A longtime family physician in northwestern Alberta is sounding the alarm about the state of primary care in his rural community, which has been plagued with physician staffing issues and ER closures.
For the past 12 years, Dr. Harley (Bob) Irvine has practised medicine in the town of Fairview, roughly 550 kilometres northwest of Edmonton.
Irvine, 66, has plans to retire, hopefully sometime in 2025. He worries about what will happen to his patients and other area residents after he hangs up his stethoscope.
According to Alberta Health Services, three physicians are currently practising in Fairview, which has a population of about 2,800 people.
One of the two other doctors has told patients he plans to leave his practice in November, according to a letter that CBC News has seen.
“I’m afraid for my family more than anything, and I know half the town. I’m afraid for them, for my patients, that I’m going to retire and then they might not have health care,” Irvine told CBC News.
Irvine said Fairview’s doctors serve a total of about 9,000 people, many of them living on farms in the area. By his estimate, more than half of the 9,000 don’t have family doctors.
The issues in Fairview are being reflected across Alberta. The Alberta Medical Association has said that more than 650,000 Albertans, many of them in rural communities, are currently searching for a family doctor. Earlier this year, the town of Hinton declared a health crisis because of a shortage of family physicians.
In a statement, Alberta Health Services said three more doctors have been recruited for Fairview. One is scheduled to begin worth this month, and all of them are slated to be in place by early next year.
Irvine said the AHS recruitment protocol has been reactionary, rather than proactive. Recruitment efforts for a doctor to replace him shouldn’t wait until after he retires, he said.
“They should have somebody else waiting in the wings or coming in, rather than make us go back down to three or four or two [doctors],” Irvine said.
He said Fairview has had as few as two doctors and as many as six in the recent past. He said he has seen 10 other doctors come and go in his time in the town.
Pressure on ER
The doctor shortage has put pressure on the emergency department at the Fairview Health Complex, which has seen intermittent closures since summer 2023. Irvine said three physicians stopped practising in Fairview in the span of a few months.
According to updated information from the AHS facilities temporary service disruption website and the Town of Fairview, the facility’s emergency department will be closed for at least 21 of October’s 31 days.
AHS listed 16 days without the ER between Oct. 1 and Oct. 19. On Friday afternoon, the town issued an advisory that that there will be no physician in the ER for five days next week.
“This is a temporary measure due to a lack of available physicians and an inability to secure locum coverage,” the town said on social media. “Patients are asked to call 911 if they have a medical emergency.”
When the ER is closed, patients are referred to Spirit River, Grimshaw or other communities.
In an emailed statement to CBC News, Alberta Health said staffing is a priority and that more needs to be done. The ministry said it continues to work on a new physician compensation model with the Alberta Medical Association.
Friends of Medicare, a patient advocacy group, notes the compensation model is overdue and there is currently no timeline on when it’s coming.
“More and more family physicians are leaving the province and even when we recruit a new one, they’re just filling a gap from someone who left,” said Chris Galloway, the organization’s executive director.
“We’re never getting caught up, let alone getting ahead,” he said. “You can never recruit your way out of a retention problem. You’re never going to get caught up. and we’re not seeing a retention plan. That’s what the AMA would asking for,” he said.
“They need a new physician compensation model to stabilize these clinics so they can stay open and stay operating, and so that people don’t leave because they are leaving.”
Irvine, meanwhile, said that if a new payment model for primary care physicians had been in place by now, it might have helped him decide to stay practising longer.
He said he hopes to work until he can be replaced by a new doctor.
“I’ve got a son, daughter-in-law, four grandkids that live here,” he said. “My mom still lives here, my mom and her husband,… and I’m afraid for them because they’re going to need health care and it’s not going to be available.”