title: Rural surgical services in two Canadian provinces.
abstract: OBJECTIVE
  Contrast alternative health delivery systems and the use of differently trained physician providers in the supply of surgical services to rural residents in 2 Canadian provinces.
  
  
  METHODS
  Four surgical procedures (carpal tunnel release, inguinal herniorrhaphy, appendectomy and cholecystectomy) provided to rural residents of Alberta and Northern Ontario were identified between 1997/98 and 2001/02. Surgical staff were identified as specialists or non-specialists. Rural populations were mapped into the catchment areas of rural acute care facilities. Rural surgical programs were characterized by the level of surgical service available locally.
  
  
  RESULTS
  Alberta and Northern Ontario have a similar number of rural surgical programs staffed by Canadian-certified general surgeons (10 and 12, respectively). However, Alberta has 27 smaller rural surgical programs staffed by non-specialist surgeons and Northern Ontario has only 4. These non-specialist surgeons play a significant role in Alberta, often in collaboration with specialist surgeons. In Northern Ontario the non-specialist surgeons play a minor role. The small rural surgical programs in Northern Ontario that are staffed by specialist surgeons are significantly more successful in retaining the local surgical caseload compared with similar programs in Alberta.
  
  
  CONCLUSIONS
  The principal differences between Alberta and Northern Ontario in the delivery of rural surgical services are the greater number of small rural surgical programs in Alberta, and the substantial role of non-specialist surgical staff in these programs.
authors.affiliation: Rural Family Physician, Gibsons, BC.
authors.forename: Stuart
authors.initials: S
authors.lastname: Iglesias
authors.forename: Joshua
authors.initials: J
authors.lastname: Tepper
authors.forename: Erik
authors.initials: E
authors.lastname: Ellehoj
authors.forename: Brendan
authors.initials: B
authors.lastname: Barrett
authors.forename: Peter
authors.initials: P
authors.lastname: Hutten-Czapski
authors.forename: Kir
authors.initials: K
authors.lastname: Luong
authors.forename: William
authors.initials: W
authors.lastname: Pollett
mesh_terms: D000416:Alberta; D002391:Catchment Area, Health; D005194:Family Practice; D006801:Humans; D009864:Ontario; D012041:Regional Medical Programs; D019035:Rural Health Services / Q000600:supply & distribution*; D013043:Specialties, Surgical; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D014195:Travel; D000078329:Workforce