It's taken a long time to heal, but the doctor shortage in Humboldt is getting better.
One new doctor began practising at the Humboldt Clinic last week, three more are due to arrive before this time next month, and another will be coming in November, if everything works out.
That will give the Humboldt Clinic a total of 12 permanent doctors, plus one locum physician who is planning to stay until December.
It's a far cry from the situation over the past year when the practice has fluctuated between seven and eight doctors.
On staff now are Dr. W.N. Huber, Dr. D. Kirchgesner, Dr. C. Levick, Dr. R. Ockbazghi, Dr. J. Bourgeois, Dr. K. Ledding, Dr. M. Zwane, and now, Dr. R. Graf.
Dr. Rose Graf started her work at the Humboldt clinic on August 8. She's no stranger to Humboldt, having worked here during her nine years of training, including an eight-week term as a second-year resident, she told the Journal on her second day of work.
From Wishart originally, Graf has trained in large centres like Edmonton and Saskatoon, but has also spent time in rural Saskatchewan hospitals.
"I'm quite familiar with rural (medicine)," she smiled.
During her residency in Saskatoon, she rotated through hospitals, and over two years, did a little bit of everything, she said.
Working in Humboldt, it's her first job out of school. She just completed her residency in June.
She chose Humboldt, she said, because she knew she wanted to practise in rural Saskatchewan, but she didn't want to be the only doctor in town,. She wanted the variety of practice being a rural physician entails.
"(Humboldt) is one of the only places where you get to do everything," she said - clinic hours, emergency and deliveries.
"You can follow from birth to death... (and) you never get bored," she smiled.
In the larger cities, family physicians don't cover emergency rooms, and only some actually do deliveries.
In rural centres, family physicians do it all, from clinic visits to hands-on procedures. That was a draw for Graf.
But as she also wants to have a life outside of her work, she wanted to work in a place where she was not the only physician.
"Humboldt... has enough doctors that you always have back-up," she said.
It's also close to her hometown, and her husband's - he hails from Watson.
She's familiar with the Humboldt hospital, she said, which she called "beautiful."
So far, she's comfortable in her new home.
"It's been great. Everybody is so welcoming and happy. (The clinic) hasn't had 10 doctors in so long."
The staff at the clinic has been great, she said - they will help you with anything.
And she's been busy - she's booked solid every day until the end of the month.
"That's exactly what I want," she said. "I'm not getting more than I can handle."
With Graf, there are eight physicians at the clinic; with the addition of the locum, Dr. Saul-Duke, there are nine available to see people now.
"And I hear there are more to come after me," said Graf.
Indeed, there are.
Dr. Moola and Dr. Moosa, a husband and wife team from South Africa, will be arriving later in August, and Dr. Davids, another South African doctor, is planning on arriving in the first week of September, reported DonnaLyn Thorsteinson, chair of Humboldt's Doctor Recruitment and Retention Committee (HDRRC).
A doctor from Great Britain, Dr. Rengarajan, visited Humboldt last week with his family, and plans on beginning his practice here in November, she added.
"It's really busy right now. We have so many doctors coming all at once," she said.
Graf is just the first of the new influx, but is the only doctor trained in Canada.
"It's nice to have someone somewhat local come back to practise here," she said.
Their committee, she said, is trying to encourage the government to increase residency training in Humboldt, so that new doctors form a bond with the current physicians, and are more apt to come back.
Graf, who trained with Dr. Bourgeois and Dr. Levick in Humboldt, is proof of that, she noted.
Humboldt has a fantastic facility for that training, she added, and will have doctors willing to do it, once there are enough physicians here to handle the patient load.
Of course, Thorsteinson is also pleased with the foreign-trained doctors they've been able to recruit to Humboldt.
Doctors Moola and Moosa have passed all the exams necessary so they can practise here, as has Dr. Davids.
All three have also done their clinical field assessments in Prince Albert and Melfort as part of getting qualified to practise in Canada, so they are familiar with this part of the province and the demands of centres like Humboldt.
The main role of the HDRRC with all four doctors had been finding them appropriate rental housing, Thorsteinson said. They have also paid three months of their rent to welcome them to the community.
"Some of our funding is going towards that," she said.
Physician training, here or abroad, comes with significant costs, she noted, so money is an issue for these physicians. Getting these doctors set up and on their feet in the community is important, she feels.
Local businesses have also jumped in to welcome the doctors, Thorsteinson said, explaining that the local vehicle dealerships have come together to offer a deal to the three doctors coming in from out of country.
