Communities play key role in physician recruitment, retention – Fort St. James case study

Fort St. James, BC - Photo: ChadBriggs, Creative Commons Fort St. James is a northern BC community located on the edge of Stuart Lake

In the late months of 2011, Fort St. James faced a physician supply crisis. Three physicians left the northern BC community of 5,000, leaving only one full-time physician to provide local primary care and hospital coverage.

[Read more about Fort St. James’ successful physician recruitment in The Prince George Citizen]

Northern Health recognized that Fort St. James needed additional resources and assigned locum support along with a dedicated physician recruiter to the community in February 2012. After assessing the situation, Northern Health quickly realized it needed local support to promote Fort St. James to prospective recruits, so it approached the local medical community with a simple question: “If we bring in prospective doctors, how will you welcome them and how will you promote Fort St. James to them?”

In response, the medical staff reached out to the community for ideas and solutions. Ann McCormick, Director of the Fort St. James campus of the College of New Caledonia, was asked if she could ‘put something together’ to welcome the prospective physicians into the community. “They wanted the physicians to feel that they’re valued and that Fort St. James would offer them a lot, in terms of lifestyle and professional practice.”

The first step that McCormick took was to reach out to local businesses, school principals, young professionals and the local Nak’azdli First Nation. “People in Fort St. James – in any small community – will bend over backwards to try to support a community initiative. All you need to do is ask, and people will come on board.” The group quickly became a committee – so many people were volunteering that McCormick had to turn away offers of help – and got to work devising the best way to promote their community.

The group looked at the recruits not only as physicians, but also as potential neighbours. “We looked at them as a whole person. What are their interests, their passions? What do we have in Fort St. James that can support those passions?” To learn more about the physicians, the committee asked to view each candidate’s resumé ahead of his or her visit and then tailored each individual’s community tour to address their interests. For example, Drs. Pieter and Marlie Van Zyl, a young South African couple who eventually chose to settle in Fort St. James, expressed an interest in aboriginal health, so the committee included a visit to the progressive Nak’azdli First Nations Health Centre as part of their tour. The committee also flew the Van Zyls via helicopter to a remote first nations reserve served by Fort St. James physicians. Over the course of two days, the committee guided the Van Zyls through the community’s schools and available accommodations, and also introduced them to young professionals living in the community. “When a candidate has an understanding of his or her medical role and of our community – it’s a lot easier to make a decision,” says McCormick. “Prospects get to know from their visits that the community is welcoming and committed to them.”

By July 2012, Fort St. James and Northern Health had successfully recruited three young physicians. “The recruitment was a true partnership between Northern Health and the community,” says Michael McMillan, Chief Operating Officer, Northern Interior Health Service Delivery Area, Northern Health. “The community deserves the credit for making the [new] doctors feel welcomed and wanted.” Shortly after the recruitment, a new issue emerged: the three new physicians wanted to focus on the provision of care and service to patients and were not interested in privately managing the town’s health clinic. The community was at a bit of a loss as to what steps to take next, until Northern Health proposed that the clinic be run as a not-for-profit venture. “There was lots of discussion about that idea,” says McCormick. “We asked ourselves ‘is that really our responsibility? Could we partner with Northern Health?’” The community has existing partnerships with Northern Health to run Assisted Living and other health programs; however, this would be a much bigger venture.

Eventually, the community agreed to form a society and undertake the operation of the clinic. This solution, however, is not one that McCormick would recommend for all rural BC communities. Fort St. James has a long history of volunteerism – the local ski hill, golf course, and curling rink are all successfully managed and run by private societies using a cost-recovery model. Operating the local health clinic as a not-for-profit venture is a natural solution for this strongly community-driven population. McCormick freely admits that this solution is the ‘typical flavour’ for Fort St. James and advises that any community thinking of running a clinic needs to look at their community and what their unique strengths are. “The model that works for us might not fit a community down the road.”

The clinic’s society has nine board members that are currently learning how to best support the medical staff. Future plans include expanding existing clinic facilities to accommodate three (or potentially five) physicians, and evaluating how to provide additional health programming. “We’re definitely consulting with the community and Northern Health on how to best achieve these goals,” says McCormick.

McCormick attributes Fort St. James’ recruitment success to the community’s ability to own the situation. “I think that when we’re allowed to solve our own problems and invest in the solution, our community becomes stronger.”

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