The Society has never had a majority vote of the membership to confirm this status, and has only once had a vote to ratify a contract with the government. The Society is seen as neither representative nor accountable by most rural physicians. Even though rural physicians have, on occasion, been presidents or officers of the Society, they don't serve long enough to overcome vested urban interests and the inertia of the Society's bureaucracy. The recently formed section of rural practice has had every one of its proposed incentives vetoed by the section of general practice, which is dominated by urban interests. About two-thirds of the province's physicians live within 20 miles of Halifax, and the Society has never dealt with underrepresentation for those from remote areas who have difficulty getting to Society meetings.
Financial constraints do determine the numbers and kinds of physicians and where they practise.
The problems of present-day rural medicine appear overwhelming. Over the last year scarcely a week has gone by in this province without reports of yet another physician leaving rural practice. It should be clear that the key to survival of rural practice is the adoption of sustainable working conditions and adequate remuneration. Recruiting programs that do not address this are, at best, temporary solutions and are doomed to ultimate failure. Many of the remedies proposed in this report are directly applicable to all rural areas in the country.