An estimated four million Canadians still don't have a family doctor — a shortage that continues to plague small towns in Alberta.
Two out of three doctors in Milk River, Alta., quit nearly four years ago. If it wasn't for the dedication of the last remaining doctor, residents say they don't know what health care would be like today.
Dr. Elisabeth Lewke-Bogle has been working in that town's hospital and clinic for four decades, and has decided to not retire until the town can find a replacement.
"It's the people," she said. "It's the satisfaction you get in your job. You actually have people who say 'thank you' almost every time ... and that reward is immeasurable. I don't have a lot of angry patients and I'm really fortunate in that."
Lewke-Bogle said her son often reminds her to retire and spend more time with her grandchildren, but her passion is to see that Milk River is well looked after. She moved to the small town in southern Alberta in the 1970s and fell in love with it.
Lewke-Bogle concedes that being a country doctor isn't for everyone, but she gets the sense her patients aren't taking her for granted.
Closest medical centre 45 minutes away
Like Barb Hoytos, who owns a beauty salon just down the street from the hospital.
"I think it's really stressful on the lady that's still here helping us out," she said.
"Thank goodness she's still here. But if you're not going to get a doctor here, you're not going to get people wanting to come and either retire here or come here and open a business, and have your kids go to school here when you don't have any facility… You've got to go up the road 45 minutes [or] an hour for health care."
There is a hospital, which was built in the 1970s, and a private health clinic that needs three doctors to staff. It used to be a full-service hospital, but it now only offers emergency care with cuts over the years. Besides Milk River, the hospital covers Warner, Coutts, half a dozen Hutterite colonies and hundreds of farms and oil and gas operations. It also serves 30,000 tourists who visit nearby Writing-on-Stone Provincial Park every year.
The town created a committee to address the doctor shortage in 2009.
Katharine Hockney, who has been volunteering as a recruiter, says they have had more than 70 inquiries and interviewed more than 20 doctors over the last four years, but have had no luck.
"It consumed most of my days and most of my nights," she said. "I was in touch with doctors overseas, in Canada, Australia, trying to let them know what a beautiful place we had with an urgency behind me being pressed 'we need doctors, we need doctors.' And they just weren't forthcoming. I think there's a shortage of doctors worldwide."
Milk River not alone in struggle
Milk River isn't the only small town dealing with a doctor shortage, as there are currently more than 250 job vacancies for general family practitioners provincewide.
And nearly 40 rural communities that are dealing with a critical doctor shortage.
Provincial officials say Alberta's doctor recruitment rate is actually better than the national average, and Alberta Health Services says it's working on recruitment campaigns to address the problem.
Dr. Doug Myhre, who helps run the Rural Integrated Community Clerkship program at the University of Calgary, says he is seeing more and more graduates taking work in small towns.
The program he works with places students in rural hospitals and clinics for nine months as they work with rural doctors and learn the ropes of a country practice.
"The sooner you get them, the longer you get them, the more you follow up and build those mentoring relationships that are important, the more likely you're going to get them to stick," he said.
"Now they might train in Bassano and they might go to work in Three Hills, but they're still going back to rural Alberta."
Lewke-Bogle also teaches students through the program, and hopes that one or more of them will eventually choose to return to Milk River.