Staffing rural emergency departments in Ontario: The who, what and where

Tyler Randle; Arunim Garg; Vijay Mago; Salimur Choudhury; Robert Ohle; Roger Strasser; Sean W Moore; Aimee Kernick; David W Savage

doi:10.4103/cjrm.cjrm_51_22

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ORIGINAL ARTICLE

Year : 2023 \| Volume : 28 \| Issue : 2 \| Page : 73-81

Staffing rural emergency departments in Ontario: The who, what and where Tyler Randle¹, Arunim Garg², Vijay Mago², Salimur Choudhury³, Robert Ohle⁴, Roger Strasser⁴, Sean W Moore¹, Aimee Kernick⁵, David W Savage⁶ ¹ Undergraduate Medical Education, NOSM University, Thunder Bay, Ontario, Canada ² Department of Computer Science, Lakehead University, Thunder Bay, Ontario, Canada ³ Department of Computer Science, Lakehead University, Thunder Bay; School of Computing, Queen's University, Kingston, Ontario, Canada ⁴ Division of Clinical Sciences, NOSM University, Sudbury, Ontario, Canada ⁵ Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada ⁶ Division of Clinical Sciences, NOSM University, Thunder Bay, Ontario, Canada Correspondence Address: MD, PhD, CCFP(EM) David W Savage Division of Clinical Sciences, NOSM University, Thunder Bay, Ontario Canada Source of Support: None, Conflict of Interest: None DOI: 10.4103/cjrm.cjrm_51_22

Introduction: The emergency department (ED) in rural communities is essential for providing care to patients with urgent medical issues and those unable to access primary care. Recent physician staffing shortages have put many EDs at risk of temporary closure. Our goal was to describe the demographics and practices of the rural physicians providing emergency medicine services across Ontario in order to inform health human resource planning. Methods: The ICES Physician database (IPDB) and Ontario Health Insurance Plan (OHIP) billing database from 2017 were used in this retrospective cohort study. Rural physician data were analysed for demographic, practice region and certification information. Sentinel billing codes (i.e., a billing code unique to a particular clinical service) were used to define 18 unique physician services. Results: A total of 1192 physicians from the IPDB met inclusion as rural generalist physicians out of a total of 14,443 family physicians in Ontario. From this physician population, a total of 620 physicians practised emergency medicine which accounted for 33% of their days worked on average. The majority of physicians practising emergency medicine were between the ages of 30 and 49 and in their first decade of practice. The most common services in addition to emergency medicine were clinic, hospital medicine, palliative care and mental health. Conclusion: This study provides insight into the practice patterns of rural physicians and the basis for better targeted physician workforce-forecasting models. A new approach to education and training pathways, recruitment and retention initiatives and rural health service delivery models is needed to ensure better health outcomes for our rural population.



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