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Lessons learned from the COVID-19 pandemic: The importance of physician leadership in responding to rural community ecosystem disruptions. 从 COVID-19 大流行中吸取的经验教训:医生领导力在应对农村社区生态系统混乱中的重要性。
IF 1.1 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-14 DOI: 10.4103/cjrm.cjrm_27_23
Alexandra Bland, Anna de Waal, Stefan Grzybowski

Introduction: The COVID-19 pandemic presented an unprecedented challenge for rural family physicians. The lessons learned over the course of 2 years have potential to help guide responses to future ecosystem disruption. This qualitative study aims to explore the leadership experiences of rural Canadian family physicians during the COVID-19 pandemic as both local care providers and community health leaders and to identify potential supports and barriers to physician leadership.

Methods: Semi-structured, virtual, qualitative interviews were completed with participants from rural communities in Canada from December 2021 to February 2022 inclusive. Participant recruitment involved identifying seed contacts and conducting snowball sampling. Participants were asked about their experiences during the COVID-19 pandemic, including the role of physician leadership in building community resilience. Data collection was completed on theoretical saturation. Data were thematically analysed using NVivo 12.

Results: Sixty-four participants took part from 22 rural communities in 4 provinces. Four key factors were identified that supported physician leadership towards rural resilience during ecosystem disruption: (1) continuity of care, (2) team-based care models, (3) physician well-being and (4) openness to innovative care models.

Conclusion: Healthcare policy and practice transformation should prioritise developing opportunities to strengthen physician leadership, particularly in rural areas that will be adversely affected by ecosystem disruption.

Introduction: La pandémie de COVID-19 a représenté un défi sans précédent pour les médecins de famille en milieu rural. Les leçons tirées au cours des deux années écoulées peuvent aider à orienter les réponses aux futures perturbations de l'écosystème. Cette étude qualitative vise à explorer les expériences de leadership des médecins de famille ruraux canadiens pendant la pandémie de COVID-19, en tant que prestataires de soins locaux et chefs de file de la santé communautaire, et à identifier les soutiens et les obstacles potentiels au leadership des médecins.

Mthodes: Des entretiens qualitatifs virtuels semi-structurés ont été réalisés avec des participants issus de communautés rurales du Canada entre décembre 2021 et février 2022 inclus. Le recrutement des participants a consisté à identifier des contacts de base et à procéder à un échantillonnage boule de neige. Les participants ont été interrogés sur leurs expériences durant la pandémie de COVID-19, notamment sur le rôle du leadership des médecins dans le renforcement de la résilience des communautés. La collecte des données s'est achevée après saturation théorique. Les données ont été analysées thématiquement à l'aide de NVivo 12.

Rsultats: Soixante-quatre participants provenant de 22 communautés rurales de qu

简介:COVID-19 大流行给农村家庭医生带来了前所未有的挑战。在 2 年的时间里吸取的经验教训有可能帮助指导应对未来的生态系统破坏。本定性研究旨在探讨加拿大农村家庭医生在 COVID-19 大流行期间作为当地医疗服务提供者和社区健康领导者的领导经验,并确定医生领导力的潜在支持和障碍。方法:从 2021 年 12 月到 2022 年 2 月(含),对来自加拿大农村社区的参与者进行了半结构化、虚拟的定性访谈。参与者的招募包括确定种子联系人和进行滚雪球式抽样。参与者被问及他们在 COVID-19 大流行期间的经历,包括医生领导力在建设社区复原力中的作用。数据收集在理论饱和时完成。结果:来自 4 个省 22 个农村社区的 64 名参与者参加了调查。结果:来自 4 个省 22 个农村社区的 64 名参与者参与了研究。研究发现,在生态系统破坏期间,支持医生领导力实现农村恢复力的四个关键因素是:(1)护理的连续性;(2)基于团队的护理模式;(3)医生的幸福感;(4)对创新护理模式的开放性。结论:医疗保健政策和实践转型应优先发展加强医生领导力的机会,尤其是在将受到生态系统破坏不利影响的农村地区:COVID-19大流行给农村地区的家庭医生带来了前所未有的挑战。过去两年中吸取的经验教训有助于指导应对未来的生态系统破坏。本定性研究旨在探讨加拿大农村家庭医生在 COVID-19 大流行期间作为当地医疗服务提供者和社区卫生领导者的领导经验,并确定医生领导力的潜在支持和障碍。方法:在 2021 年 12 月至 2022 年 2 月(含)期间,对来自加拿大各地农村社区的参与者进行了半结构化虚拟定性访谈。参与者的招募包括确定核心联系人和滚雪球式抽样。参与者被问及他们在 COVID-19 大流行期间的经历,包括医生领导力在建设社区复原力中的作用。数据收集工作在理论饱和后完成。结果:来自 4 个省 22 个农村社区的 64 名参与者参与了研究。结论:卫生政策和实践转型应优先发展加强医生领导力的机会,尤其是在将受到生态系统破坏不利影响的农村地区。
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引用次数: 0
Informal peer support for rural doctors. 为乡村医生提供非正式的同伴支持。
IF 1.1 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-14 DOI: 10.4103/cjrm.cjrm_16_23
Tandi Wilkinson, Rola Ajjawi, Shireen Mansouri

