Lack of jobs for physicians' spouses affecting doctor retention in the rural north: study

Research by a group of healthcare professionals in northwestern Ontario has found that physician burnout, lack of amenities and a lack of career options for physicians' spouses are among the leading reasons doctors leave small towns in the north.

Drs. Jilayne Jolicoeur, Eliseo Orrantia and Lily DeMiglio and kinesiologist Lindsay Nutbrown published their paper, titled "Why They Leave: Small town rural realities of northern physician turnover," in the Canadian Journal of Rural Medicine.

"People who had children who were approaching high school age were looking for opportunities for their children that didn't … exist in the community, so [in] some of the communities, organized sports for their children to participate in or certain types of classes at the high school that weren't offered," Jolicoer said.

Physicians often found themselves having to weigh the advantages of rural life, such as proximity to nature and access to unorganized outdoor activities, with the disadvantages for their families, she said. 

The study comes as rural communities in the north are dealing with a growing shortage of physicians since the early days of the COVID-19 pandemic, according to Orrantia.  

Rural communities are currently short 97 rural generalist physicians, he said.

The Northern Ontario School of Medicine opened in 2005 with a mandate to train physicians to work in the north, and research published in 2017 found that more than two thirds of its graduates remained in the region.  

However, a study published in 2016 found that only around 16 per cent of family physicians who graduated between 2011 and 2013 who had done either or both of their graduate or postgraduate studies at NOSM were working specifically in the rural north.

"People are staying in the north and mostly staying in the large centres of Sudbury, Thunder Bay, Timmins, Sault Ste-Marie and North Bay," Orrantia said.

Jolicoeur, who is from Fort Frances, instigated the research project during her second year of medical school, inspired by her own experience.

"I noticed growing up in our community, we definitely had a lot of troubles with recruitment and retention of physicians," she said.

The team interviewed a total of 12 physicians who had closed their practices in small northern communities over the preceding five years to find out why they left.

"Some of them did really struggle, depending on what sort of area of work their spouse was in, in gaining that community integration piece," Jolicoeur said.

The study quotes one physician who felt a lack of reciprocity from her community when it came to helping her spouse find employment.