How a doctor in Red Lake, Ont., contends with that community's critical physician shortage

It's 9:15 a.m. at Margaret Cochenour Memorial Hospital in Red Lake, Ont., as staff crowd around the white board in the hallway across from the nursing station for their daily huddle. 

"Urgent care is not open again," one person reports with an exasperated emphasis on the word "again."

It has become a regular occurrence due to the shortage of available physicians in the northwestern Ontario community, which last year was the first in the province to temporarily close its emergency room due to a lack of physicians. 

Today, Dr. Akila Whiley is the doctor seeing those patients. 

She's seated at a workstation in an office area behind the nursing station with a pile of charts already on her desk. She wears a beige L.L. Bean knitted pullover and green scrub pants in place of the traditional lab coat.

"I've seen a few of the patients who would've likely been directed to the urgent care clinic," she said. "and all of them have something that requires treatment." 

Whiley is originally from Halifax, but she did her residency at the University of Toronto and discovered that urban family practice wasn't for her.

So when it came time to do a rural rotation, Whiley sought placements as far from Toronto as she could get. And you don't get much farther from Toronto than Red Lake. 

The picturesque town of around 4,000 people, situated on the shores of its namesake lake, is about 500 kilometres northeast of Winnipeg and more than 550 kilometres northwest of Thunder Bay. It's part mining town, part tourist destination for hunters, fishers and wilderness enthusiasts.

But Red Lake has continued to struggle to attract and maintain a full physician staffing complement, as factors that have long deterred doctors from practicing in the rural north – such as distance from family and friends – collide with newer deterrents. 

A lot of younger doctors are looking for a better work-life balance than the older generation had, Whiley said, and some find the workload in the community excessive. Whiley works at least 60 hours a week between direct patient care and on-call hours, she said. On busier weeks, that number is closer to 80.

A survey of family physicians conducted in 2019 by the Canadian Medical Association found that family doctors worked an average of around 48 hours a week, not including on-call hours, and put in an additional 111 hours of on-call time per month on average.  

However, a survey of all physicians, including learners and specialists, conducted by the Ontario Medical Association in March of 2020, before COVID-19 overwhelmed hospitals, also found that 66 per cent were already either burned out or burning out. And the numbers were higher in northern Ontario. 

Whiley arrived in Red Lake for the first time in the middle of a northern Ontario winter.