Hello national licence, goodbye rural practice? Here’s what the data says about that

Getting doctors to come to work—and stay—in Canada’s rural communities has long been a difficult challenge, with only 8% of the country’s physician workforce today serving the estimated 20% of Canadians who live in these small and often remote areas. Could national licensure exacerbate this problem by making it easier for rural doctors to pursue opportunities in other parts of the country? Preliminary findings from a survey by the Society of Rural Physicians of Canada, which were presented last week at the association’s annual conference, suggest expanding doctors’ licences to cover all provinces and territories would not trigger an exodus to urban areas. But SRPC presenters at the conference, which took place from April 20 to 22 in Niagara Falls, Ont. told audience members that medical licensure is not a factor in why physicians leave rural communities. Indeed, of the 1,147 SRPC members who responded to the survey, more than 70% said they’ve never left rural practice to move to an urban area due to licensure. Read: Small-town docs get $7.4 million for advanced skills training On the other hand, having national licensure would allow all doctors to help out in other provinces. SPRC presenters said some rural doctors have talked about urban colleagues' willingness to support them "but couldn’t because of licensure.” Urban doctors aren’t the only ones keen to help rural doctors. The SPRC survey found those already practising in rural areas are also eager to help their counterparts in other jurisdictions, with more than three out of four saying their support for national licensure was motivated by a desire to relieve or help their fellow practitioners. Almost four out of five cited the ability to seek out-of-province locum opportunities as a key reason for supporting national licensure, while a similar number said it would allow them to practise temporarily in rural or remote areas outside their current province or territory. “We also see pan-Canadian licensure as a method of improving access to virtual care for patients in rural communities,” said Dr. Sarah Lespérance, SRPC’s president. “We view it with the understanding that access to virtual care is better than no care or having to wait for care.” The country’s billing system for healthcare is, for the most part, already set up for national licensure, she added. “We already have reciprocal billing, which works for every province except Quebec,” said Dr. Lespérance. The SRPC’s survey findings align with data released earlier this year by the Canadian Medical Association, which found almost three out of four doctors believed pan-Canadian licensure would encourage relief of colleagues in another province or territory, and improve access to healthcare in rural, remote and northern communities. Read:Should doctors campaign more with nurses and others for national licences? Dr. Kathleen Ross, the CMA’s president-elect, told the Medical Post that within the rural medicine context, national licensure would open up opportunities for rural doctors to go to other provinces to upgrade their skills. “You cannot do this with provincial licences, even for training,” she said. “With this portability from province to province, we will see rural-based physicians travelling to urban centres outside their province to upskill. This training piece of national licensure is really important.” Working short-term in rural or remote areas is something many doctors are also interested in doing between locum postings, said Dr. Ross. A national licence would make that a lot easier. A full report of the SRPC’s survey finding is expected to be released over the next few weeks. Read: What might a 'National Registry of Physicians' mean for national licensure?

Hello national licence, goodbye rural practice? Here’s what the data says about that

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