The Humboldt Newcomer Centre will also be stepping up to help the new doctors fit into the community, to help them not feel so isolated in moving here.
Most of the staff of the Newcomer Centre has moved here from other countries, and so will know what the foreign-born doctors are going through in settling in.
"They are a great resource in terms of setting up utilities, etc," Thorsteinson said. "Everything they need assistance with, between the Newcomer Centre and our group, we've covered most."
The HDRRC is also lobbying the government to get some things changed in Humboldt to make it more attractive for doctors to come here.
The main thing is emergency room coverage, compensation and expectations, Thorsteinson said.
In larger centres, doctors are not expected to cover the emergency room in addition to their clinic duties. There are doctors paid to be on staff at the emergency room in the hospital.
That's what the HDRRC wants in Humboldt, and they've spoken to local physicians and the Minister of Rural and Remote Health about it.
"It would take lots of strain off physicians," Thorsteinson said, who currently rotate 24-hour on-call shifts.
The expectations for rural doctors in covering a busy emergency room is "ridiculous," she said.
"We're asking for them to look at options for our emergency room, to address the inequalities somewhat."
The HDRRC recently incorporated as an organization, Thorsteinson added, with seven people on their executive, including Milt Kerpan of Watson, Anita Renneberg of Humboldt, Dr. Jacquie Bourgeois, Councillor Aaron Behiel of the City of Humboldt, Kelvin Fisher, a retired employee with the Saskatoon Health Region, and Janine Hart of the Humboldt Newcomer Centre.
Dr. Warren Huber, chief of staff at the Humboldt District Hospital, and a partner in the Humboldt Clinic, seems satisfied that they will soon have 12 doctors at the Humboldt Clinic, which also has physicians seeing patients in LeRoy, Watson, Quill Lake, Bruno and Middle Lake.
However, he is cautious about saying that number will be enough for a long time.
"Everything is so dependent on what happens to the surrounding area," he told the Journal.
Twelve doctors, he said, is sufficient for the current population of their service area. However, there are many variables at play.
"We don't know what's happening in Lanigan. We don't know what's happening in Wadena, Watrous," he said.
Those areas, as well as Wynyard and Kelvington, are having difficulty recruiting physicians.
"I think given the numbers we will have available to use at the end of the year, we should be okay for (a period of time)."
Just how long that is remains to be seen.
"One never knows what the future holds," he said. "Physicians come and physicians leave. That's the nature of life. People are mobile. As far as I know, there are no pending departures, and with the new people coming in, that should make a big difference."
He remains concerned, however, with the utilization of the local emergency room. It has been extremely busy in the past months.
When a doctor is on call for a 24-hour shift, they are staying at the hospital for the whole day, he said, unable to spend any time seeing patients at the clinic.
"That used to be an exceptional situation, that you were called away from the clinic," he said.
Now it's the norm.
And they can be away for more than one day.
As some doctors are at the hospital emergency department for most of the evening and frequently through the night as well, they have started not working at the clinic after their day on call, Huber reported. That takes people out of the office for two days.
Though there will be more doctors available to take call soon, Huber is still recommending discretion in the use of the emergency room.
People unable to get appointments at the clinic right away have been going to the emergency room for issues that are not emergent matters, he indicated.
For non-emergent issues, getting on the cancellation list at the clinic is the way to go, even if you do not have a family doctor, Huber noted.
These days, people have been able to get in to see doctors fairly quickly through that cancellation list, he added.
The local physicians, he said, definitely feel the time has come to consider staffing the emergency room here with doctors, and they have talked about that with the Ministry.
"The problem is that it is very expensive to staff an ER full time," he said, and it was previously felt that the numbers didn't necessarily warrant a full-time position in Humboldt's emergency room.
But it should be looked at again, Huber feels.
There are plenty of new people in Humboldt who use the emergency room, he noted, and people are coming in from outlying areas as well. They are also dealing with people from Humboldt who doctor out of town.
"Our emergency room is seeing a lot of people not generally part of our practice," he said.
Doctors who want to practise outside major cities are the exception, not the rule, Huber believes.
Getting these new doctors to Humboldt has taken years of effort, he added. They have been speaking with Dr. Graf for two years, he said, and with the foreign doctors soon to arrive for well over one.
"It's been a long wait," he said. "I hope the community makes them feel welcome, and that they will enjoy their practice."
