An estimated four million Canadians still don't have a family doctor — a shortage that continues to plague small towns in Alberta.
Two out of three doctors in Milk River, Alta., quit nearly four years ago. If it wasn't for the dedication of the last remaining doctor, residents say they don't know what health care would be like today.
Dr. Elisabeth Lewke-Bogle has been working in that town's hospital and clinic for four decades, and has decided to not retire until the town can find a replacement.
"It's the people," she said. "It's the satisfaction you get in your job. You actually have people who say 'thank you' almost every time ... and that reward is immeasurable. I don't have a lot of angry patients and I'm really fortunate in that."
Lewke-Bogle said her son often reminds her to retire and spend more time with her grandchildren, but her passion is to see that Milk River is well looked after. She moved to the small town in southern Alberta in the 1970s and fell in love with it.
Lewke-Bogle concedes that being a country doctor isn't for everyone, but she gets the sense her patients aren't taking her for granted.
Closest medical centre 45 minutes away
Like Barb Hoytos, who owns a beauty salon just down the street from the hospital.
"I think it's really stressful on the lady that's still here helping us out," she said.
"Thank goodness she's still here. But if you're not going to get a doctor here, you're not going to get people wanting to come and either retire here or come here and open a business, and have your kids go to school here when you don't have any facility… You've got to go up the road 45 minutes [or] an hour for health care."
There is a hospital, which was built in the 1970s, and a private health clinic that needs three doctors to staff. It used to be a full-service hospital, but it now only offers emergency care with cuts over the years. Besides Milk River, the hospital covers Warner, Coutts, half a dozen Hutterite colonies and hundreds of farms and oil and gas operations. It also serves 30,000 tourists who visit nearby Writing-on-Stone Provincial Park every year.
The town created a committee to address the doctor shortage in 2009.
Katherine Hockey, who has been volunteering as a recruiter, says they have had more than 70 inquiries and interviewed more than 20 doctors over the last four years, but have had no luck.
"It consumed most of my days and most of my nights," she said. "I was in touch with doctors overseas, in Canada, Australia, trying to let them know what a beautiful place we had with an urgency behind me being pressed 'we need doctors, we need doctors.' And they just weren't forthcoming. I think there's a shortage of doctors worldwide."
Milk River not alone in struggle
Milk River isn't the only small town dealing with a doctor shortage, as there are currently more than 250 job vacancies for general family practitioners provincewide.
And nearly 40 rural communities that are dealing with a critical doctor shortage.
Provincial officials say Alberta's doctor recruitment rate is actually better than the national average, and Alberta Health Services says it's working on recruitment campaigns to address the problem.
Dr. Doug Myhre, who helps run the Rural Integrated Community Clerkship program at the University of Calgary, says he is seeing more and more graduates taking work in small towns.
The program he works with places students in rural hospitals and clinics for nine months as they work with rural doctors and learn the ropes of a country practice.
"The sooner you get them, the longer you get them, the more you follow up and build those mentoring relationships that are important, the more likely you're going to get them to stick," he said.
"Now they might train in Bassano and they might go to work in Three Hills, but they're still going back to rural Alberta."
Lewke-Bogle also teaches students through the program, and hopes that one or more of them will eventually choose to return to Milk River.
Fuels Cancer In Animal Studies
A recent animal study conducted by Wake Forest University researchers showed that <a href="http://www.huffingtonpost.com/2013/01/28/stress-prostate-cancer-mice_n_2569256.html?1359412688">stress could help cancer cells survive</a> against anti-cancer drugs. The study, published in the Journal of Clinical Investigation, was done on mice induced to experience stress by being exposed to the scent of a predator. When experiencing this stress, an anti-cancer drug administered to the mice was <a href="http://www.huffingtonpost.com/2013/01/28/stress-prostate-cancer-mice_n_2569256.html?1359412688">less effective at killing cancer cells</a>, and the cancer cells were actually <em>kept</em> from dying because of the adrenaline produced by the mice, Everyday Health reported.
Shrinks The Brain
Even for healthy people, stressful moments can take a toll on the brain, a new study from Yale University suggests. Researchers reported in the journal Biological Psychiatry that stressful occasions -- like going through a divorce or being laid off -- can <a href="http://www.huffingtonpost.com/2012/01/10/extreme-stress-shrinks-brain-gray-matter_n_1197437.html">actually shrink the brain</a> by reducing gray matter in regions tied to emotion and physiological functions. This is important because these changes in brain gray matter could signal future psychiatric problems, researchers warned.
Prematurely Ages Kids
The extreme duress that a child experiences when exposed to violence early on could lead to <a href="http://healthland.time.com/2012/04/24/how-bullying-and-abuse-may-age-children-prematurely/">premature aging of his or her cells</a>, according to research in the journal Molecular Psychiatry. The study, which followed 236 children born in England and Wales between the ages of 5 and 10, showed that those who had been bullied, as well as those who were witnesses of violent acts or victims of violence by an adult, had shorter telomeres -- a sign that they <a href="http://healthland.time.com/2012/04/24/how-bullying-and-abuse-may-age-children-prematurely/">were aging faster</a>, TIME reported.
Could Affect Your Offspring's Genes
The <a href="http://www.newscientist.com/article/dn23109-stress-can-affect-future-generations-genes.html">effects of stress on a person's genes</a> may be passed on from generation to generation, according to a recent Science study -- suggesting stress's effects may not just take a toll on the person itself, but the person's progeny, too. New Scientist reported on the research, which was conducted in mouse germ cells (before they become eggs or sperm) by University of Cambridge researchers. They reported that certain markings to the genes, influenced by outside factors like stress, are generally thought to be erased in the next generation. But the new study shows that some of these markings to the genes <a href="http://www.newscientist.com/article/dn23109-stress-can-affect-future-generations-genes.html">still exist in the next generation</a>. "What we've found is a potential way things can get through, whereas before, everything was considered to be erased," study researcher Jamie Hackett told New Scientist.
