attracting physicians and keeping physicians on the Island is a continuing challenge. There is a shortage of physicians across North America and physicians may leave the Island for a number of reasons. The physician workforce is changing with many more female physicians in training and most medical graduates looking for a workload balance so they have time for family and other interests.”
“As a result, Government will be continuously reevaluating and increasing the overall number of physicians on PEI with the goal to having all Islanders have access to a family physician and specialist if required,” added Minister Gillan.
Studies show that recruitment and retention of physicians is affected by two major categories – professional and lifestyle issues. Multifaceted recruitment programs appear more successful than those relying on financial incentives alone.
Dr. Richard Wedge, Director of Medical Programs, said, “The new strategy differs from the original plan in that its focus expands beyond financial incentives. The new strategy builds upon strengths of the original plan by enhancing existing initiatives while introducing new ones. We recognize it is important to combine professional practice and personal issues, in addition to the financial concerns of physicians.”
Negotiations for the Physician Master Agreement in 2004 allowed both government and physicians to remove some of the barriers to recruitment and helped to ensure Island physicians are paid a competitive rate. The new contract helped the province remain competitive with other Maritime provinces to attract and keep our physicians while living within our means.
Dr. Wedge added, “We are confident that our strategic initiatives in physician recruitment and retention will allow competitive compensation, a fulfilling professional career and a balanced lifestyle advantage that will allow us to provide stable access to medical services.”
The strategy recognizes that recruitment and retention of physicians is a shared responsibility and success demands increased involvement from numerous individuals and organizations. This team effort includes the Department of Health and its designated recruitment staff, Island physicians and medical office staff, and individual communities and their leaders.
“The Department of Health would like to recognize the work of the Medical Society of Prince Edward Island in this recruitment partnership. We will continue to work collaboratively to achieve our shared goals of providing high-quality health care to Prince Edward Islanders,” said Minister Gillan.
BACKGROUNDER
Physician Recruitment/Retention and Medical Education Strategy
The new PEI Enhanced Physician Recruitment/Retention & Medical Education Strategy offers initiatives which address the financial, professional, and lifestyle concerns of today’s physicians by targeting three distinct groups: physicians in training, physicians being recruited to the Island, and physicians currently in practice on PEI. The initiatives are aimed at each of these different groups, yet they are designed to support and build upon each other.
Family physicians are the foundation for publically-funded and accessible health care. They are usually a patient’s first point of entry into the health care system. At the present time, approximately 4000 Islanders are registered with the Department of Health’s Patient Registry as seeking a family doctor. With 138,900 Islanders registered with our Medicare office, this means 97.1% of Islanders currently have a family doctor which is well above the national average of 85.8% recently reported by Statistics Canada.
In the budget speech, the government announced 2.7 million dollars for new physician positions and recruitment and retention initiatives. The new enhanced strategy allocates approximately 500,000 additional dollars from that allocation resulting in the recruitment, retention, and medical education budget increasing from 1.5 million to approximately two million dollars, a 33 percent increase. This leaves approximately 2.2 million dollars for new physician positions.
HIGHLIGHTS FROM THE STRATEGY
The enhanced strategy builds on existing initiatives established in the April, 2000 physician recruitment and retention strategy with numerous additional areas. The following information reviews new initiatives in the strategy and there is a table at the end of this document which reviews all components of the strategy - including those initiatives which are continuing from the previous strategy.
Medical Residency Debt Reduction Program
This program was designed to offer incentives to medical residents to come to PEI to practice. The program provides funding in the form of a return-in-service grant. Sponsorships are available to residents in training who agree to return to PEI to practice for a minimum of two years. Currently family physicians are offered $20,000 and specialists are offered $25,000. These amounts will be increased to $30,000 and $40,000 respectfully. These increases will allow PEI to remain competitive with other provinces.
Site Visits
Site visits are funded to provide prospective physicians an opportunity to visit the province and get a first hand look at the working environment and Island lifestyle. Physicians and spouses/families are invited to PEI to visit, typically for three to five days. While on the Island, potential recruits tour hospitals and medical facilities and are introduced to medical staff.
