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Operating room road trip: How rural Alberta hospitals are making space for urban doctors
CBC
It was a Thursday morning in April and Dr. Richard Bochinski was starting the fourth of seven surgeries and 20 medical appointments scheduled that day in the small hospital of a central Alberta town.
The podiatrist was correcting a condition called hammer toe that can cause pain and difficulty walking. He sliced into a long bone in the foot then threaded a guidewire to direct the screw that would help straighten the bent joint.
At the end of the typically busy day, the doctor drove two hours from the hospital in Vermilion, Alta., to his home in Edmonton. The next morning, he'd embark on another hour-long commute to get to his weekly clinic hours in Camrose.
These prairie commutes, which take him past grazing bison and fertilizer plants, have become part of Bochinski's weekly routine.
His clinic is in Edmonton but the surgeries he performs are in three rural hospitals located between 100 and 200 kilometres away. It's an arrangement he said is rooted in necessity — even if the travel schedule isn't exactly convenient.
After completing a medical residency at a busy Los Angeles hospital, Bochinski returned to his hometown of Edmonton in 1995 and opened a clinic for patients experiencing foot problems. But there was one problem: he couldn't find an operating room to perform surgeries, which severely limited the scope of what he could do.
"It was extremely challenging to find space in Edmonton at that time," he said.
It was 15 years before he found a solution.
His father, a urologist, was working as a visiting doctor in Vermilion, which is how Bochinski learned the hospital had a functioning operating room that wasn't being used full-time.
He realized there was a way to benefit his Edmonton patients while also providing new services for rural patients by doing his surgeries in Vermilion. Bochinski started with one day a month then expanded his surgical visits to two days every other week.
In time, he found more communities interested in this model of care. These days, he's on the road every week to work at three rural hospitals — Vermilion, Camrose as well as Wainwright, located near the Saskatchewan boundary.
And his patients — lured by the prospect of speedier surgeries — are travelling, too.
About 80 per cent of the patients he treats in the Vermilion operating room are from the Edmonton area; without them, his remote operations wouldn't be possible, Bochinski said. Vermilion has about 4,000 residents; the average podiatric surgeon needs a population base of about 10 times that size to make their practice viable.
And more doctors in Alberta have adapted their practices in similar ways.