Growing dissatisfaction among Canada's rural MDs
================================================

* Lynda Buske

A recent CMA survey of rural physicians found a noticeable decrease in professional satisfaction levels since the early 1990s. FIGURE

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/162/4/553.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/162/4/553.1/F1)

Figure. 

The survey asked physicians to rate both personal and professional factors, and while satisfaction with personal and family factors remained relatively constant, the level of satisfaction with professional factors fell significantly.

For example, the percentage of physicians very satisfied with their hospital facilities/services fell from 40% in 1991 to 17% in 1999. Similarly, the proportion who were very satisfied with professional backup and specialty services dropped by at least 50%.

Respondents were asked to list the top 3 characteristics that define a community as rural from a medical perspective, and the responses clearly showed the bleak horizon many rural MDs see. More than half of the responses included the following 4 items (in rank order):

*   High level of on-call;

*   Long distance to secondary referral centre;

*   Lack of specialty services; and

*   Too few GP/FPs

Other factors rounding out the top 10 were:

*   Long distance to tertiary referral centre;

*   Absence of equipment such as x-rays and laboratory services;

*   Difficulty in obtaining locums;

*   No ambulance service;

*   Inability to provide services such as obstetrics and general surgery; and

*   Sparsely populated catchment areas.

## Footnotes

*   Readers may send potential research topics to Patrick Sullivan ([sullip@cma.ca](http://sullip@cma.ca); 800 663-7336, x2126; fax 613 565-2382).