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New book details the rewards and challenges of rural medicine

Both sad and lighthearted stories share the experience of what it’s really like to be a doctor practising somewhere in rural Canada

Doctors can’t talk about their work, but when they write about it, the stories they tell can make you laugh and cry — and see their profession in a whole new light.

Paul Dhillon

Paul Dhillon
photo: Supplied

Dr. Paul Dhillon realized those stories weren’t being told after assuming his post as a family physician.

He works for the Saskatchewan Medical Association, providing relief services for other physicians, spending his days travelling to small rural and remote communities throughout Saskatchewan and the Northwest Territories.

His patients were amazing people, and while he learned to cope with the solitude, long hours and intense demands of his job he was moved to write a few stories of his own. Stories like the one about presenting a birthday cake to a farmer, soon to die from cancer, who’d been too busy most of his life to bother with birthdays.

A friend encouraged him to collect and publish other rural doctors’ stories too, said Dhillon.

The result is The Surprising Lives of Small-Town Doctors, edited by Dhillon and published by University of Regina Press. It contains 40 stories from doctors describing what it means to be a rural physician somewhere in Canada.

“These stories are normally only shared physician to physician,” said Dhillon in an interview.

“I think they give a really honest and sometimes harsh insight into what it’s like being not necessarily someone of importance, but with a really important job in the community and the stress associated with it.”

For one thing, being the local doctor can be a lonely experience, says Dhillon. Doctors have few release valves for the stress they experience on the job, and that’s especially so for rural physicians.

“You’re really sort of isolated. You have friends, but you’re never going to be able to talk about the stressful things you deal with at work,” he said.

Doctors also work exceptionally long hours and feel intense pressure when the health of an entire town or region is depending on them.

But those who set down their stethoscopes and penned a story for this volume aren’t describing just the challenges, stress, long hours and/or even frightening experiences of their rural practices. The book tells compelling stories of some of the most profound and pivotal moments in their careers.

In short, it’s a glimpse into what being a rural doctor is really like, says Dhillon.

“Ultimately, physicians choose that path and they get huge amounts of fulfilment from their work as well,” he said. “You wouldn’t put in a 120-hour week and think it’s normal if you didn’t really enjoy the work. I think that comes out of the book as well.”

Dhillon said he hopes the book will help medical students who often shy away from becoming a general practitioner in a rural area to find out what this part of the profession is actually like, rather than what they imagine it might be.

“To me that’s the greatest job in the world, to be a GP, especially in rural areas,” he said. But many young doctors would rather become specialists and practise in larger urban centres working with other medical professionals.

Dhillon hopes to publish findings from some additional research he’s now doing into the transition from medical school into rural practice, asking medical students to share their thoughts and concerns about doing so.

“My current research is looking into how comfortable physicians are working in rural areas and why they might actually be hesitant to work in rural areas,” he said.

The research will try to actually quantify the workload of a rural physician, and how often they experience traumatic events like major car accident with multiple victims. New doctors often express fear about having to handle those kinds of things as a solitary physician.

“We are trying to figure out if there are real and/or perceived fears of going straight into rural practice after training,” said Dhillon.

The Surprising Lives of Small-Town Doctors is also a helpful read for those charged with the work recruiting and retaining rural physicians.

The rural physician shortage is not something fixed with money alone, although financial incentives are important, especially for young graduates carrying debts from med school, said Dhillon.

“I don’t think they are the full picture,” he said. Communities that pay closer attention to the broader needs of a physician, and doing things like finding opportunities for doctors’ spouses if they move there, tend to make more successful matches.

Recruitment agencies are more attentive to these kinds of things nowadays, he added.

However, it’s a natural fit for those who know what rural life is like to be inclined to live and work there. The aim with this book — and ongoing research — is to get more young doctors excited about a rural practice.

Dhillon says he discovered it for himself, after growing up in the city.

“When I go back now, and sit in traffic for 45 minutes it’s depressing,” he said. He once calculated if he commuted an hour to work every day, he’d spend 520 hours a year at it.

“That’s two months a year, literally sitting in my car.

“When I’m working in some of these small communities, why would I drive? I’ll just walk. And I go home for lunch with my wife every day. Stuff like that is hugely important for my quality of life.”

About the author

Reporter

Lorraine Stevenson is a reporter and photographer for the Manitoba Co-operator with 25 years experience writing news and features. She was previously a reporter with the Farmers Independent Weekly and has also written for community newspapers in Winnipeg and Manitoba's Interlake.

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