Introduction: Practising medicine exposes physicians to emotionally difficult situations, which can be devastating, and for which they might be unprepared. Informal peer support has been recognised as helpful, although this phenomenon is understudied. Hence, it is important to develop a better understanding of the features of helpful informal peer support from the experiences of physicians who have successfully moved through such difficult events. This could lead to new and potentially more effective ways to support struggling physicians.

Methods: Rural Canadian generalist physicians were interviewed. Using a hermeneutic phenomenological approach, data analysis was oriented towards understanding features of helpful informal peer support and the meanings that participants derived from the experience.

Results: Eleven rural generalist physicians took part. Peer support prompted the processing of difficult emotional experiences, which initially seemed insurmountable and career-ending. Participants overcame feelings of emotional distress after even brief encounters of informal peer support. Most participants described the support they received as vitally important. After the peer support encounter, practitioners no longer thought of leaving medical practice and felt more able to handle such difficulties moving forward.

Conclusions: Informal peer support enabled recipients to move through an emotionally difficult experience. Empathy, shared vulnerability and connection were the part of the peer support encounter. In addition, the support offered benefits which are known to help physicians not only process emotionally difficult events but also to acquire 'post-traumatic growth'. Practitioners, healthcare leaders and medical educators all have roles to play in enabling the conditions for informal peer support to flourish.

Introduction: La pratique de la médecine expose les médecins à des situations émotionnellement difficiles, qui peuvent être dévastatrices, et auxquelles ils ne sont pas préparés. Le soutien informel par les pairs a été reconnu comme utile, même si ce phénomène est peu étudié. Il est donc important de mieux comprendre les caractéristiques du soutien informel par les pairs à partir des expériences de médecins qui ont réussi à traverser des événements aussi difficiles. Cela pourrait conduire à de nouvelles façons, potentiellement plus efficaces, de soutenir les médecins en difficulté.

Mthodes: Onze médecins généralistes canadiens ruraux ont été interrogés. En utilisant une approche phénoménologique herméneutique, l'analyse des données a été orientée vers la compréhension des caractéristiques du soutien informel utile par les pairs et des significations que les participants ont tirées de l'expérience.

Rsultats: Le soutien des pairs a incité à vivre des expériences émotionnelles diffici