Under our enhanced program, these site visits will be coordinated between community physicians and community leaders. This will allow individual communities an opportunity to meet physicians interested in their facilities and allow the community to showcase themselves in a better coordinated fashion.
Return-in-Service Grants
Return-in-service grants are offered to newly-recruited physicians relocating to fill a vacancy in the province. Grants of $10,000 were offered, with $5,000 bonuses available to physicians willing to commit to two years or beyond, physicians committing to practice in rural communities, and to specialist physicians. These grants are being increased to $20,000 for family physicians and $30,000 for specialists.
Moving Allowance
A relocation cost assistance program offers new physicians assistance with moving and travel expenses while relocating to PEI. Physicians who are prepared to relocate to Prince Edward Island and commit to provide one year of service are eligible. Under the existing program, Moving Expense assistance ranges from $3,500 to $10,000 and is determined by the location from which their move originates. These allowances will be increased to a minimum of $5,000 and to a maximum of $15,000.
Family Medicine Residency Training Opportunities
In the past ten years, many Island students received this training through programs based in Halifax, Saint John, Fredericton or Moncton. New initiatives are being pursued to allow these residents in training more opportunities to train on PEI with Island physicians. These opportunities could include full-time, on-Island training, or training in specific areas of medicine such as pediatrics, psychiatry or emergency medicine.
During this past winter, staff in the Department of Health renewed discussions with the Dalhousie Medical School to explore options for on-Island Medical Residency Program. In conjunction with Dalhousie and Memorial University Medical Schools, the Department of Health will be considering options for expansion. Options may include the development of Centres of Excellence for family medicine residents, a new Island-based Family Residency Training Program, or creation of a third-year extended Family Medicine Training Program in areas such as Geriatrics, Palliative Care and Emergency Medicine.
The Department of Health through the Medical Programs Division has set up a Project Team consisting of government staff and local physicians who will work with Dalhousie Medical School and Memorial University to develop time lines for the establishment of this training as soon as possible.
Specialist Training Opportunities
Specialist physicians are critical to the acute care sector. We currently offer a wide range of specialized services across this province and that is only possible with the services of highly trained and experienced doctors.
Specialist training requires four to five years of university hospital-based training beyond the student’s four year medical degree.
The Specialist Training initiative will provide funding to physicians who wish to pursue specialty training in areas of need and/or upgrade their current certification. Assistance will be in the form of a return-in-service commitment and the level of compensation is determined by the training university in consultation with the Department of Health. This initiative will assist PEI in obtaining physicians in areas of particular specialty need.
Islanders Studying Medicine Abroad
Islanders studying in foreign medical schools find there are substantial barriers in enabling them to return to practice in Canada.
The Department will fund training positions to recruit Island medical graduates from non-Canadian medical schools who require additional training to meet the requirements of the College of Physicians and Surgeons, and the Medical Licensure Authority of Canada. These provincially-funded training positions will be assessed on a case by case basis. Funding for these positions will be limited to a maximum of two per year at $100,000 each. Upon completion of the residency training program the physician will be required to practice on PEI via a five year return-in-service agreement.
Fee-for-Service Guaranteed Income
The province will develop a program whereby physicians who relocate to the province on a fee-for-service payment modality will be guaranteed an annual income of $200,000 for full time work.
This compares to a minimum guarantee of $180,000 in Nova Scotia and $175,000 in New Brunswick. This initiative will assist in providing patients with ongoing access to Family doctors and allow physicians some flexibility in choosing their preferred method of payment without suffering financial hardship.
