Hope for the Rural Areas of Canada

It’s easy for many these days to characterize the younger generation of dentists as being unable to make decisions to go “on their own” and to practise away from the GTA or the larger cities of Canada. Certainly, a majority choose the city lifestyle as an associate and later on to establish their dental practices. Rarely do we find young dentists who plan to purchase a solo “country” clinic. This is evidenced by the disproportionate number of practices that brokers have for sale that are situated one hour or more from the GTA, when compared to the number of buyers seeking practices in the GTA. A review of the various websites and dental journal print ads – for both brokered and private sales – reveals a ratio of three to four practices for sale for every buyer interested in areas outside of the GTA. This ratio changes to roughly 10 or more buyers for each practice for sale within the GTA.

Across Canada, we are experiencing the same problems, as many dentists seem to be hesitant to venture out into the rural or small-town environment. Very few young dentists actually follow what was arguably the quintessential Canadian dream of the past century — to live and serve people in the small towns and rural places that abound in our wonderful country.

The reluctance is often explained by people saying “The demographics of the dental school classes have changed”. Certainly, there are more visible minorities and more women in the profession than ever before — and they seem very reluctant to practise in the smaller towns and cities.

A prime example is the oversupply of dentists in the Toronto area. There are currently too many dentists in the GTA. This is a common thread among numerous industry experts who share a consensus that the number of ‘active patients’ is now less than 1,000 patients per full-time dentist. Invariably, this leads to enhanced competition and certainly has driven the price of an average dental practice “over the top,” while perfectly sound practices in areas offering a more relaxed lifestyle, go begging.

In fact, dentistry is not alone in the move away from the rural to the urban environs, as medicine, pharmacy and veterinarian practices also are experiencing the same dearth of professionals in rural areas.

Veterinary medicine schools are now seeing mainly students who only wish to look after small animals. Thus, the large animal practitioners who are the backbone of our cattle and other livestock industries are getting harder and harder to find. One of the interviewers for the first class of veterinary medicine students at the University of Calgary confided in us that he had not found one potential vet from his cadre of interviews who wanted to pursue a large animal practice – because they are usually found in rural locations.

It is essentially the same for medicine. If it weren’t for the foreign trained physicians there would be a host of smaller communities – from Manitoba to the Pacific coast – without a physician to provide medical care to the inhabitants. There are at least two medical training programs that are trying to break that trend and they are the Thunder Bay or Northern Ontario School of Medicine and the University of British Columbia School of Medicine in Prince George. This program has just graduated its first class. These programs need to be applauded. Across this country there are no undergraduate recruitment opportunities known (to us anyway), that are attempting to bring small-town or rural students into the dentistry training programs, with the hope that they might just return “home” to rural Canada to practise after graduation. Nevertheless, there is a heartening story that we heard recently. This is the first example, in our study of young dentists breaking the “mold” and opting for a lifestyle change to live in a small town. A young female dentist from a professional family has recently moved with her husband, one rabbit, two cats and a dog to serve a small community in western Alberta.

In this particular case, the move resulted from a childhood dream of the young dentist, as an eight-year-old child traveling through the Canadian Rockies with her family. She fell in love with the country and vowed to make it her home in the future. Twenty-plus years later and rural Alberta is now the better for that dream. Surely, with the boomers retiring in greater numbers every year, there is going to be plenty of opportunity for new dental graduates and others wishing to make a lifestyle change to take a second or third look at the wonderful opportunities found in the smaller towns and rural areas of Canada. Perhaps some of the dozens of Maritime dental graduates might take a second look at their native area to begin a reverse “East Coast” move. There are many small towns and rural areas in Alberta, as well, that are hoping that our young friend, now living her childhood dream is just the first of many more professionals to come.

Co-Authored by G. Wayne Raborn

Ontario Dentist – September 2008