导言:行医过程中,医生会遇到情绪上的困难,这些困难可能是毁灭性的,他们可能对此毫无准备。非正式的同伴支持被认为是有益的,尽管对这一现象的研究还不够。因此,从成功度过此类困难事件的医生的经历中更好地了解有益的非正式同伴支持的特点非常重要。方法:对加拿大农村的全科医生进行了访谈。采用诠释学现象学方法进行数据分析,旨在了解有益的非正式同伴支持的特点以及参与者从这些经历中获得的意义。同伴支持促进了困难情感经历的处理,这些经历最初似乎是不可逾越的,也是职业生涯的终结。即使是短暂的非正式同伴支持,参与者也能克服情绪困扰。大多数参与者认为,他们获得的支持至关重要。结论:非正式的同伴支持使受助者度过了情绪上的困难时期。同理心、共同的脆弱性和联系是同伴互助的一部分。此外,众所周知,这种支持不仅能帮助医生处理情绪上的困难事件,还能帮助他们获得 "创伤后成长"。医生、医疗保健领导者和医学教育工作者都应发挥作用,为非正式同伴互助的蓬勃发展创造条件:行医过程中,医生会遇到情绪上具有挑战性和潜在破坏性的情况,而这些情况是他们毫无准备的。非正式的同伴互助被认为是有用的,但对这一现象的研究却很少。因此,根据成功应对此类困难事件的医生的经验,更好地了解非正式同伴支持的特点非常重要。方法:对 11 名加拿大乡村全科医生进行了访谈。采用诠释学现象学方法进行数据分析,旨在了解有益的非正式同伴支持的特点以及参与者从这种经历中获得的意义:结果:同伴支持引发了困难的情感体验,这些体验最初似乎是无法克服的,也是职业生涯的终结。即使在与非正式同伴支持短暂接触之后,参与者也克服了情绪困扰。大多数参与者认为,他们获得的支持非常重要。结论:非正式的同伴支持帮助受益人度过了情感上的困难时期。同理心、共同的脆弱性和联系是同伴互助的一部分。此外,众所周知,这种支持不仅能帮助医生应对情绪上的困难事件,还能帮助他们获得 "创伤后成长"。医生、医疗保健领导者和医学教育工作者都应发挥作用,为非正式同伴互助的蓬勃发展创造条件。
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引用次数: 0
Diversité. 多样性。
IF 1.1 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-14 DOI: 10.4103/cjrm.cjrm_29_24
Peter Hutten-Czapski
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引用次数: 0
Erratum: Pan-Canadian licensure: Potential impact on the rural physician workforce. 勘误:泛加拿大执照:对乡村医生队伍的潜在影响。
IF 1.1 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-14 DOI: 10.4103/cjrm.cjrm_31_24
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引用次数: 0
Diversity. 多样性。
IF 0.7 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-14 DOI: 10.4103/cjrm.cjrm_13_24
Peter Hutten-Czapski
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引用次数: 0
Diversité. 多样性。
IF 1.1 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-14 DOI: 10.4103/cjrm.cjrm_29_24
Peter Hutten-Czapski
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引用次数: 0
Does proximity to a fertility centre increase the chance of achieving pregnancy in Northeastern Ontario? 在安大略省东北部,靠近生育中心是否会增加怀孕几率?
IF 1.1 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-14 DOI: 10.4103/cjrm.cjrm_20_23
Ashley R Wallace, Karen Splinter

Introduction: Northern Ontario has a population of approximately 800,000 people distributed over 806,707 km2. Before 2018, the only fertility treatment centre in Northern Ontario was located in Thunder Bay; many patients travelled south for care. In 2018, the Northeastern Ontario Women's Health Network (NEOWHN) opened in Sudbury, providing fertility treatments to people living in Northeastern Ontario. The goal of this study was to determine if proximity to this new fertility centre increases one's chance of achieving pregnancy when undergoing fertility treatment. Secondary outcomes included the quantity and types of fertility investigations and treatments completed by patients.

Materials and methods: A retrospective chart review was performed for all patients seeking fertility treatment at NEOWHN between January 2019 and December 2020. Traveling >100 km to access healthcare was considered to be a clinically significant determinant of health.

Results: Seven hundred and 5 patients were seen in consultation for fertility services at NEOWHN during the study period. One hundred eighty-one of 478 (37.9%) patients living <100 km from NEOWHN achieved pregnancy compared to 39 of 227 (17.2%) patients living >100 km from NEOWHN (P < 0.01).

Conclusion: Living in proximity (<100 km) to NEOWHN increased the likelihood that individuals in Northeastern Ontario would seek fertility services and would achieve pregnancy. Financial constraints and inaccessibility likely play a role in this, but further studies are needed to explain this difference.

