It hasn't made their jobs any less stressful, but it's allowed them to focus on their patients. There are now 12 doctors at the Humboldt Clinic. A good dozen family physicians practising in the city - a number that was once down to seven. With another doctor set to arrive in January, and a current locum doctor perhaps staying longer, that number could be up to 13 in the new year. "We are at the level we want to be for the time being given the current population," said Dr. Warren Huber. "With the increase in numbers in the next year, we will be adequately served in Humboldt for the foreseeable future," he added.That has made a huge difference for the local clinic and for local doctors. First, at the clinic, they normally do have openings in their appointment books each day now, said manager Gail Ewen. That was not the case last year at this time, when it could take weeks to get an appointment to see a physician, if you could get in at all. The lack of available appointments led many to head to the emergency room at the Humboldt District Hospital in order to see a doctor, even for non-urgent concerns. They definitely don't need to do that anymore. "People should definitely check here first for non-urgent matters," Ewen said. In addition to clinic hours in Humboldt, local physicians have been doing clinics in outside communities like Bruno, Watson, LeRoy, Quill Lake and Middle Lake full force again. For Dr. Huber and Dr. Kevin Ledding, who spoke to the Journal on behalf of Humboldt's 12 physicians, it's the on-call portion of their schedule that is so much better with more doctors in town. "I think in our office practice, we don't see as much of a change. We all see patients and we still have full days. But the hospital call was becoming too much for everyone," said Dr. Huber. "It's made a huge difference (in that area), having the support of new people."Having more doctors share the on-call schedule for the Humboldt District Hospital means fewer days on call for each doctor every month. Each doctor is on call for a 24-hour shift at a time. When they were short-staffed, each physician was taking call twice a week. That has now dropped to three or four times a month."It's a big difference," said Ledding.The amount of time spent on call affected the number of doctors available to see patients at the clinic on a given day.If a doctor was at the hospital for the entire day on call, and into the night, that meant they saw no patients at the clinic during that time, and likely missed the next day as well, trying to catch up on rest as they had to take call again that week."It really meant that, though we had eight people in the practice, at any given time, there were not that many in the office," Huber said. Their itinerant clinics were still in operation as well, he added, so those took people out of the Humboldt office on a daily basis, too. "Now that we have new people, we will be able to expand our itinerant clinics," Huber said. They have increased service to Watson and Bruno and are speaking to other communities in the area who may be interested in having them out. The emergency room at the HDH remains busy, though some are likely coming to the clinic now that they can get an appointment. "The volume up there is still pretty busy," said Huber. That can be put down to an increasing population, an aging population, a lesser number of physicians in the larger area, and the nature of the population."With all the construction going on, there are more injuries. We see a lot of that," said Ledding.In general, with more people to share the patient load, there's a lot less frustration at the clinic, Huber said. Their patients are less concerned, and a lot less frustrated with clinic staff, who were feeling the brunt of the physican shortage, especially at the front desk."I think the morale among the physicians is better," said Ledding. The new doctors are fitting in well, Huber put in, calling them personable and energetic. How important is morale?"Our number one concern is retention," said Ledding. Had the level of staffing not come up, "we all would have dropped dead or quit," he said. "It was quite a heavy burden."Having a large number of doctors in a community does make it easier to keep them, Huber agreed. The modern doctor is not going into a solo practice - it's a rare exception when they do, he said.The more doctors a community has, the more support they each have, and the fewer nights they are on call. Being on-call is the most difficult part of practising in rural centres, Huber said. That's why many physicians leave for urban centres. Having more doctors in Humboldt isn't likely to make it easier for places like Wynyard or Wadena to attract more doctors, though, the two said. "I think every community has its own struggles. Part of that is that critical mass, which we've got right now," said Ledding. Without that critical mass, doctors in those areas will still be spending a lot of time on call for their hospitals. "But it's good to know there are people in medical school who are willing to work in rural practices," Huber put in. Though Humboldt now has a critical mass of doctors - the number needed to service the current population - they are not resting when it comes to recruitment. "There is always going to be change," Huber said. "Life throws curves... retirements or other opportunities come along."But Huber is hopeful that if they keep participating in the residency training program in Humboldt, that will make it somewhat easier to maintain this staffing level long term, by attracting new doctors here. "We are more apt to keep local graduates long term (as opposed to foreign-trained doctors) because they have something close to home here," Huber said.Having younger people in the practice is also likely to make Humboldt more attractive to young students. The Humboldt and District Chamber of Commerce, which spearheaded the formation of a Doctor Recruitment and Retention Committee offered a lot of support to local doctors when it came to recruiting new physicians, Ledding added, as did the Saskatoon Health Region.That helped them bring in the new doctors so desperately needed. Is their work less stressful now?"What we do is stressful at all times," replied Dr. Huber. "But the added pressure from call demands, made it extremely difficult."Having that critical mass of doctors "makes it easier to focus on the job - health issues (rather than) manpower issues," said Ledding.
