With family doctors in short supply, Ontario communities are having to be more creative to attract physicians, and it’s only getting more complex.
The Ontario College of Family Physicians reported in July that 2.6 million Ontarians are without a family doctor, up from 1.8 million in 2020.
“We’re at a point where too many families, too many Ontarians, do not have access to a family physician, and it’s not getting better because we need to see the solutions that will work to improve the ability for family physicians to see patients be implemented,” said Jobin Varughese, the college’s president.
Varughese said they are seeing far too many new family physicians who just come out of residency and leave family medicine within the first five years.
“We also have seen studies that 65 per cent of physicians who answered a recent survey are in the next five years thinking of stopping their practice,” the president said.
As millions of residents continue to be without family doctors, the pressure it puts on communities to provide adequate health care is only growing.
In Brockton last week, home to around 10,000 people, residents started lining up at 2 a.m. when they heard a new family doctor would be taking new patients.
Brockton’s mayor, Chris Peabody, said the new doctor took the first 500 residents who signed up and placed 500 more on a waitlist for when the doctor’s wife, currently practicing in the United States, gets her accreditation to practice medicine in Canada.
Of 1,015 who lined up, Peabody said only 15 had to be turned away, with people travelling over 100 km away to try and get on the list.
Over the last 20 years, he said their community has had a physicians recruitment committee dedicated to bringing new doctors to the area, with incentives like a municipally-funded medical clinic and student loan forgiveness. In the last year, they recruited six new physicians.
He said that while he is happy with the success of the communities, they still need to bring three more physicians to the area, pointing to the need to continuously compete against neighbouring areas.
“It’s an arms race between municipalities in Ontario,” Peabody said. “You just have to fund these committees, you have to find the money, you have to get the volunteers who will do the recruitment and work really hard, and you hope the best for success.”
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He said when communities don’t have the resources to recruit doctors, they ultimately lose out.
“It does make me nervous thinking about where are the limits to get the next three doctors? How much more money do we have to put in, and does another town up the ante?” he said.
Peabody is pushing for a common funding base for physician recruitment that is available to all municipalities to create a “level playing field.”
Jill Croteau, the physician recruitment specialist for the Niagara Region, said to get doctors to the area, they sometimes have to offer up to a $100,000 signing bonus for commitment to stay for a set amount of time.
A spokesperson for the Ford government told Global News that “the facts speak for themselves,” and said Ontario “leads the country with the highest number of people attached to a primary care provider.”
“Since 2018, our government has increased our investment in connecting people to primary care by 50 per cent and we are not stopping there,” they said.
“We have launched the largest medical school education system expansion in 15 years, made historic investments to stand up more primary care teams, break down barriers for internationally-trained doctors through programs like Practice Ready Ontario adding 100 new family physicians in rural communities and connecting an additional 120,000 people to care in northern and rural communities.”
Varughese said family doctors need more help if they are going to continue practicing, pointing to artificial intelligence to assist with note-taking and cutting down the amount of time doctors spend on paperwork.
“These sorts of things are going to allow patients to be in front of their family doctor, allowing them to have all of their attention rather than having to keep turning back to the screen to get the next thing that needs to get done,” he said.
Croteau said she has heard similar things from doctors.
“We have heard loud and clear from our physicians that the administrative burdens in their practices have become quite significant. They’re spending more time working on administration than actually seeing patients,” she said.
She also pointed to salaries, saying that family doctors need to be paid more by the province for the amount of work they are doing.
Varughese also called for more support for family doctors through mentorship and team-based care.
“Family physicians very commonly will be asked to take on more and more, and eventually, that well of good intentions will run dry, and we need to start refilling that,” he warns.
The Ford government also pointed to the recent appointment of Jane Philpott, who has been tasked with a “mandate to connect every person who wants a primary care provider to one over the next five years.”
To the north of Toronto, in Orillia, work is underway on a potentially unique solution to the issue of attracting and retaining doctors.
The city’s local council has budgeted $500,000 and is working to redesign space within its local municipal building to open as a family doctor’s office and walk-in clinic.
In an attempt to attract new family doctors to the city, the local government plans to initially offer benefits to new doctors who join its municipal clinic and cover things like admin costs and rent, which can be a barrier to setting up a new practice.
The idea is based on a similar plan by Colwood, B.C., Coun. Ralph Cipolla told Global News.
“They actually started this process of the city itself hiring the doctors, putting them on benefits and so on, so that it would be a lot easier for doctors to relocate or the new doctors coming to Canada, coming to Orillia,” he said.
The doctors would be able to bill for procedures through OHIP, as they would if they owned the practice, but other elements of the clinic would be handled by the city. Cipolla said the town was already in conversation with the government and had received indications the plan would be acceptable to the province.
“The administration is going to be the difficult part,” Cipolla said. “Our second floor at city hall is fairly empty because we had a tenant in there that left so they can all be accommodated with no extra charges added.”
The $500,000 budgeted by the city should cover the transition, Cipolla said, to having three or four doctors operating out of city hall.
In the long run, the town hopes the change will bring more doctors to Orillia and not add to the city’s bottom line.
“Hopefully the doctors will take over once they have their permanent office established here in Orillia,” Cipolla said.
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