Introduction: Le Nord de l'Ontario compte une population d'environ 800,000 personnes réparties sur 806,707 km2. Avant 2018, le seul centre de traitement de la fertilité du Nord de l'Ontario était situé à Thunder Bay; de nombreux patients SE rendaient dans le sud pour recevoir des soins. En 2018, le Northeastern Ontario Women's Health Network (NEOWHN-le Réseau de santé des femmes du Nord-Est de l'Ontario) a ouvert ses portes à Sudbury, offrant des traitements de fertilité aux personnes vivant dans le Nord-Est de l'Ontario. L'objectif de cette étude était de déterminer si la proximité de ce nouveau centre de fertilité augmente les chances d'obtenir une grossesse lors d'un traitement de fertilité. Les résultats secondaires comprenaient la quantité et les types d'examens et de traitements de fertilité effectués par les patients.

Mthodes: Une étude rétrospective des dossiers a été réalisée pour tous les patients cherchant un traitement de fertilité au NEOWHN entre janvier 2019 et décembre 2020. Le fait de voyager >100 km pour accéder aux soins de santé a été considéré comme un déterminant de la santé cliniquement significatif.

Rsultats: Seven hundred and 5 patients ont été vus en consultation pour des services de fertilité au NEOWHN pendant la période d'étude. One hundred

导语:安大略省北部约有 80 万人口,分布在 806 707 平方公里的土地上。2018 年之前,安大略省北部唯一的不孕不育治疗中心位于桑德贝,许多患者都要前往南部接受治疗。2018年,安大略省东北部妇女健康网络(NEOWHN)在萨德伯里开业,为居住在安大略省东北部的人们提供生育治疗。本研究的目的是确定,在接受生育治疗时,靠近这家新的生育中心是否会增加患者怀孕的几率。次要结果包括患者完成的生育检查和治疗的数量和类型。材料和方法:对2019年1月至2020年12月期间在东北安大略省妇幼保健院寻求生育治疗的所有患者进行了回顾性病历审查。结果:在研究期间,有 705 名患者在东北亚妇女健康研究所接受了生育服务咨询。478 名患者中有 181 名(37.9%)居住在距离东北安大略省妇幼保健院 100 公里的地方(P < 0.01):安大略省北部约有 80 万人口,分布在 806 707 平方公里的土地上。2018 年之前,安大略省北部唯一的不孕不育治疗中心位于桑德贝,许多患者都要前往南部接受治疗。2018年,安大略省东北部妇女健康网络(NEOWHN)在萨德伯里开业,为安大略省东北部的居民提供生育治疗。本研究的目的是确定靠近这个新的生育中心是否会增加在生育治疗期间怀孕的几率。次要结果包括患者进行的生育检查和治疗的数量和类型。方法:对2019年1月至2020年12月期间在安大略东北部医院寻求生育治疗的所有患者进行了回顾性病历审查。结果:在研究期间,有 705 名患者在东北大学妇产科医院接受了生育服务。478 名患者中有 181 名(37.9%)成功怀孕,而 227 名患者中有 39 名(17.2%)成功怀孕(P < 0.01)。
{"title":"Does proximity to a fertility centre increase the chance of achieving pregnancy in Northeastern Ontario?","authors":"Ashley R Wallace, Karen Splinter","doi":"10.4103/cjrm.cjrm_20_23","DOIUrl":"10.4103/cjrm.cjrm_20_23","url":null,"abstract":"<p><strong>Introduction: </strong>Northern Ontario has a population of approximately 800,000 people distributed over 806,707 km2. Before 2018, the only fertility treatment centre in Northern Ontario was located in Thunder Bay; many patients travelled south for care. In 2018, the Northeastern Ontario Women's Health Network (NEOWHN) opened in Sudbury, providing fertility treatments to people living in Northeastern Ontario. The goal of this study was to determine if proximity to this new fertility centre increases one's chance of achieving pregnancy when undergoing fertility treatment. Secondary outcomes included the quantity and types of fertility investigations and treatments completed by patients.</p><p><strong>Materials and methods: </strong>A retrospective chart review was performed for all patients seeking fertility treatment at NEOWHN between January 2019 and December 2020. Traveling >100 km to access healthcare was considered to be a clinically significant determinant of health.</p><p><strong>Results: </strong>Seven hundred and 5 patients were seen in consultation for fertility services at NEOWHN during the study period. One hundred eighty-one of 478 (37.9%) patients living <100 km from NEOWHN achieved pregnancy compared to 39 of 227 (17.2%) patients living >100 km from NEOWHN (P < 0.01).</p><p><strong>Conclusion: </strong>Living in proximity (<100 km) to NEOWHN increased the likelihood that individuals in Northeastern Ontario would seek fertility services and would achieve pregnancy. Financial constraints and inaccessibility likely play a role in this, but further studies are needed to explain this difference.</p><p><strong>Introduction: </strong>Le Nord de l'Ontario compte une population d'environ 800,000 personnes réparties sur 806,707 km2. Avant 2018, le seul centre de traitement de la fertilité du Nord de l'Ontario était situé à Thunder Bay; de nombreux patients SE rendaient dans le sud pour recevoir des soins. En 2018, le Northeastern Ontario Women's Health Network (NEOWHN-le Réseau de santé des femmes du Nord-Est de l'Ontario) a ouvert ses portes à Sudbury, offrant des traitements de fertilité aux personnes vivant dans le Nord-Est de l'Ontario. L'objectif de cette étude était de déterminer si la proximité de ce nouveau centre de fertilité augmente les chances d'obtenir une grossesse lors d'un traitement de fertilité. Les résultats secondaires comprenaient la quantité et les types d'examens et de traitements de fertilité effectués par les patients.</p><p><strong>Mthodes: </strong>Une étude rétrospective des dossiers a été réalisée pour tous les patients cherchant un traitement de fertilité au NEOWHN entre janvier 2019 et décembre 2020. Le fait de voyager >100 km pour accéder aux soins de santé a été considéré comme un déterminant de la santé cliniquement significatif.</p><p><strong>Rsultats: </strong>Seven hundred and 5 patients ont été vus en consultation pour des services de fertilité au NEOWHN pendant la période d'étude. One hundred","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In situ clinical education of frontline healthcare providers in under-resourced areas: A rapid review. 资源匮乏地区一线医护人员的现场临床教育:快速审查。
IF 1.1 Q3 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI: 10.4103/cjrm.cjrm_95_22
Michael Seabrooke, Adrienne Seabrooke

