Marathon Physicians Advocate for Health Care through Research

For Drs. Lily DeMiglio and Eli Orrantia, research is driven by the real-world challenges they face every day as rural physicians and the search for solutions that improve health outcomes.  

The Marathon-based family doctors study topics including physician recruitment and retention, nursing shortages, and travel for health care. They see firsthand how research makes a difference in health-care practice and government policy.  

“The goal of our research is to understand the problem, raise awareness, and use our findings as a tool for advocacy to create change,” says Dr. DeMiglio, Associate Professor and NOSM University alumna. 

For example, the physicians’ obstetrical research has informed negotiations with government to better support health-care providers and communities to sustain rural obstetrical care. Meanwhile, studying the Northern Health Travel Grant has helped identify rural challenges and advocate for change.  

“Our research is important because it aims to find tangible solutions to issues such as emergency department closures, reliance on costly agency nursing, and health-care provider burnout,” says Dr. Orrantia, Professor.  

Their findings can help shape the future of rural health care. Their research shows that recruiting and keeping doctors takes more than financial incentives. Meaningful employment opportunities for doctors’ partners also play an important role. For nurses, retention strategies are more effective when they reflect factors such as age and work experience. Across health professions, their research highlights the value of team-based care rather than practicing in isolation. Work-life balance and recognizing that physicians have lives and connections to their communities outside of work can help them thrive. 

These findings are influencing the work of recruiters across the North.  

Rural obstetrics and the maternity care desert are also important research topics for Dr. Orrantia—and ones that resonate with families and health-care providers in Northern Ontario. Over the last 20 years, many rural obstetrics programs have closed, leaving only nine rural hospitals that provide obstetrics services north of the French River to the Manitoba border. Pregnant people must travel great distances for obstetrics care, and that increased travel time to care is linked to poorer maternal and fetal outcomes. Dr. Orrantia’s research suggests possible solutions, including improving medical residency education, providing ongoing mentorship, creating opportunities for upskilling, and strengthening relationships between rural and urban hospitals. He hopes that these solutions can be embedded within a larger strategic vision for Northern Ontario obstetrics. 

Drs. Orrantia and DeMiglio believe rural Northerners should have a strong voice in shaping health care, helping ensure people can access the care they need closer to home.  

“Engaging rural residents and health professionals as research participants provides them with the opportunity to share their personal lived experiences and perspectives, which itself is empowering,” says Dr. DeMiglio. 

Successful research grants from the Northern Ontario Academic Medicine Association (NOAMA) have been central to filling gaps in research literature about rural practice. 

“When rural perspectives are underrepresented in the evidence base, health-care systems and policymakers risk relying on knowledge from urban settings and ineffectively applying it to rural environments. We are extremely grateful to NOAMA for helping move rural research forward,” says Dr. Orrantia. “Health-care research historically has been shaped by urban perspectives. As rural clinicians, we identify the issues that impact patients in Northern Ontario and advocate through research.” 

The Ontario College of Family Physicians recently named Dr. Orrantia as 2026 Reg L. Perkin Ontario Family Physician of the Year. Congratulations to Dr. Orrantia on this prestigious honour!