The Ontario College of Family Physicians reports on Family Doctor Shortage

Are we still in Crisis Mode?

The Ontario College of Family Physicians, in conjunction with Harris/Decima, conducted a public opinion survey this summer on the issue of family physician shortages in this province. Our organization released these results to the media on August 26^th to raise awareness on family doctor shortages as perceived by the public.

What were the key messages OCFP is delivering based on this public survey?

While some progress has been made over the last 5 years by our government to improve family health care, when it comes to the supply of family physicians, the situation is still very serious:

·         Between 663,000 and 879,000 Ontarians are without a family doctor

·         59% of these orphaned patients have tried to find one

·         The majority of these patients are concerned about not having one and 30% are very concerned.

Ontarians without family doctors have been forced to seek episodic care in walk-in clinics and emergency departments; therefore, they miss out on the prevention and early detection of treatable diseases and proper management of chronic diseases. In addition, they have difficulty accessing specialty services, mental health services and lack of continuity in their medical records.

·         Almost 250,000 of those orphaned patients are over 50 years of age – the segment of our population most prone to serious chronic illnesses such as diabetes, heart disease and cancer.

·         In the past 3 years, 63% of our orphan patients went to walk-ins or the ED for episodic care. The majority of them would prefer to be treated by their own doctor or their doctor’s partner(s) rather than a doctor in an emergency room or walk-in clinics.

Ontarians polled were very clear on the importance of having their own family doctor:

·         95% believe that it is important that their family doctor provides the majority of care and coordinates care provided by others.

·         86% believe family doctors are the most important part of the healthcare system.

·         92% believe that the healthcare system would be improved if more emphasis placed on family doctors providing preventive care.

Ontarians believe that the shortage is serious

·         90% of the public agree that there is a family doctor shortage (an 8% increase since 2003)

·         72% believe it is serious

·         63% say they are not satisfied with how the Ontario government is handling the shortage.

What about family doctor shortages in rural communities?

As you may know, Ontario has a population of close to 13 million with 80% living in urban centres, largely in cities on the shores of the Great Lakes. Though 20% of the population lives in rural areas, only 10% of all physicians work in these areas. A higher percentage of rural Ontarians report that they do not have a family doctor (10% compared with 8% overall). In addition, rural populations have been shown to be sicker than their urban counterparts. Our rural colleagues have been feeling the family doctor shortages at distressing levels, as reported by our CEO in her last NewsBrief. Physicians in rural areas are fewer in number and fulfill a wider range of roles. The loss of a single physician in these communities can change how the entire system is organized and run. Rural doctors are working longer and harder than ever. It is time for their commitment to be recognized by the government and all of us.

What was our proposed call for action?

1.      Every community has unique needs and should have a practical action plan in place to deal with the family doctor shortage. The LHINs and their communities need to make the delivery of primary care more of a priority. We recommended to government an orphan patient registry that would identify the number and health needs of patients in that community without a family doctor, calling out for a more local response to improve access to primary care and support family doctors in that area. We will also be able to put on the radar those communities where the percentage of orphan patients is higher than in the rest of the province.

2.      We need to provide better supports to more family physicians so they can involve medical students and residents in their practices to encourage them to become family doctors and work in diverse communities, urban, rural and remote. We need to ensure that family physicians throughout the province have the resources they need to provide training to the influx of additional students now in medical school and to encourage them to head into family medicine especially in the rural stream. Currently, family physicians are overwhelmingly busy and do not have the structure or incentives to take this on too. We need at least 30% of the family physicians in Ontario to play this educational role in order to meet the need in this province.

3.      Eliminate some of the stress overburdened family doctors are experiencing by better integrating coordination between them and other health care providers in their regions. One of the many by-products will be less stress, meaning more students will be attracted to family medicine. We need to eliminate the sense of isolation and powerlessness that family doctors now feel in interacting with the broader healthcare system. By establishing “communities of care”, together, we can make a difference. For more information on the survey, visit our website www.ocfp.on.ca/whatsnew

To feel what a community can do when they set their minds and hearts to a goal, rent from your video store Seducing Doctor Lewis. For comments, please contact me at president_ocfp@cfpc.ca .

Your President,

Renée Arnold, MD, CCFP, FCFP