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Hippocratic oath meets Herculean challenge Add to ...

Cary Pettinger still remembers how the locals convinced him to work in Dryden. "They tricked me!" he jokes, laughing amicably.

To be fair, the recruitment team at the Dryden Health Centre wasn't exactly devious in its plot to bring Dr. Pettinger to the town 350 kilometres northwest of Thunder Bay. They were simply creative. At a medical conference, they set up a raffle for a free float-plane ride, and while they were at it they gave him their sales pitch. Five years later, Dr. Pettinger still works in the emergency room here.

It takes that kind of creativity to snag a doctor when you're a small northern town. As the torch relay turned north again through the lake-mottled lands of Northwest Ontario, it passed through plenty of communities that would be lucky to attract even one doctor. And it stopped in Dryden, a little town where a handful of doctors are working overtime.

Dryden is home to about 8,000 people, but the health centre serves a population nearly double that size. Patients come from as much as an hour away. With only eight family physicians, who do double duty in the emergency room, it's a challenge to accommodate everyone.

According to the Ontario government's standards, Dryden is underserviced - one of many in this part of the province.

The fact is, the rural population simply does not get the same access to health care that Canadians in larger centres do. About one in five Canadians live in rural areas, but less than one in 10 physicians practice there, according to the most recent figures in 2004 - and those numbers have not changed drastically since then, according to Raymond Pong of the Northern Ontario School of Medicine at Laurentian University in Sudbury. Dr. Pong studies how small communities attract and keep doctors. It's a problem that exists not just in Northern Ontario but across the country.

Here in Dryden, as recently as November, the emergency room was in danger of closing because of staffing shortages.

Eighty per cent of the staffing depended on "locum" doctors, who come into a small community occasionally from bigger centres to help pick up shifts. When two full-time emergency-room doctors decided to leave town, things got even more hectic. The other doctors had to pick up the slack, working more than 100 extra hours every month.

"It was unsustainable," said Stephen Viherjoki, a family practitioner. More staff has come in now, but all it takes is a retirement, or a maternity leave to spark another doctor-shortage crisis.

Dr. Viherjoki was drawn to working in Dryden because he knew the region - he grew up in Thunder Bay, leaving only for medical school at Queen's University. He is typical of people who grow up in the North, Dr. Pong said.

"The best way to get physicians to work in rural, northern, remote areas is ... to get people from those areas to go to medical schools. They are more likely to return and practice in those areas," he said.

There's an upside to working in Dryden. Dr. Viherjoki is only a couple of years out of his residency, and unlike young doctors working in big cities, he gets the chance to do almost everything. Yesterday morning he saw a stroke patient, a chronic heart patient, did pediatric checkups, treated a person with anxiety and depression. Plenty of dollars are thrown at doctors who can commit to working in rural areas. The Ontario Ministry of Health offers extra pay for working in underserviced communities - $10,000 a year for up to four years.

Thanks to fundraising efforts and some government money, Dryden also offers its family physicians a $160,000 signing bonus if they commit to three years of work here.

Five years after he took that fateful float plane ride, Dr. Pettinger splits his time between his practice in Winnipeg and his work in Dryden. And while he admits the financial incentive draws him here, the variety of the work, and the community, make it hard to leave.

***

SO CLOSE AND YET SO FAR AWAY

The average distance of the general population to the nearest doctor and hospital, urban v. rural.

Family medicine

Urban (pop. 1,000,000 and higher): 0.7 km

Smaller urban (pop. 500,000-999,999): 1.1 km

Rural (pop. 10,000 and under, excluding territories): 15.05 km

Specialists (surgical, clinical, etc.)

Urban: 1.1 km

Smaller urban: 2 km

Rural: 45.1 km

Pediatricians

Urban: 2.5 km

Smaller urban: 4.1 km

Rural: 81.3 km

General hospital (without long-term care)

Urban: 13.2 km

Smaller urban: 54.6 km

Rural: 77.9 km

General hospital (with long-term care)

Urban: 5.7 km

Smaller urban: 7.2 km

Rural: 46.4 km

Source: Canadian Institute for Health Information, 2006 report

***

LIGHT BRIGADE

DAYS 67, 68 & 69

Thunder Bay

Dryden

Kenora

Steinbach

Winnipeg

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