International Educated Health Professionals - IMG Component
This initiative will enhance the ability to recruit physicians to PEI through assistance in the assessment of credentials of International Medical Graduates (IMGs). PEI will partner with Nova Scotia to achieve maximum return for the investment through the sponsorship of the assessment of IMGs, and participate in required educational enhancements recognized during the assessment. This partnership will also include the development of a physician-led mentorship program for physicians
Retention Initiatives
An increased focus will be placed on the retention of our current physician workforce, including the following efforts:
1.Regular follow-up with new physicians to ensure a positive experience integrating into the medical and social community;
2.A coordinated approach for physicians to bring forward concerns with respect to adjusting to professional and personal life in the province; and
3.Recognition for levels of long service and acquisition of special skills.
Office Medical Equipment Fund
In the current medical practice environment, and with new graduates in particular, physicians are looking to work in a technology friendly environment. New technology not only supports quality patient care, it becomes a recruitment tool.
Physicians have expressed concern over the cost of office medical equipment. Due to changes in medical technology, more surgical procedures, which used to be done in a hospital setting, are being done in physician offices.
Our enhanced strategy recognizes this need and will provide up to $30,000/year to provide this equipment where necessary.
An Office Medical Equipment Fund will be available to salaried physicians to assist in acquiring specialized office equipment necessary to their medical practice.
Physician Leadership Program
A Physician Leadership Bursary Program will be established whereby four bursaries will be available annually to Chiefs of Staff and Medical Directors to attend physician leadership courses.
Continuing Medical Education
The Continuing Medical Education (CME) Program is an initiative which supports practicing physicians by providing educational opportunities to maintain, develop, and increase their practice skills and knowledge in the medical field. Keeping up to date in the profession maintains and promotes quality of the clinical practice.
A relationship has been developed between the Medical Education Program and the Medical Society to work in partnership to provide two such educational sessions per year, focused on teaching and practice topics. The program funding was increased to $140,000 per year in 2004/05 and is administered by the Medical Society of Prince Edward Island.
Locum Support
The Locum Support Program offers support to physicians wishing to fill temporary physician locum vacancies in the province. Funding is used to identify locums, assist with their travel and accommodations, and remove barriers such as additional licensing and professional dues associated with practicing in an additional jurisdiction.
The Locum Support Program will attempt to provide continuous physician services when temporary physician vacancies exist in the province. The program provides physicians with coverage in their practices during times of temporary absence for reasons including extended vacation, continuing medical education, illness, and maternity leave. The priority of this program is to relieve some pressure of providing on-call services.
A centralized database will be developed, providing easy access to potential replacements for physicians seeking locum services and outline opportunities for locums who contact the recruitment program looking for opportunities.
Currently this program provides funding of $100/day or $500/week or $2,000/month. Under our enhanced program physicians providing services to our rural hospital Emergency Rooms will be paid $150/day or $750/week or $$3,000/month. This increase will allow these physicians to offset some additional costs associated with working outside of the urban areas.
Community Development
In cooperation with communities across the province, community liaison leaders will be identified who will work with the Provincial Recruitment Coordinator. The role of the Community Liaison Leaders will be to facilitate the involvement of the communities in the recruitment and retention of physicians for the people of their communities.
The ultimate goal is to create welcoming communities, enabling physicians from different countries and backgrounds to feel at home. This would involve the development of welcoming committees, welcoming incentives, orientation to community services, and the establishment of support systems to nuture the sense of ‘belonging’ and commitment.
The Department’s new recruitment coordination efforts will support the Island’s seven hospitals, the Family Health Centers, the private physician clinics, and individual community needs throughout the province. These partnerships will be critical for the successful recruitment of new doctors and retention of current physicians.
Marketing and Promotion
The Department will be reviewing its current advertising techniques to recruit physicians to vacancies in the province. They will work with Strategic Marketing and Design to develop a new design for advertisements and promotional material. Promotional material will be translated and made available in the French language. A student/resident newsletter for Island medical students and residents will be developed and published electronically on a monthly basis.
The web site for physician recruitment will be redesigned with the intent of providing easier access and more comprehensive information. Physicians will not only have access to a list of current vacancies but will also be able to obtain essential information about the position.
The Department will be developing data collection methods of recruitment activity which will be shared across the province on a regular basis. Efforts will be made to focus on testimonials and success stories adding a positive direction for the program.