Surgical Task‐Sharing in the Western Canadian Arctic: A Networked Model Between Family Physicians with Enhanced Surgical Skills and Specialist Surgeons

• Published in: World Journal of Surgery
• Main Authors: Falk, Ryan, Topstad, Dawnelle, Lee, Laura
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2022
• Subjects: Arctic; Canada; Northwest Territories
• Online Access: http://dx.doi.org/10.1007/s00268-022-06524-x; https://link.springer.com/content/pdf/10.1007/s00268-022-06524-x.pdf; https://link.springer.com/article/10.1007/s00268-022-06524-x/fulltext.html; https://onlinelibrary.wiley.com/doi/pdf/10.1007/s00268-022-06524-x

Abstract Background With the loss of generalism in the surgical specialties, there has been a move in Canada to train family physicians in enhanced surgical skills (FP‐ESS) to address the surgical needs of rural and remote populations. This research project sought to describe one network integrating FP‐ESS and specialist surgeons, focusing on the role of FP‐ESS and their relationship with specialist surgeons, in the surgical care of the Beaufort Delta Region of the Northwest Territories of Canada. Methods Using a participatory approach, semi‐structured interviews were conducted with 22 stakeholders within the surgical system. Interviews were transcribed and reviewed, then imported into NVivo 12 for analysis. First‐level coding was performed based on both deductive and inductive reasoning in an iterative fashion during interview collection to develop and refine the codebook. This was followed by second‐level categorizing. Results The FP‐ESS physicians provide cesarean section services to maintain a local obstetrics program, to provide gastrointestinal endoscopy, and to provide emergency on‐call support, as described by one stakeholder. FP‐ESS work together with specialist surgeons through an informal network keeping surgical care as close to home as possible. FP‐ESS within this health regions were seen as “a really big gain to the system.” Conclusions This study deepens our understanding of rural surgical service delivery, in particular where FP‐ESS and specialist surgeons function collaboratively. It also contributes to strengthening rural surgical systems in Canada and therefore to addressing the health gap between rural/remote/indigenous and urban populations.