Role of the general practitioner in the delivery of surgical and anesthesia services in rural western Canada

Abstract

Objective: To determine the present role of general practitioners (GPs) in the delivery of surgical and anesthesia services in rural western Canada.

Design: Survey by mailed questionnaire in November 1993, with telephone follow-up of nonresponders.

Setting: Rural British Columbia, Alberta, the Yukon Territory and the Northwest Territories.

Participants: Administrators of 148 rural hospitals; of the 121 who completed it 101 represented hospitals that met the inclusion criteria (fewer than 51 beds and serving a population of 15,000 or less).

Outcome measures: Hospital characteristics, type of practitioners providing surgical and anesthesia services, length and location of GPs', surgical and anesthesia training, types of surgical procedures performed by GPs and opinions of administrators regarding the delivery of surgical services in their community.

Results: Surgical services were provided by 56 (55%) of the 101 hospitals; at 45 (80%) they were provided by GPs, and at 33 (59%) they were provided by GPs with limited additional surgical training. Fifteen (27%) of the 56 hospitals were said to rely solely on GPs with limited surgical training for surgical services. At 45 (80%) of the 56 hospitals anesthesia services were provided by GPs, all of whom had limited additional training in anesthesia; 36 (64%) were said to rely solely on GPs for anesthesia services. Just over three quarters (76% [74/98]) of the administrators felt that their community's surgical needs were well met.

Conclusion: GPs with limited specialty training continue to play a role in providing surgical and anesthesia services in rural western Canada. This has implications for postgraduate training programs in Canada.