
                         GOOD HELP IS HARD TO FIND


                              By ANNE MULLENS
                               Vancouver Sun

     VANCOUVER - Every day for five weeks this winter, Mariane Davis
     drove an hour south to Bellingham, Wash., had radiaton therapy at a
     private cancer clinic, and then turned around and drove home.

     The 37-year-old Richmond, B.C., woman had found a small lump in her
     right breast as she showered one morning around Christmas. Surgeons
     lost no time giving her a lumpectomy.

     But when it came time for the next stage of treatment - radiation -
     there was a hitch.

     An extreme shortage of radiation therapy technologists in Vancouver
     had backed up treatment for weeks.

     ``I was told I would have to wait six to eight weeks in Vancouver
     to receive treatment, or I had the alternative to go to
     Bellingham,'' said Davis, a bank supervisor.

      ``I was anxious to get on with it, so I chose to go south.''

     As health care has become more sophisticated, its delivery has
     expanded beyond just doctors and nurses - to physiotherapists,
     occupational therapists, medical technologists and others.

     And increasingly, shortages of these skilled partners in health
     care have come to cripple the medical system.

     Such is the case with radiation therapy technologists, who run
     linear accelerators and calibrate radiation treatment for cancer
     patients.

     ``There is a world-wide shortage of radiation therapy
     technologists,'' said Dr. David Klaassen, director of the B.C.
     Cancer Control Agency.

     ``These are highly technical people and we are all trying to
     recruit them. We raid Britain, New Zealand and Australia. The
     United States raids us.''

     B.C. had been trying to recruit new technologists for several
     months before the province's shortage turned critical last
     December.

     When hundreds of patients were forced to wait for treatment, some
     as long as 12 weeks, clinics in Bellingham and Seattle agreed to
     accept 10 people from B.C. each week.

     Davis was one of them.

     ``The last thing you want to do with cancer is wait around,'' she
     said.

     But even Seattle, despite helping B.C. with its backlog, is short
     21 radiation therapy technologists, said Dr. Neil Fatin, a senior
     provincial consultant who negotiated the emergency deal with the
     U.S. clinics.

     It's the same elsewhere in Canada.

     Eighteen months ago an enormous backlog of patients forced
     Toronto's Princess Margaret Hospital to close its doors for two
     months. New cancer patients were sent to other regions for
     treatment.

     With occupational therapists, physiotherapists, medical laboratory
     technicians, perfusionists, speech pathologists, respiratory
     technicians also in short supply, cancer patients are not the only
     ones who must endure waits for care, go elsewhere or do without.

     ``It is a symptom of our increasingly sophisticated medical
     system,'' said Fatin.

     ``It used to be that nurses did everything that doctors didn't do.
     But now health care has evolved so much and areas have become so
     specialized that we've created niches for people with specialized
     training and we can't do without them.''

     Take the example of perfusionists, who run heart-lung machines
     during open heart surgery. Canada has about 150 of them.

     ``We take over the role of the patient's heart and lungs once they
     are under surgery,' said Dave Failows, one of five perfusionists at
     Victoria's Royal Jubilee Hospital.

     ``It is one of the only professions where a 15-second lapse in
     attention can kill or brain damage a patient.''

     Last year, a shortage of three perfusionists in Vancouver
     contributed to a backlog of more than 700 patients waiting for
     cardiac bypass surgery in B.C.

     This year, Toronto hospitals, short five perfusionists, were forced
     to temporarily contract perfusionists from the U.S.

     Federal statistics predict job opportunities in all allied health
     fields will grow by more than three per cent in the next decade,
     double the growth rate expected in other occupations.

     Almost 8,000 positions are expected to be created in that time for
     physiotherapists, 4,000 jobs could open for occupational therapists
     and 24,000 for medical laboratory technologists, who perform
     chemical, microscopic and bacteriological tests.

     Why do shortages in these fields exist? Experts cite several
     factors:

      - Female-dominated professions: Traditionally, as many as 85 per
     cent of the people in allied health professions have been women.
     This has meant high attrition, particularly in child-bearing years,
     and reliance on part-time work.

     Now, other career opportunities, such as medicine and engineering,
     have emerged to compete for women with good academic records.

     - Salaries: Even when acute shortages exist, salaries do
     not reflect demand. Higher salaries often beckon from the U.S.

     Last year, all six people who graduated as perfusionists in Toronto
     went to the U.S., lured by the chance to make as much as $75,000 to
     $100,000 a year, instead of $50,000 in Canada.

      - Too few training positions: Training of allied health
     professionals takes two to five years. Without enough training
     positions in universities, community colleges or hospitals, Canada
     has instead relied on immigration.

     Training is also limited by the availability of equipment - in the
     case of radiation therapy technologists this means the availability
     of $1.4-million linear accelerators. In short supply, these are
     almost constantly needed for patients - not students.

      - Unpredicted needs: The shortage of radiation therapy
     technologists developed in part because the medical profession and
     governments did not accurately forecast needs, Klaassen said.

     In the 1970s, it was thought chemotherapy would replace radiation,
     but in the 1980s new uses for radiation emerged, including radiaton
     of the breast after lumpectomy and radiation for prostate cancer
     and colon cancer.

     Likewise, the frequency of cardiac bypass surgery has grown faster
     than the supply of perfusionists.

      - Lack of public awareness about the professions: ``Most people
     know what doctors and nurses do, but they have no idea what a
     radiation therapist or a perfusionist does,'' said Ruth Emery, a
     federal government labor analyst.

     ``Many people choose careers based on familiarity with that career.
     We are trying to tell high school students and others about these
     jobs and the opportunities available in them.''
