Ontario’s primary health care system 'beyond crisis levels' as 1 in 4 will soon be without family doctor: OMA

The Ontario Medical Association is sounding the alarm about a growing family doctor shortage in Ontario, one it believes is only going to get worse over the next two years.

According to a recent study commissioned by the Ontario College of Physicians, 2.3 million Ontarians are currently without a family doctor.

“Also because of our aging and demographics curve, both from a physician workforce standpoint, as well as our population, we are heading into a perfect storm,” said Dr. Andrew Park, the president of the Ontario Medical Association (OMA).

That same study projects the number of people without a family doctor to double to 4.4 million by 2026, potentially leaving one in four people without access to primary care.

“That means no access to our health care system, which just is not fair,” said Dr. David Barber, a family doctor based in Kingston.

Dr. Barber was part of a panel discussion organized by the OMA Thursday morning, which provided insight into the struggles with primary care and offered up possible solutions.

Two speakers on the panel provided the perspective of family doctors who recently made the difficult decision to leave their practice.

“Right now, the primary care system in Ontario is beyond crisis levels. And I think the public needs to be aware of that,” said Dr. Natalie Leahy, who now serves as a general practitioner in Oncology in the Durham Region.

Before that, she says she was an overworked, underpaid, burned out family doctor. She left her practice last year.

“It was a big decision for me to close and I can tell you there were a lot of tears shared amongst my patients and myself,” Dr. Leahy said, noting she left her practice for a number of reasons, but mainly because she was putting work over important personal and family life events and was overburdened to a breaking point.

“For my own well-being, for the well-being of my family, something had to change,” she said. “And ultimately that's what my final decision was, to leave family medicine.”

Another doctor, Dr. Dannica Switzer was a family doctor in northern Ontario.

“I don't want a higher salary, I don't want to be paid twice as much,” said Dr. Switzer, now a rural generalist. “I just want to do the work of one doctor, not two.”

She said her community she served has a need for seven family doctors, but currently has only three.

“We cannot recruit our way out of a retention problem,” Dr. Switzer said. “Full time, hardworking rural physicians, they're going to continue to leave. So we need retention measures, not recruitment.”

The doctors shared some other concerns, such as what they call an “exponential” increase in the volume of paperwork, leading to a reduction in clinical hours.

“By the time I left practice, I was spending on average three hours a day on paperwork and I'm not talking about patient charting,” said Dr. Leahy. “I’m talking about forms and prescription renewals and referrals and the volume and requests for that type of information.”

Dr. Leahy added running a family practice means you’re also running a small business, with overhead like payroll, bills and equipment costs. She said rising costs, driven by inflation in recent years, was making it difficult to make ends meet because compensation through the OHIP billing process hasn’t kept pace.

“Right now in Ontario, family medicine is a failed business model,” Dr. Leahy said, adding before she left her practice, she was picking up a shift a week at the hospital to “make ends meet.”

The doctors provided a series of recommendations, including immediate stabilization funding to stop the exodus of family doctors. Other suggestions included the introduction of more family health teams and better long-term planning that outlasts election cycles.

“The government has a huge role to play in reducing the burden,” said Dr. Barber.

Last week, the federal government announced $3.1 billion of funding to the province over three years, money they say will help create primary care teams and boost access to family doctors.

”At this point, we're still we're still so far behind the mark, that while we're hopeful and think that there's a lot of good use that can be done with that money, we're still quite a ways behind in terms of the funding that we need for a stable system,” said Dr. Park.

With the steady exodus of family doctors, lack of interest in family medicine among the next wave of medical school graduates and a wave of retirements expected in the coming years, the OMA warns of reduced access to family medicine for people across Canada. It warns that scenario could lead to worsening health outcomes and a less efficient health care system.

“The health of our province depends on getting this right, and getting it right, now,” said Dr. Leahy.