Abstract: Rural communities are geographically isolated from large urban areas, affecting access to definitive care, specialists and other health services that only service urban areas. Rural decision-makers are often faced with numerous challenges regarding the availability, capacity, sustainability and performance of health systems in rural and remote areas. We evaluated the current body of literature on educational initiatives being used in under-resourced areas to increase the knowledge or skills of healthcare workers. This rapid review followed the methods laid out by the Cochrane Rapid Reviews Methods Group and included published articles from any of three databases that described and evaluated an educational intervention, in which healthcare workers were the learners and which took place in an under-resourced area. Papers were excluded if they were deemed to be too resource intensive, were an opinion or concept paper or took place in an urban area. Results were synthesised descriptively. Ten studies were identified that contained information on educational initiatives in a variety of countries. The healthcare workers targeted in the studies varied from physicians, nurses and midwives to community health workers and students. The quality of studies also varied and included randomised control trials, systematic reviews and both prospective and retrospective studies. Initiatives involving simulation or point-of-care ultrasound were most common and showed the most benefit to a learner's knowledge and skill development. A limited body of literature exists on educational initiatives for healthcare workers in under-resourced areas. While simulation and hands-on learning showed positive results, the opportunity remains for a low-cost, high-yield educational initiative tailored to the unique needs of healthcare workers in under-resourced areas.Les communautés rurales sont géographiquement isolées des grandes zones urbaines, ce qui affecte l'accès à des soins définitifs, à des spécialistes et à d'autres services de santé qui ne desservent que les zones urbaines. Les décideurs ruraux sont souvent confrontés à de nombreux défis concernant la disponibilité, la capacité, la durabilité et la performance des systèmes de santé dans les zones rurales et éloignées. Nous avons évalué l'ensemble de la littérature actuelle sur les initiatives éducatives utilisées dans les zones sous-dotées pour améliorer les connaissances ou les compétences des travailleuses et travailleurs de la santé. Cette examen rapide a suivi les méthodes définies par le Cochrane Rapid Reviews Methods Group et a inclus des articles publiés dans l'une des trois bases de données qui décrivaient et évaluaient une intervention éducative dans laquelle les travailleuses et travailleurs de la santé étaient les apprenants et qui SE déroulait dans une zone manquant de ressources. Des articles jugés trop gourmands en ressources, des opinions, des documents conceptuels ou en lien

