Building and maintaining surgical services in rural hospitals, using physicians with expanded skill sets, supporting rural specialists.

These are some of the challenges and topics to be discussed by rural and northern physicians at a conference co-chaired by two members of the Faculty of Medicine this week in St. John’s.

Drs. Gabe Woollam and Margo Wilson are welcoming more than 500 participants at the 26th annual Rural and Remote Medicine Course, the Society of Rural Physicians of Canada’s annual conference.

One of the hot topics will be generalist medicine. According to the Royal College of Physicians and Surgeons of Canada, generalists have a broad-based practice — they diagnose and manage clinical problems that are diverse, undifferentiated and often complex and they have an essential role in co-ordinating patient care and advocating for patients.

Caring for rural populations

Dr. Woollam, who came to Newfoundland and Labrador from British Columbia for a residency in 2006 and never left, says he loves the broad scope of medicine he is able to provide as a rural generalist practising in Labrador.

However, he says that in order to care for rural communities, physicians who can deal with the full scope of medicine with minimal specialty backup are needed.

“There is an ongoing problem in Canada that is slowly being addressed and the Society of Rural Physicians of Canada has been key in pushing the medical schools and the regulatory bodies to improve the output of physicians that are comfortable with providing a generalist practice and are comfortable working in low-resource environments,” said Dr. Woollam.

“We have a long way to go but there are schools, like Memorial, that have done a very good job of training graduates that are comfortable working in those environments.”

Leading in telehealth

One thing Newfoundland and Labrador does well for rural and remote medicine is telehealth, Dr. Woollam says.

“We are leaders in terms of the use of telehealth in access to specialty services and for primary care and emergency services. We do a lot of tele-psychiatry and tele-oncology, so a lot of people are able to have better health care close to home and don’t have to travel far for those services.

“We excel at this partly out of necessity in Labrador,” he continued. “We have a huge land mass with people spread out in many different communities that don’t have on the ground, medical resources. So, over time, we’ve developed a very strong video communication system.”

While different provinces are at different stages with the technology, he says Newfoundland and Labrador is “at the top of the heap.”