For the past eight years, Dr. Allison Adamus of Martensville Collective Health and Wellness (MCHW) has been advocating to help bring more doctors and health services to the community.
One of the biggest challenges for this is regarding the Return of Service (ROS) agreements that allow doctors to complete their residency training requirements within rural and remote communities, which both Martensville and Warman, along with other communities in the province are excluded from due to their proximity to larger cities.
Back in 2016, Adamus was under the impression that this had been changed and Martensville and Warman would be included within the Return of Service agreements based on a letter received from the province stating changes were being made; however, in 2020, Adamus learned that Martensville had only been removed from two of the seven lists and the community was still unable to access the same options to recruit doctors as other municipalities within the province.
“Once we learned that, it explained why we weren’t getting the doctors from that change that we thought we would have. At the time, we had a doctor interested in serving this region; but they were unable to due to the Return of Service agreements,” said Adamus.
For Adamus, the biggest struggle has been making Martensville stand out and be a desirable location for physicians. “We are trying to give people a reason to come here when the competition is so strong with physicians everywhere,” Adamus said.
Currently there are five doctors at MCHW; however, by the end of May, that number will decrease to three. Due to the lack of doctors within the community, MCHW has been forced to limit some of the services offered, including their walk-in options. “Our focus has always been to provide primary care and we must focus on the big picture. We can’t continue to offer four nights and one day a week and still be able to provide the same level of care to our patients.”
The inability to bring doctors to Martensville isn’t due to a lack of need, but according to Adamus, due to the challenge of a competitive market for doctors. “We are a unique community, and we need unique solutions in order to do that.”
One solution would be for changes to be made to the ROS, but Adamus believes there are other options that could help to recruit more doctors, such as increasing other health services available in the community, which would ease some of the burden from physicians. “One of the biggest struggles is mental health, which impacts all of us, but when there aren’t acceptable mental health services, a lot of the time, that then falls on the doctors. It’s not that we don’t want to do it, or can’t do it, but it takes an enormous amount of our time, whereas if a patient can access that service elsewhere, it frees up our time to do more.”
Another option would be to have incentives in place. Adamus expressed her desire to have the City of Martensville contribute more to the cause. “I do think that the City needs to think outside of the box a little bit. What has been taking place isn’t working, so new ideas are needed,” Adamus said.
One of those ideas came from Adamus’ research on what other communities with the same challenges have done. “One thing that I found interesting in other communities is that the community itself owns the facility and then the doctors work for the community in that facility. It takes the burden of owning the business off the physicians so they can focus on seeing patients and reduces the overhead. It is then a publicly owned business and is more appealing to physicians that don’t have the capita to open a clinic of their own.”
There are ways that the public can help in this struggle. One of which is to contact the Minister of Rural and Remote Health, Everett Hindley, at everettmla@sasktel.net and send a personal story about how existing physician services have positively impacted you and your family, what the loss of such services would mean to you and your family, and/or how your family is impacted by inadequate numbers of physicians in your community.
Another option for community members to get involved would be a similar setup as the Martensville Community Recreation Project, where a group of people came together to bring awareness to the need for a new recreation facility in the community. “Something like that could really help this situation as well, but its just not something that I have the time to do and not something anyone else has taken initiative on.”
“I have been so impressed with our community and how they have stepped up. It has been the most incredible community to work with and work for and it is the reason I keep working so hard because the people are absolute gems and they keep me going, ”Adamus explained.
In May of 2018, Martensville City Council discussed Physician Recruitment Opportunities that could help bring doctors to the community. At this time, two new doctors were coming to MCHW and prior to their move to Martensville, they met with City representatives and created an incentive plan between the two doctors that equaled $20,000; however, Adamus noted that this was not enough to make Martensville a desirable location to remain.
For Dillon Shewchuk, Martensville’s Community Economic Development Manager, the biggest thing that the City of Martensville has been doing to help bring awareness to this issue is constant advocacy for the better part of ten years. “We are all frustrated. We are in an odd spot because in a way, we are competing directly against the province. A lot of family medical residents have Return of Service contracts that explicitly exclude communities like Martensville and Warman. They can’t come here even if they wanted to. We could provide an incentive to get someone in, but we are competing against a public system,” Shewchuk explained.
He continued to note that there are limitations on what the City can directly invest into, stating that even if the City were to invest and put millions of dollars into a facility, there would still be the struggle to recruit doctors.
Similar to Adamus, Mayor Kent Muench has spent many years facing the same challenges throughout the entire duration of his political career in Martensville, both as Councilor and as Mayor. “Health services has been the biggest challenge, bar none,” Muench said. “As a Government Ministry, it is just so large and there are so many working pieces to the puzzle.”
Muench noted the ambulance service that recently began in Martensville was a lengthy process to get running. Approximately two years ago, the province announced that there would be money in the budget to improve ambulance service in rural communities; however, it wasn’t until late last year that an ambulance began being stationed in Martensville at the Fire Hall, and just this week, at the April 12th Committee of the Whole meeting, Council discussed the proposal for an ambulance station to be constructed on Centennial Drive North.
“It took a long time, even though there was already a commitment from the province. In this region, between Martensville, Warman, Osler and the RM, there are nearly 30,000 people, and that is still what it took,” Muench stated. “In terms of services like ambulances, labs, and imaging, many of those pieces are all provided through the public side of things. We couldn’t just open a lab in Martensville. It is a provincial responsibility.”
Part of the challenge for Martensville is that MCHW is a private clinic and that creates some foggy areas. “We have other health services in the community like dentists, massage, chiropractors etc. and we are dealing with tax-payer dollars to a private business. How do we determine where this money goes and what if another private clinic comes in, and then a large company opens a clinic? Do they still get the money from taxpayers?”
Muench also expressed that Council has support for all businesses in the community, which is why they created the Economic Development Tax Incentive Program, which can give businesses up to a 5-year tax abatement at no direct cost to tax-payer dollars.
“As Council, we said we would support things like incentive programs, but the issue is we can do that, but at the end of the contract, the doctors leave because they weren’t actually invested in the community. We have been making small gains such as with the ambulance service, and we have Public Health leasing a space within the Civic Centre, but there is so much more to be done.”
What is really telling is that we have an amazing family doctor in Martensville that owns the clinic, and she can’t retain doctors. Clearly, there is a problem here and we will continue working towards solving this problem,” Muench added.
