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

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

Just Posted

As of Friday, Alberta has under 10,000 active COVID-19 cases. (Image courtesy CDC)
Three new COVID-19 deaths in Central zone, Alberta under 10,000 active cases

The Central zone sits at 849 active cases, with 52 people in hospital and 10 in the ICU.

(File photo)
After several years in limbo, Parkland Manor to be torn down

Rimoka Housing Foundation has received funding and approval for the demolition

Alberta’s chief medical officer of health Dr. Deena Hinshaw announced 16 additional deaths Thursday. (Photo by Chris Schwarz/Government of Alberta)
No easing of Alberta’s COVID-19 measures Thursday, 678 new COVID-19 cases

The province also hit 1,500 COVID-19 deaths since the beginning of the pandemic

Alberta Premier Jason Kenney said the Canadian government should consider sanctions on the U.S. if they refuse to reconsider the decision to cancel the Keystone XL Pipeline. (THE CANADIAN PRESS/Sean Kilpatrick
Keystone XL officially cancelled, Kenney vows to fight on

U.S. President Joe Biden cancelled the presidential permit for the pipeline on first day of office

Alberta’s chief medical officer of health Dr. Deena Hinshaw said province’s test positivity rate for COVID-19 is steadily declining. (Photo by Chris Schwarz/Government of Alberta)
669 new COVID-19 cases in Alberta, 21 additional deaths

COVID-19 test positivity rate down to 4.5 per cent

Alberta’s chief medical officer of health, Dr. Deena Hinshaw, updates media on the COVID-19 situation in Edmonton, Friday, March 20, 2020. Hinshaw says residents in long-term care and supportive living facilities will remain the priority as the province grapples with a looming slowdown in COVID-19 vaccine supply. THE CANADIAN PRESS/Jason Franson
Alberta long-term care residents remain priority in looming slowdown of COVID vaccine

There are 119 patients in intensive care and 1,463 people have died

Black Press File Photo
Maskwacis RCMP lay charges for attempted murder, kidnapping, and flight from police

Female victim remains in hospital in serious condition.

In this Dec. 18, 2020 photo, pipes to be used for the Keystone XL pipeline are stored in a field near Dorchester, Neb.  THE CANADIAN PRESS/AP-Chris Machian /Omaha World-Herald via AP
‘Gut punch’: Alberta Premier Jason Kenney blasts Biden on revoked Keystone XL permit

Kenney said he was upset the U.S. wouldn’t consult with Canada first before acting

Joe Biden, then the U.S. vice-president, and Prime Minister Justin Trudeau take their seats at the start of the First Ministers and National Indigenous Leaders meeting in Ottawa, Friday, Dec. 9, 2016. THE CANADIAN PRESS/Adrian Wyld
Trudeau, Biden to talk today as death of Keystone XL reverberates in Canada

President Joe Biden opposed the Keystone XL expansion as vice-president under Barack Obama

Prince Edward Island’s provincial flag flies on a flag pole in Ottawa, Friday July 3, 2020. A lozenge plant in Prince Edward Island has laid off 30 workers, citing an “almost non-existent” cold and cough season amid COVID-19 restrictions. THE CANADIAN PRESS/Adrian Wyld
‘Almost non-existent’ cold and cough season: P.E.I. lozenge plant lays off 30 workers

The apparent drop in winter colds across the country seems to have weakened demand for medicine and natural remedies

Gov. Gen. Julie Payette takes the royal salute from the Guard of Honour as she makes her way deliver the the throne speech, Wednesday, September 23, 2020 in Ottawa. THE CANADIAN PRESS/Fred Chartrand
Gov. Gen. Julie Payette resigns, apologizes for ‘tensions’ at Rideau Hall

Payette, who is the Queen’s representative in Canada, has been the governor general since 2017

Grounded WestJet Boeing 737 Max aircraft are shown at the airline’s facilities in Calgary, Alta., Tuesday, May 7, 2019. WestJet will operate the first commercial Boeing 737 Max flight in Canada today since the aircraft was grounded in 2019 following two deadly crashes. THE CANADIAN PRESS/Jeff McIntosh
Passengers unfazed as WestJet returns Boeing 737 Max to service on Calgary flight

After a lengthy review process, Transport Canada cleared the plane to return to Canadian airspace

(Photo submitted)
Community Futures brings back Social Media Challenge for 2021

This time the challenge is for non-profits and community groups

Lucas Berg, left, with the backpacks filled with essential items he donated to the Red Deer Mustard Seed Jan. 19, 2021. (Photo submitted)
Central Alberta teenager donates filled 20 backpacks to Red Deer Mustard Seed

Lucas Berg, 14, of Ponoka County says he ‘just wants to help people’

Most Read