Following the deployment of RPAP's new Community Resource Guide last spring, communities have been jumping on the bandwagon and, in concert with their health region and local physicians, taking ownership of their physician resources. Over the past few months, RPAP has been invited to work with several Alberta communities to assist them in their physician recruitment and retention efforts. What a privilege it has been for RPAP staff to be a part of the enthusiasm, determination and commitment to address physician needs in the communities of La Crete, Vegerville, Three Hills/Trochu and the Smoky River Region!

RPAP's focus on communities is founded in the belief that physician recruitment and retention issues are a local concern and that community action, in partnership with the RHA and local physicians, can have a positive effect in attracting and retaining physicians. With the advent of regionalization, there has been a perceived shift in responsibility for physician recruitment from local communities to regional health authorities (RHA) exclusively. "RHAs don't recruit physicians by themselves," notes David Kay, Program Manager for RPAP. "Physicians are private business people who choose to practice and to establish themselves in a given community. Yes, RHAs have an overall responsibility for health services in the region and can assist with recruitment efforts but it is the individual physician who decides to locate in a given community... and that community must be attractive to both the physician and his or her family."

Rural doctors are generally fulfilled by the challenge and diversity of their practice. Keeping the doctor in town, however, is often dependent on successfully integrating the spouse and family into the community and their experiencing the rewards of rural living.  Through community meetings, RPAP assists a cross section of organizations such as the RHA, Chamber of Commerce, town, county and/or municipal district councils, economic development authorities, local businesses and industries, community health councils, local health facility administration, and volunteer groups etc., to better understand the challenges and opportunities of rural medicine and to identify where local action, coordinated with regional efforts, can make an impact on physician retention.

 "During a recent visit to a northern Alberta town," says Nancy Rowan, RPAP Physician Consultant (North), "I had the pleasure of meeting with a physician who arrived in Canada with this family a few years ago. He had used his life savings to get here and, much to his surprise, was unable to get a bank loan to buy a car or a house because he didn't have a credit rating. Fortunately, the town stepped in and provided temporary accommodation for him and his family. He was able to rent clinic space from the town and, with two other physicians, set up his practice. Within the first week of the family's arrival, some of the town's people threw a welcoming party which left an indelible impression on the new immigrants. The family quickly became engaged in local activities.  The children got involved with school and local sports groups and now, close to a decade later, this physician and his family are well established in the community and have no intention of leaving."

Not all physicians are so lucky. Some - whether foreign medical graduates or Alberta graduates - find themselves with huge debt loads and remain socially isolated from the local residents.  They find themselves coping with demanding on-call schedules associated with a one-, two- or even a three-person practice. The people in the Smoky River Region view physicians as a regional resource. The towns of Falher and McLennan, their outlying communities and the Municipal District are establishing a plan to integrate their diverse community resources in order to attract and retain physicians to the area. For example, different community, public and volunteer groups are working together to develop a physician retention plan in support of the RHA's plan that includes a marketing package for the area to address such issues as access to credit, housing, transportation, community support and integration.

RPAP's partnership with Alberta Community Development (ACD) was established in 2003 to better support rural communities efforts related to recruitment and retention.  This partnership has been a real asset in its support of the Smoky River Recruitment and Retention Committee. The regional Community Development Officer provides a local resource to facilitate their planning work. This partnership also permits the professional growth of both RPAP consultants and ACD's community development officers as each contributes their unique body of knowledge to enhance community capacity in managing physician resources and meeting common goals. As this partnership progresses, tools will be developed to increase community capacity to address recruitment and retention issues.