The critical shortage of health care staff affecting the province doesn’t just include nurses and hospital staff and began in rural communities long before the pandemic.
While many believe that staffing shortages in Northern B.C. are primarily due to the COVID-19 pandemic, this doesn’t appear to be the case. There is evidence to suggest that this issue is not a new one in rural communities.
Previous newspaper articles and studies dating back to the 1970s have shown that staffing challenges have pervaded rural communities for decades.
History of health care in Fort St. John
The first hospital in the Fort St. John area was the Grandhaven Red Cross Outpost Hospital. The hospital was a two-bedroom building and was used from 1930 to 1931.
The second was opened in 1931 by the Sisters of Providence after receiving a request to visit the area from Father L. Beuglet. According to the South Peace Historical Society, the original hospital was 30 by 50 feet, two stories high and contained ten beds. A third story was added during the construction of the Alaska Highway.
The facility, known as the Providence Hospital, initially began operating with just one doctor, Dr. Brown and two registered nurses — Sister Alfred of the Cross and Miss Laura Murphy.
Before the hospital had even officially opened its doors, it had already begun admitting patients due to the community’s immense need for medical care.
In 1962 the Sisters, along with the Peace Liard Regional Hospital District, built a new 44-bed facility, which became a public hospital in 1973 and was renamed the Fort St. John General Hospital.
Shortly after the hospital became a public facility, the first official records of staff shortages were reported.
“Policies designed to force urban doctors to “do their time” in rural communities have not yet worked.”
DR. HARVEY THOMMASEN
Historical health care shortages in Fort St. John
After Energeticcity.ca reviewed the public archives at the Fort St. John North Peace Museum, it became clear that health care shortages have been —at the very least—an intermittent issue within the community.
In August 1974, Alaska Highway News reported that the Fort St. John Hospital was in the midst of a nursing shortage, with over a quarter of the 32 nurses in the hospital’s employ away on holidays, resulting in a loss of services at the hospital and a drop in personal attention paid to an average of 65 patients daily.
A hospital administrator at the time, Rick Wilson, said the issue was one the hospital regularly experienced at that time of year, claiming it would likely be solved in the fall.
At that time, the hospital was reportedly having difficulty finding specialty nurses, particularly those to work in the ICU, which at that time was being staffed by two “regular” nurses — one full-time nurse who planned to leave in the fall and one part-time. In the major surgery ward, there were 35 patients —nine of which needed special care — being looked after by four nurses each shift.
In a 1975 article discussing a then-new policy requiring doctors immigrating to B.C. to practice in the north of the province for five years, Garth Wortman, an administrator of Fort St. John’s medical clinic, told Alaska Highway News that there wasn’t a shortage of doctors in the city, adding that there were no problems in recruiting doctors to the region.
But, recruiting and retaining doctors in rural communities like Fort St. John has been a long-standing issue for decades.
In May of 1995, the city of Fort St. John found itself in the midst of a dire doctor shortage, with Dr. Mike Wright telling AHN that doctors in the region working with a patient-to-physician ratio of 3,500 to one — about fives times the provincial standard at the time.
Dr. Wright said that Fort St. John doctors had been “burdened for years with an overwhelming work schedule,” one that is typically temporarily reserved for training physicians.
Earlier that same month, Fort St. John mayor Steve Thorlakson told AHN that despite paying doctors a substantially higher rate than their counterparts in the lower mainland, the province had been unable to encourage an adequate amount of physicians to practice in the city.
The population in Fort St. John has since grown from 14,156 in 1991 to 21,465 in 2021. About $7.7 million has been invested in the Fort St. John Hospital in the past decade, yet the B.C. Nurses Union says nurses in Fort St. John have reported increased negative patient outcomes due to a lack of nursing staff.
“[The province] is in a healthcare crisis, but rural B.C. has been in a healthcare crisis for decades,”
PAUL ADAMS, BRITISH COLUMBIA RURAL HEALTH NETWORK
Rural areas contending with health care crisis “for decades.”
Fort St. John is not the only rural area to have problems with high turnover rates when it comes to physicians. Studies dating back to at least 1971 have illustrated the issues when it comes to the recruitment and retention of rural physicians.
A 2000 study completed by Dr. Harvey Thommasen compared recruitment and retention in rural B.C. communities based on population.
This data showed that after two years, the number of rural physicians remaining after 2 years range between 64% and 74%. By three years, differences in physician retention are significant between communities with less than 7000 people and those with more than 7000 people.
In his report, Dr. Thommasen said that training more doctors likely won’t correct the issue of poor staffing in rural areas.
“The problem is primarily one of poor distribution—doctors recruited from urban centres, trained in urban centres, not surprisingly, want to work in urban centres. Policies designed to force urban doctors to “do their time” in rural communities have not yet worked.”
While this study is now about 22 years old, its findings still ring true for Paul Adams, an administrator of the B.C. Rural Health Network says there needs to be a focus on training rural medical students to serve rural communities.
“[The province] is in a health care crisis, but rural B.C. has been in a health care crisis for decades. You could probably take that back a hundred years if you want to look at it from that perspective,” Adams said.
“We need to have more equity in who’s going to come back to rural communities. So we need to train more rural people if we wanna see that intended result.”
Adams says that while a lot of things have changed over the past hundred years in regard to health care, it has always been challenging to recruit and retain physicians to work in rural communities.