摘要:农村社区在地理上与大城市地区隔绝,影响了人们获得明确的护理、专家和其他只服务于城市地区的医疗服务。农村决策者往往面临着与农村和偏远地区医疗系统的可用性、能力、可持续性和绩效有关的诸多挑战。我们评估了目前有关资源不足地区为提高医护人员的知识或技能而采取的教育措施的文献。本次快速综述遵循 Cochrane 快速综述方法小组制定的方法,收录了来自三个数据库中任何一个数据库的已发表文章,这些文章描述并评估了在资源匮乏地区开展的以医护人员为学习者的教育干预措施。如果文章被认为资源密集度过高、属于观点或概念性论文或发生在城市地区,则将其排除在外。对结果进行了描述性综合。共确定了 10 项研究,这些研究包含了不同国家教育计划的相关信息。研究中针对的医护人员各不相同,有医生、护士和助产士,也有社区医护人员和学生。研究的质量也各不相同,包括随机对照试验、系统综述以及前瞻性和回顾性研究。涉及模拟或护理点超声波的研究最为常见,对学习者的知识和技能发展也最有益处。关于针对资源匮乏地区医护人员的教育计划的文献数量有限。农村社区在地理位置上与大城市隔绝,这影响了他们获得明确的护理、专家和其他只服务于城市地区的医疗服务。农村决策者往往面临着有关农村和偏远地区医疗系统的可用性、能力、可持续性和绩效的诸多挑战。我们评估了目前有关资源不足地区为提高卫生工作者的知识或技能而采取的教育措施的文献。本次快速综述遵循 Cochrane 快速综述方法小组规定的方法,收录了发表在三个数据库之一的文章,这些文章描述并评估了在资源匮乏地区开展的以医疗工作者为学习者的教育干预措施。被认为过于耗费资源、观点、概念性文件或与城市地区有关的文章被排除在外。对结果进行了描述性总结。共确定了 10 项研究,其中包含有关各国教育措施的信息。研究对象包括医生、护士、助产士、社区卫生工作者和学生。这些研究的质量也各不相同,包括随机对照试验、系统综述以及前瞻性和回顾性研究。涉及模拟或 POCUS 的措施最常见,对学习者知识和技能的发展也最有益。有关资源匮乏地区医护人员教育计划的文献十分有限。尽管模拟和实践学习已显示出积极的效果,但仍有可能针对服务不足地区医护人员的具体需求,制定低成本、高回报的教育计划。
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引用次数: 0
Pan-Canadian licensure: Potential impact on the rural physician workforce. 泛加拿大执照:对乡村医生队伍的潜在影响。
IF 1.1 Q3 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI: 10.4103/cjrm.cjrm_19_23
Carmela Bosco, Louise Sweatman, Kyle Sue

