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

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Larry
Reeve Larry Clarke reappointed for another one-year term, leading into elections in 2021

Clarke was acclaimed during council’s recent organizational meeting held Oct. 21st

Ember
Stettler’s own Ember Graphics takes Board of Trade 2020 Business Service Award

The 2020 Business and Citizenship Awards Gala was held Oct. 22nd

There were 410 COVID-19 cases recorded in Alberta Wednesday. (File photo)
Alberta records 410 new COVID-19 cases Wednesday

Central zone dropped to 160 active cases

Shaun Isaac, owner of Woodchucker Firewood in Trochu, is awaiting a new shipment during a firewood shortage in the province. All of the wood he has left is being saved for long-time customers who need it to heat their homes. (Contributed photo).
Firewood shortage in central Alberta caused by rising demand, gaps in supply

‘I’ve said “No” to more people than ever’: firewood seller

Royal Alexandra Hospital front-line workers walk a picket line after walking off the job in a wildcat strike in Edmonton, on Monday, October 26, 2020. THE CANADIAN PRESS/Jason Franson
Alberta labour board orders health-care staff who walked off the job to go back to work

Finance Minister Travis Toews said in a news release that he was pleased with the labour board’s decision

Husky Energy logo is shown at the company’s annual meeting in Calgary on May 5, 2017. THE CANADIAN PRESS/Jeff McIntosh
Husky pipeline spills 900,000 litres of produced water in northwestern Alberta

The energy regulator says environmental contractors are at the site

A raccoon paid a visit to a Toronto Tim Hortons on Oct. 22, 2020. (shecallsmedrew/Twitter)
Who are you calling a trash panda? Raccoon takes a shift at Toronto Tim Hortons

Tim Hortons said animal control was called as soon they saw the surprise visitor

Sharon Hickin, general manager of the Days Inn Sylvan Lake and the new Lake House Diner, poses for a photo outside the new restaurant. Photo by Megan Roth/Sylvan Lake News
Pandemic puts extra hurdles in place for new Sylvan Lake businesses

Over the past seven months numerous new businesses have opened in Sylvan Lake, despite the pandemic

file photo
Maskwacis RCMP investigate pedestrian fatality

Collision on Highway 2A causing fatality still under investigation.

Rachel Notley, leader of Alberta’s official Opposition, speaks in Edmonton on Wednesday, Oct. 16, 2019. Notley says the government needs to sharply ramp up the number of contact tracers if it wants to get a handle on the rising number of COVID-19 cases. THE CANADIAN PRESS/Jason Franson
Alberta Opposition calls for more COVID-19 contact tracers as case numbers rise

Alberta has about 800 tracers, and chief medical health officer Dr. Hinshaw says more are being recruited

Royal Alexandra Hospital front-line workers walk a picket line after walking off the job in a wildcat strike in Edmonton, on Monday, October 26, 2020. Hospital and health-care workers who staged a one-day illegal walkout returned to work Tuesday while politicians swapped recriminations and accusations in the house over the dispute. THE CANADIAN PRESS/Jason Franson
Alberta health staff return to work, surgeries resume after one-day walkout

AHS estimated 157 non-emergency surgeries, most of them in Edmonton, had to be postponed as a result of the walkout

Prime Minister Justin Trudeau makes his way to provide an update on the COVID pandemic in Ottawa on Tuesday, Oct. 27, 2020. Canada has reached a grim milestone in the COVID-19 pandemic, surpassing 10,000 novel coronavirus deaths. THE CANADIAN PRESS/Sean Kilpatrick
Alberta COVID deaths pushes Canada past milestone of 10,000 deaths

Canada crossed the threshold of 5,000 deaths on May 12, a little over two months after the first was reported

Most Read