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A quantitative day in the life of a Saskatchewan rural physician

A quantitative day in the life of a Saskatchewan rural physician

Canadian Journal of Rural Medicine: the Official Journal of the Society of Rural Physicians of Canada 23(2): 45-49

ISSN/ISBN: 1203-7796

PMID: 29547381

Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision. The data were summarized in a graphic 1-month format to portray a typical month in the life of a rural physician in the province. In the office setting, rural family physicians saw 16.8% more cardiac presentations in adults over 65 years of age than did urban family physicians; otherwise, there were no significant differences in the top office diagnosis categories seen by the 2 groups. Differences were apparent, however, in the hospital setting: urban family physicians saw more patients presenting with pain and, reflective of centralization of obstetric delivery services, performed more deliveries than did rural physicians. There are differences in the clinical presentations seen by rural and urban family physicians, and these need to be considered by new physicians considering rural practice. Our simple visual depiction of average workload, vacation and activity levels of rural physicians can further inform medical residents on the realities of working in rural Saskatchewan as a family physician. A more complete understanding of clinical workload expectations may promote recruitment of resident physicians. Les médecins de famille en milieu rural sont souvent appelés à fournir des services médicaux très variés qui sont par ailleurs la responsabilité des médecins spécialistes, en milieu urbain. Cela dit, beaucoup de médecins en milieu rural apprécient la variété et la capacité de répondre aux besoins médicaux des patients dans ce contexte de soins plus étendu. Nous avons tenté de quantifier et de résumer la charge de travail ainsi que les troubles cliniques des patients reçus par les médecins de famille en milieu rural en Saskatchewan par rapport aux médecins de famille en milieu urbain. Nous avons utilisé les données de facturation du ministère de la Santé de la Saskatchewan pour 2015–2016 afin de comparer la prestation des soins en milieu rural et urbain. Les données ont été résumées sous forme de graphique représentant un mois typique dans la vie d’un médecin exerçant en milieu rural dans la province. En cabinet, les médecins de famille en milieu rural ont reçu 16,8 % plus de patients de 65 ans atteints d’une cardiopathie que les médecins de famille en milieu urbain. Par ailleurs, il n’y avait pas de différences significatives dans les principales catégories de diagnostics en cabinet entre les deux groupes. Toutefois, des différences étaient évidentes en milieu hospitalier : les médecins de famille en milieu urbain ont reçu plus de patients présentant une douleur et ont pratiqué un nombre plus élevé d’accouchements que les médecins en milieu rural, ce qui reflète la centralisation des services obstétriques. Les troubles cliniques des patients reçus par les médecins de famille en milieu rural et urbain diffèrent et doivent être pris en compte par les nouveaux médecins qui envisagent la pratique en milieu rural. Notre représentation visuelle simple de la charge de travail, des vacances et du taux d’activité moyen des médecins en milieu rural peut éclairer les médecins résidents sur les réalités de la pratique du médecin de famille en région rurale en Saskatchewan. Une compréhension plus complète des attentes en matière de charge clinique pourrait favoriser le recrutement des médecins résidents.

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