After the goldrush

GPs are fleeing the Klondike in droves. The territory's healthcare "orphans " feel the freeze of shortages

By Juliann Fraser

Dr Bruce Beaton moved to Whitehorse from California in 1975 for a brief adventure as a community doctor in the great white north. Like so many others, he fell in love with the untouched wilderness, the mountainous landscape, the small-town hospitality, a good educational system for his kids and an overall lifestyle that's best described as 'laid-back.'

But after calling this place home for three decades, the GP is contemplating greener pastures.

"This is where I want to make a life, but that choice is becoming tougher and tougher, " says Dr Beaton. In many of the provinces, the wages are high enough to allow a doctor to work just a few years, accrue savings, then return home and retire. That's what Dr Beaton's been debating as he moves into fifties. "I seriously contemplated going to Sioux Lookout, Ontario, to work. " So far the severe doctor shortage has prevented him from retiring or leaving the Yukon. But two of his colleagues in BC are doing exactly that right now. They get locums to look after their patients and "keep their practice in Whitehorse, pay the overhead, and put $70,000 in take-home pay in the bank, " says Dr Beaton.

"They'll make more there than they will here in half the time, " says Dr Ken Quong, vice-president of the Yukon Medical Association as well as a part-time family physician. Fortunately, money is not the biggest issue for him right now. He's determined to continue raising his two young children in the territory where he was born.

Though he hasn't managed to retire yet, Dr Beaton decided to at least scale back his hours. He tried for five years to find a physician to take over his family practice but was finally forced to close it down, leaving his patients to their own devices after failing to recruit someone for the full-time gig. Dr Beaton's plan was to keep his clinic hours in land-locked Old Crow and work part-time at Whitehorse General Hospital. Because of the intense demand, however, he finds himself doing ER rotations of 100 hours a month -- more than twice the average. And he's had to give up Old Crow.

In 1999, there were just 49 doctors in this vast territory, compared to 59 today, but that's still not enough GPs to attend to all of the territory's hospital patients. The Whitehorse General Hospital recently discovered that up to 25% of the people admitted didn't have a family doctor to follow up on exams and treatments. The hospital physicians have taken to calling these patients 'orphans' and have created an 'orphan roster' at the hospital to keep track of them. Dr Quong's been taking on some of the 'orphans,' including a woman in her 70s who has lived in the Yukon all her life. She became an 'orphan' after her last family physician left the territory -- he was her third in three years. Another three patients had to be taken on by doctors in other towns -- Dr Gerard Parsons of Dawson City (five hours north) took two and Dr Said Secerbegovic of Watson Lake (five hours south) took the third.

GET OUTTA DAWSON
In recent years, most of the physicians who've come to the territory have been foreign-trained. Many came mainly to gain elusive Canadian medical experience -- the stereotype is that once they get their license to practice, they move south. But a recent Yukon government exit survey of 17 physicians who left the territory (12 of them foreign-trained) in the last four years, found that they too claimed that it was the low wages that made them leave. Some say they were making just $40,000 a year and got zero compensation for overtime work and being on call 24-hours a day.

The Yukon became a lot less attractive to foreign physicians last March. That's when the government demanded incoming doctors have at least two years of Canadian experience, a standard requirement in the rest of the country. Less than a year later, the Yukon is already feeling the impact. "The next few years will be very telling to see if we can keep the existing doctors in the Yukon and if we can replace them, " adds Dr Quong, who shares his practice with an Australian, Dr Kate Brown. He isn't too optimistic about the future. "Right at this moment I don't think things are as desperate as they are going to get. "