Doctor shortages in rural Saskatchewan have reached crisis levels, and the province needs to do more to hire and keep physicians in the smaller centres, the annual meeting of Saskatchewan's Medical Association heard on the weekend.

"This is our last kick at the cat, we're going to have practices falling apart out there," said Dr. David Ledding, a veteran physician working in the small town of Rosetown.

He made the remarks to health professionals who gathered in Saskatoon for the conference on Saturday.

"Even larger group practices are struggling right now — this is not a minor issue. I don't think it's possible to understate it," Ledding said.

Saskatchewan is below the national average when it comes to the number of family doctors and specialists working in rural centres.

Nationally, figures from the Canadian Institute for Health Information show that less than 10 per cent of doctors are located in rural areas, compared with 21.1 per cent of Canada's population.

Just 2.4 per cent of specialists were located in rural areas or small towns.

CBC News reported on Oct. 17 that a Lloydminster, Sask., doctor who agreed to take a shift in the small northern community of Meadow Lake, Sask., worked 72 hours without a break, prompting concerns from the medical community about a lack of resources.

System has changed, so must expectations: health minister

But the registrar of Saskatchewan's College of Physicians and Surgeons said people living in rural areas must realize that the era where a doctor lived just down the street from them is over.

"There's a sense of wanting to retain a vision of each little community having their own doctor," Dr. Dennis Kendall said.

"And that's not compatible with retaining Saskatchewan [medical] graduates, or getting them into rural Saskatchewan," Kendall said.

Health Minister Don McMorris agreed, saying the system and environment of how doctors deliver their services is changing.

"Can I ensure that there will be a doctor in every community like there used to be? We can't just do that," McMorris said.

"The way health care was delivered in rural Saskatchewan, especially 20 or 30 or 40 years ago, isn't going to be the way it's going to be delivered in the next number of years," he added.

McMorris said the province is hoping to create a new agency to look at the recruitment and retention of rural doctors. He said he hopes to have it operational by early 2010.