A family doctor recruited to work for a decade in a northern Manitoba community left after just 16 months and is now refusing and/or neglecting to repay a $100,000 interest-free loan, according to documents filed in court.
Dr. Andrea Wilson signed a loan agreement with The Pas Community Development Corporation (CDC) on Apr. 1, 2019 after finishing her family medicine residency program at the University of Manitoba, according to a lawsuit filed against her by the CDC.
She agreed to work at least 880 clinical hours during each of ten years of full-time medical services in The Pas between 2020 and 2030. Wilson entered into a contract with the Northern Regional Health Authority (NRHA) on July 1, 2020, the documents say.
Wilson agreed to repay the loan if she terminated the agreement, if it was cancelled for cause, or if she was dismissed for cause before the expiry of the agreement.
A social media notice posted on June 29, 2020, by the NRHA welcomed her to the community with a population of 5,639, located about 625 kilometres northwest of Winnipeg.
"The Northern Health Region is pleased to announce the arrival of Dr. Andrea Wilson as the new physician to the Fischer Avenue Clinic," it said.
Doctor now works in Vancouver
However, the court documents say Wilson left The Pas on Nov. 7, 2021, and moved to Vancouver, breaching the agreement.
She was hired by Mint Integrative Health, which posted a notice on Nov. 23, 2021, heralding her arrival. "She's what you always hoped family medicine could be and should be," the notice read.
Wilson has since left Mint and is working at another clinic in Vancouver.
On Nov. 22, 2022, Wilson was advised she had breached the agreement with the NRHA and it was being cancelled with cause. The Pas Community Development Corporation demanded repayment of the loan by Dec. 31, 2022.
"The defendant has refused and/or neglected and continues to refuse and/or neglect to pay the loan," court documents say.
According to her LinkedIn profile, Wilson did her undergrad science and psychology degree at the University of Calgary from 2001-2006. She did a master of Public Health at the University of British Columbia from 2009-2011 and her Doctor of Medicine at the University of Calgary from 2013 to 2016. She worked as an epidemiologist for Health Canada in Edmonton from 2012 to 2014.
Wilson did her family medicine residency at the University of Manitoba and got her licence to practice in December 2019.
Wilson could not be reached for comment. Staff at her current clinic in Vancouver said she is away for several weeks. Wilson has until early December to file a statement of defence in court.
The Pas Community Development Corporation and its lawyer, Jonathan Paterson, declined to comment because the case is before the courts.
In a statement, the NRHA said it also can't comment on a legal case but says it is continuously recruiting family physicians.
The NRHA did not respond to questions about if it had been able to replace Wilson.
Recruiting, retention a 'massive problem'
Meanwhile, a survey by the Association of Manitoba Municipalities (AMM) found more than 90 per cent of 137 municipalities are reporting doctor shortages.
"It's a massive problem right across our entire province and across our entire country," he said.
"Every single community is trying to find ways to properly staff their emergency services, whether that be nurses, doctors, paramedics, etc., and it is just at a critical point."
Blight, who wasn't commenting specifically on the example from The Pas, said the responsibility to recruit health professionals is provincial and federal, but municipalities are doing whatever they can to sell their communities.
When it works, he says it creates peace of mind for residents, knowing quality health care is close to home.
"That can make the difference of saving your life or not."
When it doesn't work, it's "absolutely devastating" to the community and its residents, Blight said.
"Not only are they out financially for some sort of incentive that's been provided, but also the fact that they've lost this caregiver."
But, even with incentives, it can be hard for physicians to settle in rural and remote communities, doctors' groups say.
They may not have professional colleagues and could face cultural or religious isolation. They may have spouses who also need a job, and children who require care.
If the family can't set down roots, the relationship may not work out long-term.
Matching doctor to community is crucial
So, while financial incentives are important, it's also crucial to find a good match with a community, said Dr. Nadin Gilroy, a family physician and Manitoba representative of the Society of Rural Physicians of Canada.
"If we want to be long-lived in our jobs, we have to ensure that we have … balance in our lives," she said. "And feeling potentially that you're not part of the community, that can be a challenge to people that makes them not want to … remain in a certain location. And when it is approached with the lens of financial incentive, that can be easily missed."
Communities and governments need to get creative and be flexible with things like living arrangements, said Gilroy, who splits her practice between family and emergency medicine in Norway House Cree Nation in northern Manitoba and Winnipeg, where she works as a palliative care physician.
She believes doctors and nurses don't necessarily have to live in a community full time to do a great job for their patients.
"Allowing individuals to split their practice can lead to a much more solid and long-lived team of physicians that are dedicated to the community and are there for the long haul," she said, noting that some communities might feel that physicians shouldn't split their practices, but she can think of several examples "where that absolutely has worked."
And when it doesn't?
"What I feel confident in saying is that you would be hard-pressed to find a physician that wants to abandon their patients," Gilroy said.
"A physician who has worked in a location for more than a few months is going to feel a great responsibility to the patients that they have in their practice and to the people that they look after and the community that they're trying to be part of," she said.
"So I don't believe that these decisions are ever made lightly."
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