Abstract: Proposals to establish pan-Canadian licensure for physicians have broad support amongst medical groups to address physician shortages in underserved rural communities. The concept has also elicited concern from some stakeholders that its implementation could exacerbate rural physician workforce shortages by prompting an exodus of rural physicians to urban centres. An environmental scan of reports from key medical groups published within the past 10 years was conducted to determine factors influencing rural physician practice patterns. Data from membership surveys of the Society of Rural Physicians of Canada and the Canadian Medical Association - conducted in fall 2022 - were reviewed to determine whether licensure is a factor in rural physicians' decisions to leave or stay in practice in rural Canada. Factors contributing to physicians' decisions to leave rural practice identified in the environmental scan included lack of infrastructure support, inability to find locum coverage, inadequate support for team-based care and effects of high workloads on wellness. A common theme found in responses to the membership surveys was the recognition of licensing restrictions as barriers preventing rural physicians from practising in multiple provinces or territories. Survey respondents also voiced strong support for national licensure implementation. Pan-Canadian licensure holds promise as a strategy to enhance the recruitment and retention of physicians in rural communities. It could also provide physicians flexibility to work in multiple jurisdictions to address the health workforce needs of underserved communities.Les propositions visant à établir un permis d'exercice pancanadien pour les médecins bénéficient d'un large soutien de la part des groupes médicaux afin de remédier aux pénuries de médecins dans les communautés rurales mal desservies. Ce concept a également suscité des inquiétudes de la part de certaines parties prenantes qui craignent que sa mise en oeuvre n'aggrave les pénuries de médecins en milieu rural en provoquant l'exode de ces derniers vers les centres urbains. Une analyse environnementale des rapports des principaux groupes médicaux publiés au cours des dix dernières années a été effectuée pour déterminer les facteurs influençant les modes de pratique des médecins ruraux. Les données des enquêtes sur les membres de la Société de la médecine rurale du Canada et de l'Association médicale canadienne-menées à l'automne 2022-ont été examinées pour déterminer si le permis d'exercice est un facteur dans la décision des médecins ruraux de quitter ou de rester en pratique dans les régions rurales du Canada. Les facteurs contribuant à la décision des médecins de quitter la pratique rurale, identifiés dans l'analyse de l'environnement, comprenaient le manque de soutien en matière d'infrastructure, l'incapacité à trouver une couverture de suppléance, le soutien inadéquat des soins en équipe et les effets des charges

摘要:建立泛加拿大医生执照制度的建议得到了医疗团体的广泛支持,以解决服务不足的农村社区医生短缺的问题。这一概念也引起了一些利益相关者的担忧,他们认为,这一概念的实施可能会促使乡村医生流向城市中心,从而加剧乡村医生队伍的短缺。为了确定影响乡村医生执业模式的因素,我们对主要医疗团体在过去 10 年内发表的报告进行了环境扫描。对加拿大乡村医生协会(Society of Rural Physicians of Canada)和加拿大医学协会(Canadian Medical Association)于2022年秋季进行的会员调查数据进行了回顾,以确定执照是否是影响乡村医生决定离开或留在加拿大乡村执业的一个因素。环境扫描中发现的导致医生决定离开农村执业的因素包括缺乏基础设施支持、无法找到临时工、对团队护理的支持不足以及高工作量对健康的影响。在对会员调查的答复中发现的一个共同主题是,许可限制是阻碍乡村医生在多个省份或地区执业的障碍。调查回复者还表示强烈支持实施全国执照制度。泛加拿大执照制度有望成为加强农村社区招聘和留住医生的一项战略。建立泛加拿大医生执照的建议得到了医疗团体的广泛支持,认为这是解决服务不足的农村社区医生短缺问题的一种方法。这一概念也引起了一些利益相关者的担忧,他们认为这一概念的实施可能会导致医生流向城市中心,从而加剧农村医生的短缺。为了确定影响乡村医生执业模式的因素,我们对过去十年发表的主要医疗团体报告进行了环境扫描。对加拿大乡村医生协会(Society of Rural Physicians of Canada)和加拿大医学协会(Canadian Medical Association)在2022年秋季进行的会员调查数据进行了研究,以确定执照是否是影响乡村医生决定离开或留在加拿大乡村执业的因素。环境扫描中发现的导致医生决定离开农村执业的因素包括缺乏基础设施支持、无法找到临时工、对团队护理的支持不足以及高工作量对健康的影响。成员调查回复中出现的一个共同主题是认识到执照限制是阻碍乡村医生在多个辖区执业的障碍。调查对象还表示支持全国执照制度。泛加拿大执照制度是改善农村社区招聘和留住医生的一项有前途的战略。它还可以让医生在多个辖区工作,以满足服务不足社区的卫生劳动力需求。
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引用次数: 0
Sécurité alimentaire. 食品安全。
IF 1.1 Q3 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI: 10.4103/cjrm.cjrm_7_24
Sarah Lespérance
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引用次数: 0
期刊
Canadian Journal of Rural Medicine
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