How Lethbridge, Alta., found a solution to its family doctor shortage

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Like in countless cities and towns across the country, a quiet crisis was playing out in Lethbridge.

For several years, there had been a revolving door of family doctors in the southern Alberta city. Some coming in, but more leaving. And before anyone seemed to grasp the severity of the situation, which was exacerbated by the COVID-19 pandemic, an estimated 40,000 people found themselves without a dedicated physician in a city of just 100,000.

But in an unusual move, the municipal government in Lethbridge, which was rarely part of provincial recruiting efforts, formed a partnership with Alberta Health Services. The result: 17 family doctors were hired last year – more than triple the intake of 2021 and far beyond the four total hires in 2020 and 2019.

Now, other parts of the province are trying to replicate the Lethbridge model.

Dr. Aaron Low, medical director for the AHS South Zone, which covers the area south of Calgary and includes Lethbridge and Medicine Hat, said the pandemic effectively thwarted recruitment while a wave of physicians left or retired.

“We knew there were gaps, but we didn’t maybe understand how vulnerable we were,” he said. “All of a sudden we realized, and people started to say that we were short physicians.”

Lethbridge Mayor Blaine Hyggen remembers having a similar “aha” moment. While campaigning during the municipal election in late 2021, it was a topic that came up constantly as he knocked on doors. “I don’t have a doctor,” he recalls being told over and over.

A Globe and Mail analysis last fall found access to primary care is getting worse in many parts of Canada despite the country having more family doctors than ever before. The crumbling ecosystem has been linked to improper human-resources planning and the primary-care field becoming less attractive because of factors such as compensation. And foreign-trained doctors have to deal with restrictive contracts.

In Alberta, any physician paid a recruitment incentive is subject to these contracts, which place doctors in rural towns or regional centres for, on average, five years. Dr. Low said once these agreements lapse, many doctors move to urban areas, often to connect with the larger cultural and religious communities there. He suspects that was the reason some physicians left Lethbridge.

With no single group dedicated to attracting and keeping family doctors in the small city, a change was needed. AHS, in co-operation with the municipal government, launched a large-scale recruitment drive.

Of the 17 new doctors hired last year, 16 are internationally trained. Dr. Low said AHS spent between $50,000 and $80,000 to sponsor each physician to come to Canada while also covering the costs of relocation and assessments required of internationally credentialed graduates through Alberta’s regulatory body.

Not only did AHS “quickly expedite” what is often a gruelingly slow process, Dr. Low said, but direct placement to Lethbridge ensured the physicians could begin seeing patients while completing their months-long assessments. The city also stepped up.

Carly Kleisinger, who until recently was chief of staff to Lethbridge’s city manager, helped create a physician shortage action plan, which was approved by council last May to recruit and retain family doctors. It included petitioning the provincial government to improve health facilities and connecting incoming family doctors with a range of experts, from real estate and child care to recreation and education.

The city also spent $25,000 in marketing, part of which went toward scenic advertisements that ran across Canada. “Here are the stats, we need you here. Stat!” one read. Alberta’s southernmost city underscored local attractions, such as hundreds of kilometres of hiking trails and 320 days of sunshine.

Dr. Genevieve Nwankwo, a graduate of Igbinedion University in Nigeria, is among the latest cluster of physicians arriving in Lethbridge. She was living in Edmonton during the height of the pandemic and finishing her assessments. At the time, she said, there were no openings in Alberta’s two largest cities and she was worried about interrupting her family life by moving to a small community.

She said Canadian-trained doctors take on big-city roles, leaving limited options for primary-care providers like herself. “So, Lethbridge was a catch – a good catch,” Dr. Nwanko said.

It meant her husband could continue working in his field and her two boys, ages 6 and 9, could keep up with French immersion. She took over another doctor’s practice late last year and has already seen about half of her 1,000 patients.

At least six doctors are already practising in Lethbridge and all 17 of the new physicians are expected to be active by December.

Lethbridge resident Sara Peters remembers scrolling through Instagram late one night and seeing a post about a new doctor joining a nearby clinic. Having been without a family physician for more than a year, she thought this might be her shot. Early the next morning, she called to inquire and was soon invited for a meet-and-greet with one of the doctors from the latest wave of recruits.

“There was certainly a relief I felt that I didn’t even maybe realize I was carrying around,” Ms. Peters said.

The next challenge is ensuring that the newest group of physicians doesn’t end up going back through the revolving door like so many of their predecessors. Armed with a kind of care package that highlights what Lethbridge has to offer, city officials are now connecting directly with doctors to pre-empt another string of departures. It may sound simple but conversations like this just weren’t taking place before, said Mr. Hyggen, the mayor.

The incoming doctors will shorten the wait list, with each taking on between 1,000 and 2,000 patients, but the problem isn’t solved. The Chinook Primary Care Network website, which allows people to search for clinics accepting new clients, showed only opioid dependency practices last week.

Taylor Wiebe, 25, has been without a physician for about four years after trying to make an appointment with her family doctor and being told that he had moved. Walk-in clinics have served as a substitute but often she has to weigh whether it’s worth the hours-long wait.

“Every once in a while, I’ll call a bunch of clinics and offices and stuff and hope,” she said.

But Mr. Hyggen is hopeful Lethbridge has made a good start.

“Is it enough?” he said. “We’d like to have 30 or 40, but I’d say that 17 is better than zero.”