Recently, Vanessa Weatherbee, a senior consultant with Alberta Health Services (AHS) Medical Affairs, was joined by Susan Smith and Alecia Kerber, physician resource planners in the North and South Zone respectively, to share their experiences recruiting rural physicians during an RhPAP Rural Information Series event.
Vanessa used a timely hockey metaphor to explain the relationship between physicians, AHS, and Alberta Health, which she likened to NHL players under contract, an NHL team, and the league respectively. Like contract players in the NHL, rural physicians are usually independent contractors. AHS sets the team policies, hires the team staff, and manages team scheduling within its facilities. Alberta Health sets the rules of the game.
While this metaphor isn’t perfect, it truly breaks down around how physicians are paid. Rather than being paid by the team, most physicians bill Alberta Health for the services they provide in their own offices and in AHS facilities.
Physician’s community practices are a private business in which AHS is not involved. Where AHS is involved is when the physician also works in an AHS facility or hospital in the community. For physicians working in these facilities, AHS Medical Affairs is responsible for everything from recruitment and privileging (authorizing the specific scope of patient care services the physician can provide within the facility) to discipline related to Medical Staff Bylaws and Rules, AHS Policies and Procedures and Chief Medical Officer Policies.
AHS’ work doesn’t start with posting a physician position. A significant amount of effort goes into identifying physician vacancies and ensuring the availability of organizational resources to support the physician. These resources include, but aren’t limited to, lab and dictation capacity, operating room capacity, and health-care team capacity.
Vanessa, Susan, and Alecia received many questions from webinar participants around rural physician hiring processes.
Community members were particularly interested in how local communities are involved in the recruitment process. AHS hiring involves a search and selection committee. The standards for this committee aim for diverse membership to encourage an inclusive hiring process. Community medical directors are usually part of this process and expected to keep their communities in the loop.
The involvement of the community and local attraction and retention committees is particularly important when it comes to the site visits of potential candidates. Making sure these candidates get a good sense of the community that aligns with their interests and lifestyle choices can help ensure a good fit.
Recognizing how long it takes to train a physician, participants were also interested in the process around hiring an international medical graduate.
Vanessa and Alecia noted that there is a select list of countries whose medical training programs meet Canadian medical training standards. Only medical graduates from these training programs can expect to have their credentials recognized in Canada.
While they may meet Canadian standards, the recruitment process for a physician who graduated from one of these international programs is still very complex. Starting in 2014, Service Canada requires a Labour Market Impact Assessment that includes a description of efforts to hire a Canadian-trained physician and what is being done to encourage a reduced reliance on foreign-trained doctors.
After this assessment is approved, physicians must complete a number of exams and also require an assessment to ensure they meet Canadian practice expectations. With these assessments, recruiting an international physician can take more than two years.
This session was part of RhPAP’s ongoing virtual information series that explores health-related organizations connected to rural Alberta that are of interest to RhPAP’s rural health workforce attraction and retention network.