Ten thousand Ontarians will be left without a family doctor come May after a health centre in Sault Ste. Marie said it's been experiencing a "severe shortage of physicians and nurse practitioners."
The announcement from Group Health Centre (GHC) on Thursday morning has the Ontario Medical Association warning that such situations could become more common across the province if the primary care "crisis" isn't addressed.
In an open letter, GHC said the centre, which cares for around 60,000 patients, and its team of doctors — through the Algoma District Medical Group (ADMG) — have been dealing with the shortage for some time.
"This trend is not unique to our community. The rate of new providers entering the field has not kept pace with retirements, and many existing primary care providers face burnout.," wrote Lil Silvano, GHC's president and CEO, and Dr. Jodie Stewart, CEO and chair of the ADMG, in the joint letter.
"Despite many proactive efforts, including extensive recruitment initiatives (locally and internationally), securing temporary providers, delaying retirements and re-engaging retired professionals, this situation is no longer sustainable," they wrote.
"ADMG will be informing patients of those Primary Care Providers who have recently retired or left their practices that they will no longer have primary care services. Approximately 10,000 patients will lose access to their primary care provider and the same-day clinic services at GHC as of May 31, 2024."
Silvano told The Trillium that the centre has been able to still provide care for some of the 10,000 patients even after their doctors or nurse practitioners left. So far three doctors and one nurse practitioner have left, with the remaining four leaving in the next few months.
Silvano and Stewart said they'll be trying to "stabilize our operations" and continue care for the other 50,000 patients.
They added that they're looking to work with community partners and the health ministry "to build additional capacity for the future."
Silvano said the centre had flagged to the health ministry that it could have to de-roster up to 10,000 patients if it wasn't able to increase the number of providers. GHC also signalled to the province that it is looking for funding for additional mental health and chronic disease management supports for doctors through social workers, dieticians and others and "modification" to the "Grow Your Own Nurse Practitioner" program to increase the number of providers at the centre.
"I believe if we were able to have built more nurse practitioners, we would may have been able to mitigate some of that de-rostering," she said, adding that another 6,000 patients "are at risk" because several doctors are already past retirement.
She said 35 per cent of the centre's care providers are over the age of 60.
"The funding that we've asked for will definitely help us in terms of avoiding that additional de-roster of the 6,000," she said, adding that they're hoping for around $11 million, $4 million of which would be ongoing.
Asked about GHC's announcement, Hannah Jensen, a spokesperson for Health Minister Sylvia Jones said the centre "notified the ministry of these changes just over a week ago. While the ministry has made several attempts to work with GHC on a possible solution, finding an immediate replacement for these patients on such short notice was not achievable."
Jensen said the government is preparing to "launch the largest expansion of new primary care teams in Ontario’s history, including two new sites in Sault Ste. Marie," and that details would be announced soon.
"This expansion will build on our progress in northern Ontario to connect people to primary care. That includes launching the largest medical school expansion in over a decade, with over 100 new residency seats at the Northern Ontario School of Medicine alone, and expanding the Northern Ontario Resident Streamlined Training and Reimbursement (Nor-Star) program," she said. "Moving forward, we will continue to work with partners in Sault Ste. Marie, and across the province, to ensure primary care is available to people where and when they need it."
Meanwhile, the OMA has been calling on the province to do more to address the shortage of family doctors in the province.
“Primary care in Ontario is in crisis. What’s happening in Sault Ste. Marie is devastating,” said OMA President Dr. Andrew Park. "They're going to have worse health outcomes as a result of this and that sucks, that's a disaster for them, their community."
Park said he doesn't think this issue is going away.
"We have to come up with solutions on how to fix impending crises like this because Sault Ste. Marie won't be the last one," he said, noting that this problem has been building up for years. “This is a preview of what’s to come across Ontario if we don’t take action now.”
The OMA said in a press release on Thursday that the GHC was looking for "emergency stabilization funding and other support."
“We’d like to see a rapid response from the government to address the urgent situation in Sault Ste. Marie,” said the association's CEO, Kimberly Moran. “We are ready to work with government on long-term solutions to address the primary care crisis moving forward so that everyone in Ontario has access to a family doctor.”
The OMA recently said in a pre-budget submission to the government that it's expected 20 per cent of Ontarians won't have a family doctor in the next two years. To address this, the OMA wants to see an expansion of team-based primary care — where inter-professional health-care providers work together to provide care to patients — the creation of a workforce strategy to increase the number of doctors in northern and rural areas and less administrative tasks for doctors.
The Ontario Liberals also made health-care asks on Thursday, with Leader Bonnie Crombie calling on the Ford government to "take urgent action to support health care in rural and northern Ontario."
Crombie and MPP Adil Shamji, an emergency department physician, blamed the Ford government for not doing more to prevent the situation in Sault Ste. Marie from unfolding.
"When a clinic like the one in Sault Ste. Marie says that we need help and funding to keep our doors open, the government needs to say yes," Shamji said at a press conference at Queen's Park.
Other fixes, he said, include more incentives to attract primary care providers to northern and rural Ontario and more opportunities for medical students and nurse practitioners to train in these areas.
The Liberals also called on the province to adopt recommendations that the Rural Ontario Municipal Association included in a report earlier this week on improving primary and mental health in rural communities.
These included "uploading a significant portion of health-care costs from rural communities back to the provincial government," expanding the scope of health-care providers and requiring that Ontario Health Teams also include municipalities.