Spurs Depressive Symptoms
A study in mice suggests stress could play a role in the <a href="http://healthland.time.com/2011/08/03/study-how-chronic-stress-can-lead-to-depression/">development of depression</a>. Researchers at the U.S. National Institute on Mental Health conducted several experiments on mice, where they noted how stress affected their behavior. They found that stress was linked with <a href="http://healthland.time.com/2011/08/03/study-how-chronic-stress-can-lead-to-depression/">depression-like behaviors</a>, such as giving up swimming in a plastic cylinder and lengthening the response time it took to eat food, TIME reported. "I think the findings fit well with the idea that <a href="http://healthland.time.com/2011/08/03/study-how-chronic-stress-can-lead-to-depression/">stress can cause depression</a> or that stressful situations can precipitate depression," study researcher Heather Cameron, chief of neuroplasticity at the NIMH, told TIME.
Increases Risk Of Chronic Diseases
It's not just the stress, but <a href="http://www.huffingtonpost.com/2012/11/05/stress-reactions-health_n_2078919.html">how you react to it</a>, that could have an impact on your health down the road, according to a new study from Pennsylvania State University researchers. Published in the journal Annals of Behavioral Medicine, the study found that people who were more stressed out and anxious about the stresses of everyday life were, in turn, <a href="http://www.huffingtonpost.com/2012/11/05/stress-reactions-health_n_2078919.html">more likely to have chronic health conditions</a> (such as heart problems or arthritis) 10 years later, compared with people who viewed things through a more relaxed lens.
Raises Stroke Risk
Stressed-out people may have a <a href="http://jnnp.bmj.com/content/83/11/1104">higher stroke risk</a> than their more mellowed-out peers, according to an observational study published in the Journal of Neurology, Neurosurgery and Psychiatry. "Compared with healthy age-matched individuals, <a href="http://jnnp.bmj.com/content/83/11/1104">stressful habits</a> and type A behavior are associated with high risk of stroke. This association is not modified by gender," the researchers, from the Hospital Clinico Universitario San Carlos in Madrid, wrote in the study.
Does A Number On Your Heart
Feeling anxious and stressed is linked with a 27 percent <a href="http://www.nydailynews.com/life-style/health/chronic-stress-equals-smoking-cigarettes-day-study-article-1.1224293">higher risk of heart attack</a> -- the same effect smoking five cigarettes a day has on the heart, the New York Daily News reported. "These findings are significant because they are applicable to nearly everyone," study researcher Safiya Richardson, of Columbia University Medical Center, told the Daily News. "The key takeaway is that how people feel is important for their heart health, so anything <a href="http://www.nydailynews.com/life-style/health/chronic-stress-equals-smoking-cigarettes-day-study-article-1.1224293">they can do to reduce stress</a> may improve their heart health in the future." And not only could chronic stress raise a person's heart attack risk, but it might also affect how well he or she <a href="http://www.nbcnews.com/id/49304726/ns/health-heart_health/t/chronic-stress-tied-worse-heart-attack-prognosis/#.UQwcWFqOjKo">survives after a heart attack</a>. Reuters reported on another study, conducted by researchers at St. Luke's Mid America Heart Institute, that showed that stress is linked with a 42 percent higher risk of dying in the two years after being hospitalized for a heart attack.
Makes Colds Worse
If you always suspected that <a href="http://abcnews.go.com/Health/ColdandFluNews/chronic-stress-feeds-common-cold-study-finds/story?id=16054304">stress was making you sick</a>, you might be on to something. Research shows that stress has an impact on our immune systems, with one recent study in the Proceedings of the National Academy of Sciences even showing it can make colds worse. That's because when you are stressed, your body produces more cortisol, which can then wreak havoc on your <a href="http://abcnews.go.com/Health/ColdandFluNews/chronic-stress-feeds-common-cold-study-finds/story?id=16054304">body's inflammatory processes</a>. The researcher of the study, Carnegie Mellon University's Sheldon Cohen, explained to ABC News: <blockquote>"You have people whose immune cells are not responding to cortisol and, at the same time, they're exposed to a virus system creating an inflammatory response. But the body doesn't have the mechanism that allows it to turn off the inflammatory response, which manifests as cold symptoms," said Cohen.</blockquote>
Could Affect Cancer Outcomes
Cancer -- the diagnosis, treatment, and even the time after it's been "beaten" -- is a stressful process, and research shows that managing that stress could improve outcomes of the disease. Researchers at the University of Miami found that undergoing a Cognitive-Behavioral Stress Management program seemed to have a positive effect on <a href="http://www.miami.edu/index.php/news/releases/stress_management_improves_breast_cancer_outcomes/">breast cancer patients' immune system cells</a>. "For the women in the CBSM groups, there was better psychological adaptation to the whole process of going through treatment for breast cancer and there were physiological changes that indicated that the <a href="http://www.miami.edu/index.php/news/releases/stress_management_improves_breast_cancer_outcomes/">women were recovering better</a>," study researcher Michael H. Antoni, a professor of psychology and psychiatry and behavioral sciences at the university, as well as program leader of biobehavioral oncology at the Sylvester Comprehensive Cancer Center, said in a statement. "The results suggest that the stress management intervention mitigates the influence of the stress of cancer treatment and promotes recovery over the first year."
The Impact Of Stress On Health
In this video, we discuss how does stress impact your health