Sask. Medical Association calls for better rural health services after election

The president of the Saskatchewan Medical Association (SMA) wants whoever wins the provincial election to know that investing in rural primary care and mental health should be a priority.

Dr. Barb Konstantynowicz, a family doctor and president of the SMA, wrote an op-ed that draws attention to some of the vulnerabilities in rural health care that have been exposed by the COVID-19 pandemic.

She said health care affects every person in every facet of their lives.

"In this world of a pandemic it's even more critical to keep our eye on our health and our health system," Konstantynowicz said. "I always feel that this is absolutely critical for everyone to pay attention to."

Konstantynowicz said manpower is a big challenge.

"So when we look at manpower, we want stability, we want a workforce that has the support that they need to be able to do the work that they need to do," she said.

"Finally, a workforce that is supported and trained on a continuous basis for all of the challenges that they face in rural Saskatchewan."

Dr. Crystal Litwin, a doctor fromWynyard Sask., has worked as a family physician for more than 20 years.

She said there have been many changes in health care in the province during her career.

"There are fewer hospitals in the area, so we are seeing more patients from a broader area dealing with people that have multiple chronic medical problems," Litwin said. "People are a lot more complex than they used to be."

Litwin said she is seeing more people in outpatient care rather than admitting them to hospitals.

Retention of doctors

She said some of the challenges she faces as a doctor in rural Sask. haveto do with human resource shortages in areas like physicians, nurses, lab technicians and physiotherapists.

"When those physician numbers go down, it's very difficult to provide the same level of primary care and hospital care and emergency care," Litwin said.

In her op-ed, Konstantynowicz brought up the need for retention and recruitment of physicians in rural Sask.

"The SMA urges the next Saskatchewan government must make these positions as attractive as possible through adequate compensation and support so that a country doctor doesn't feel isolated and abandoned," Konstantynowizc said in her op-ed.

Lengthy wait lists

Konstantynowicz said she believes those living in rural Saskatchewan face a bigger challenge when it comes to receiving timely care than those living in urban areas.

Litwin said physicians in rural parts of the province have trouble getting access to care for their patients and it comes with lengthy waiting times for patients. She said these issues certainly impact patient's quality of life.

"Once we have exhausted what we can do as their primary care physician, it can be very difficult to get the care that these people need when the care just takes a very long time to get," Litwin said. "We watch our patients suffer and struggle with issues that we can't do anything more about without the assistance of a specialist or a specialized investigation in the city."

Konstantynowicz said many of the rural doctors currently feel very overwhelmed with the volume of workarounds.

"Workarounds are 'I need to get something for this particular person', whether its' a test or whether it's access to a specialist, whatever it may be," She said. "It's sometimes really hard to access what you need for a patient in a timely manner and that extra work to try and advocate for your patient sometimes just takes so much time and effort."

Mental health in rural communities

Part of the op-ed penned by Konstantynowicz focuses on mental health and addictions and how it affects people in rural Saskatchewan during the COVID-19 pandemic.

"We're really seeing a lot of people struggling, they may be feeling far more isolated, they may be struggling with trying to stay somewhat distanced," Konstantynowicz said. "They're anxious about seeing the numbers in the news and they're worried about their loved ones."

"Often we reach for things that we can find handy to try and help us deal with our problems, but sadly some of these lead us to a world of addiction."

Konstantynowicz said doctors in Saskatchewan, especially in rural parts of the province, struggle to deal with addiction issues due to lack of support. She said the doctors sometimes feel like they need to take a holistic approach in helping their patients with mental health and addictions issues.

Litwin said over the years there has been a much greater need for mental health and addiction services in the province.

"We struggle to provide them the care that they need, whether it be counselling services or psychologist or psychiatrist services," Litiwn said.

"It's difficult to try to give a patient hope that there is help for their problems when they get put on a referral wait list that could be many, many months down the road."