Rural Canadians face greater disparities from lack of anesthesia care: doctors

Rural Canadians face greater disparities from lack of anesthesia care: doctors

Rural Canadians face greater disparities from lack of anesthesia care: doctors

Canadians living in rural or remote communities are at risk of poorer health outcomes due to a shortage of anesthesia services, say researchers calling for a national strategy to address inequitable access to care.

Dr. Beverley Orser, chair of the department of anesthesiology and pain medicine at the University of Toronto’s faculty of medicine, said pregnant women in some areas must travel hundreds of kilometres for maternity services.

Patients who suffer serious injuries are at greater risk of dying in rural areas that lack adequate trauma care, she said.

Orser and Dr. Ruth Wilson, professor emeritus at the department of family medicine at Queen’s University, have authored a commentary in this week’s edition of the Canadian Medical Association Journal, outlining strategies aimed at addressing inequities in care for rural patients compared with those who live in cities.

An ongoing shortage of anesthesiologists seems be worsening across the country as evidenced by job ads going unanswered, an aging workforce and discussions among those chairing anesthesia departments at Canada’s 17 medical schools, said Orser, who is also an anesthesiologist at Toronto’s Sunnybrook Health Sciences Centre, which has the largest trauma facility in Canada.

She said it will take the collective effort of governments, who will need to fund more anesthesiology training spots at universities, as well as academics and policy-makers to deal with disparities that disproportionately affect Indigenous populations.

She cited the example of pregnant women in Bella Coola, B.C., where maternity services were eliminated in 2008, forcing patients to drive six hours to Williams Lake. Those with high-risk pregnancies may have to live there at their own expense for part of their pregnancy.

“Probably one of the most important calls to action is to undertake much better workforce planning,” Orser said. “We need to understand what’s happening and what’s needed in the future and how to address it.”

Anesthesiologists manage pain before and after surgery, as well as prior to, during and following childbirth, and provide potentially life-saving resuscitation for patients on ventilators.

Family practice anesthesiologists often work in smaller communities and are general practitioners with extra training to provide anesthesia for low-risk procedures. They’re also a cheaper option.

Orser calls them Navy SEALs because some also perform minor surgery, work in emergency rooms, deliver babies and prepare trauma patients for transport to urban hospitals.

She said there’s a need to train both types of anesthesiologists across the country though family practice anesthesiologists are not employed in rural Quebec, while in Iqaluit they are the sole providers of anesthesia.

“It’s likely there’s not one solution that fits all jurisdictions but right now we don’t have it right.”

Canada could learn from Australia, where a national curriculum for family practice anesthesiologists has been developed, along with ongoing mentorship of doctors in rural areas, she said.

“They, for example, are building a program where people who work in these communities can come back to the bigger centres for two weeks in a funded position, which is really an important model because it’s tough working in these environments.”

In Canada, support from anesthesiologists to their rural colleagues is limited, Orser said. For example, while specialists from Alberta and Saskatchewan fly to their colleagues in Yellowknife, a national program with a well integrated network is needed, she added.

However, the heavy workload of a family practice anesthesiologist often means some don’t stay long in rural areas, Orser said.

Dr. Roland Orfaly, head of the British Columbia Anesthesiologists’ Society, said the province has a high need for the specialists in both large and small communities.

“In the rest of the country it truly is a rural problem. In B.C., it’s a provincewide problem,” he said.

However, Orfaly said British Columbia employs about a quarter of Canada’s 500 family practice anesthesiologists, the most of any jurisdiction in the country, likely because the province is so geographically isolated.

Orfaly supports Orser’s call for a national strategy to address the shortage of anesthesia services.

“The provincial approach, at least to the anesthesiologists’ workforce, has not been effective so we would welcome a national approach to health human resources to see if that is any more effective in helping us.”

This report by The Canadian Press was first published July 30, 2020.

