The Ontario Medical Association is continuing to sound the alarm about the shortage of doctors in the province, saying more than 2,500 physicians are needed and that all regions are feeling the pinch.
The association released a list of major cities where doctors of all types are being actively recruited, with the province's most populous city, Toronto, at the top with 305 physicians needed.
Others include Ottawa, 171; Barrie and Muskoka region, 118; Hamilton, 114; London, 68; Kitchener, 55; St. Catharines, 51; Thunder Bay, 50; Peterborough, 40; Windsor, 36; Sudbury, 33; and Kingston, 23.
"Those are gross underestimates," said Dr. David Barber, chair of the OMA’s general and family practice section and a family doctor based in Kingston.
The numbers are according to job postings on HealthForceOntario, which is part of super agency Ontario Health and "supports the government’s health workforce objectives and contributes to the planning, recruitment, retention, transition, and distribution of health practitioners in Ontario."
Barber said the demand for family doctors alone is high. He said in Kingston, 30,000 people don't have a family doctor — representing nearly a quarter of the population — and that around 30 doctors would be needed to meet the community's needs if each took on 1,000 patients.
While the numbers represent the need for different types of physicians, the OMA has recently been highlighting the shortage of family doctors across Ontario, including last week after Group Health Centre in Sault Ste. Marie said it would be dropping 10,000 patients by the end of May due to a "severe shortage of physicians and nurse practitioners."
The news had the OMA warning that this could become a common issue across the province if the government doesn't do more to address it.
“The implications of people not being able to access primary care are severe,” OMA President Dr. Andrew Park said in a statement on Monday. “The crisis we have seen unfold in Sault Ste. Marie, leaving thousands of people without a family doctor, will replicate itself across the province. We can’t just sit back and watch this situation get worse. We need to act now so people in Ontario can get care when they need it.”
The OMA says 2.3 million Ontarians don't have a family doctor and expects that number to nearly double within the next two years.
The impact on Ontarians is "significant," as is the effect on the broader health system, said Barber, who is also a medical director at a nursing home and trains medical graduates going into family medicine.
"The family doctor is the entrance point into the medical system. So, if you don't have a family doctor, then you're stuck going to the emergency room, and we're seeing that happen, that's part of the reason for emergency rooms being overwhelmed across Ontario," he said.
The Trillium recently reported that the time patients waited in emergency departments before they were moved to an in-patient bed had reached a historical high. And emergency department closures due to staffing shortages continue to be reported, such as at Durham Hospital on Sunday night.
Barber said while walk-in clinics are another point-of-entry, in Kingston, for example, there's a shortage of those too.
“The result of the doctor shortage is people left with health-care concerns that need attention. Heart-breaking things can happen when patients don’t have primary care,” Park said. “Our goal is to make sure everyone in Ontario has access to a family doctor. People are paying for health care through their taxes and they deserve a doctor. Let’s make sure that happens.”
Barber said 7,000 patients were left without a family doctor in Kingston after six physicians retired last summer.
"I don't know how patients are getting prescriptions refilled, who's monitoring their blood pressure," he said. "If somebody's not getting screened for, let's say, colon cancer, and they go on to develop colon cancer, well that should just never happen, but it's going to start happening."
Barber said he gets asked "all the time" to expand his patient roster.
"It's really a terrible position to be in. You'd certainly want to help everybody, but you can't look after every person looking for a family doctor in Kingston," he said.
Meanwhile, doctors are facing burnout — around 73 per cent said they felt some degree of burnout in 2021 — with family doctors saying they spend around 19 hours each week on administrative tasks, according to the OMA's pre-budget submission to the government.
"I think it would be fair to say that there just are more pressures on family doctors in general these days," said Barber.
He attributed this to medical advances and "more things for us to stay on top of," more administrative work, fewer medical students wanting to go into family medicine, and people leaving this area of practice to go elsewhere in the health system.
Barber said making family medicine more attractive to medical students is part of the fix.
Overhead costs have gone up, he said, and so new graduates with hundreds of thousands of dollars in debt might keep that in mind when entering this area of practice.
The OMA has also been asking the government to boost funding, and therefore access, to team-based primary care — where inter-professional health-care providers work together to provide care to patients — and the creation of a workforce strategy to increase the number of doctors in northern and rural areas.
Barber said he thinks the government needs to do much more, and quickly.
"The government, as far as I know, hasn't even acknowledged that there's an issue with people having to finding family doctors in Ontario, I don't think either they acknowledged that the problem is getting worse," he said. "It's gonna take a lot of work to fix it, and so I am not hopeful. It's like this government have had their heads in the sand, they just don't want to hear it."
Hannah Jensen, a spokesperson for Health Minister Sylvia Jones said the Ford government has added more than 10,400 new doctors since 2018, "including a nearly 10 per cent increase in family doctors, by launching the largest medical school expansion in 15 years, adding hundreds of undergraduate and medical seats across the province, including at the University of Toronto, with 60 per cent of seats specifically for family medicine, and breaking down (barriers) for internationally and interprovincially educated health-care workers to work in Ontario, including the new Practice Ready Ontario Program that will add 50 new physicians this year."
"While Ontario is leading the country with 90 per cent of Ontarians having a primary care provider, we understand that a key part of our Your Health plan is to ensure all Ontarians who want access to primary care are able to," she said, adding that the government is "investing tens of millions of dollars to launch the largest expansion of new interdisciplinary primary care teams," and that details would be announced soon.
Jensen said the province is also working with the health-care sector on administrative burdens by simplifying forms.
"As part of the Your Health Act, our government is also ‘Axing the Fax’, replacing fax machines with a digital communications alternative at all Ontario health care providers, reducing the risk of delays in diagnosis and treatment while as well as the administrative burden on health care providers," she said.