Camille Bains, The Canadian Press

Just Posted

The Government of Alberta identified 115 new COVID-19 cases Sunday, bringing the provincial total to 3,089.
(Black Press file photo)
Red Deer drops to 71 active cases of COVID-19

Province adds 127 new cases of the virus

one
County of Paintearth theft, and other highlights from June 15th meeting

It is believed they are the same people who broke into the Public Works yard a few days prior

Police officers and their dogs undergo training at the RCMP Police Dog Services training centre in Innisfail, Alta., on Wednesday, July 15, 2015. Mounties say they are searching for an armed and dangerous man near a provincial park in northern Alberta who is believed to have shot and killed a service dog during a police chase. THE CANADIAN PRESS/Jeff McIntosh
RCMP search for armed man in northern Alberta after police dog shot and killed

Cpl. Deanna Fontaine says a police service dog named Jago was shot during the pursuit

Alberta now has 2,336 active cases of COVID-19, with 237 people in hospital, including 58 in intensive care. (Black Press file photo)
Red Deer down to 73 active cases of COVID-19, lowest since early November

The Central zone has 253 active cases of the virus

Marco Mendicino, Minister of Immigration, Refugees and Citizenship during a press conference in Ottawa on Thursday, May 13, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Canada to welcome 45,000 refugees this year, says immigration minister

Canada plans to increase persons admitted from 23,500 to 45,000 and expedite permanent residency applications

A dose of the Pfizer-BioNTech COVID-19 vaccine is pictured at a vaccination site in Vancouver Thursday, March 11, 2021. THE CANADIAN PRESS/Jonathan Hayward
NACI advice to mix vaccines gets varied reaction from AstraZeneca double-dosers

NACI recommends an mRNA vaccine for all Canadians receiving a second dose of a COVID-19 vaccine

Bruce Springsteen performs at the 13th annual Stand Up For Heroes benefit concert in support of the Bob Woodruff Foundation in New York on Nov. 4, 2019. (Greg Allen/Invision/AP)
Canadians who got AstraZeneca shot can now see ‘Springsteen on Broadway’

B.C. mayor David Screech who received his second AstraZeneca dose last week can now attend the show

A lotto Max ticket is shown in Toronto on Monday Feb. 26, 2018.THE CANADIAN PRESS
No winning ticket sold for Friday’s $70 million Lotto Max jackpot

The huge jackpot has remained unclaimed for several weeks now

Canadian Prime Minister Justin Trudeau is seen during a joint news conference following the EU-Canada Summit, in Brussels, Belgium, Tuesday June 15, 2021. Trudeau says Canada is on track now to have 68 million doses delivered by the end of July, which is more than enough to fully vaccinate all 33.2 million Canadians over the age of 12. THE CANADIAN PRESS/Adrian Wyld
Vaccine deliveries enough to fully vaccinate all eligible Canadians by end of July

Three in four eligible Canadians now have their first dose, nearly one in five fully vaccinated.

Chief Public Health Officer Theresa Tam listens to a question during a news conference, in Ottawa, Tuesday, Jan. 12, 2021. The number of confirmed COVID-19 cases attributed to the highly contagious Delta variant grew in Canada this week. THE CANADIAN PRESS/Adrian Wyld
Canada’s public health agency reports spike in confirmed cases of Delta variant

More than 2,000 cases of the variant confirmed across all 10 provinces and in one territory

The federal government says it wants to ban most flavoured vaping products in a bid to reduce their appeal to youth. THE CANADIAN PRESS/AP-Craig Mitchelldyer
Health Canada proposes ban on most vaping flavours it says appeal to youth

If implemented, the regulations would restrict all e-cigarette flavours except tobacco, mint and menthol

The Montreal Police logo is seen in Montreal on Wednesday, July 8, 2020. Some Quebec politicians are calling for an investigation after a video was released that appears to show a Montreal police officer with his leg on a young Black man’s neck during an arrest. THE CANADIAN PRESS/Paul Chiasson
Probe called for after video appearing to show Montreal officer’s knee on Black youth’s neck

Politicians call for investigation after clip evokes memories of George Floyd incident

Most Read