Wednesday, January 26, 2022

Why 1 Ontario community is facing a severe physician shortage | CBC News

This story is part of CBC’s new pop-up bureau in Kingston, Ont. If we should be aware of an incident happening in this area, send us an email.

Mark Richardson and her husband have been on the Family Doctor’s waiting list since 2019.

Since moving back to Canada from the United States in August 2018, the couple have reached out to more than a dozen clinics in Kingston, Ont., to no avail, and it has only recently become more worrisome. Richardson is having frequent stomach ache.

“I hope it’s … nothing permanent,” he said. “But I mean, it could happen.”

Mark Richardson and her husband Adam Keeping have been waiting for a family doctor since 2019. (Submitted by Mark Richardson)

Richardson’s desperation is familiar to many living in the Kingston area, which, ironically, houses a major medical school and several state-of-the-art research institutions at Queens University.

Despite those benefits, CBC News found that more than 80 percent of family physicians practicing in the city are not accepting new patients. Some that are, such as military doctors, are often inaccessible to the general public.

“It seems like the biggest obstacle is something I have no control over,” said Richardson, who works at the Astroparticle Physics Research Institute. “And that’s just the number of doctors in the area.”

He is among nearly 29,000 patients in Kingston who are without a local family doctor—the highest total among Ontario’s five regions. Southeast Local Health Integration Network, according to a Kingston Area Health Care Task Force’s 2020 Report,

The report also found that Kingston had the most overuse of emergency rooms in the area and that the city would need 20 additional family physicians immediately, with 38 doctors retiring within the next decade to be replaced.

Meanwhile, Kingston has been kept out of the province. Specified list of areas of higher physician need, which critics say only exacerbates the shortage of doctors. Communities on the list, which include large cities such as Toronto and Ottawa, are exempt from provincial restrictions that limit physicians from setting up new clinics.

‘The system cheated,’ says doctor

CBC News cross-referenced 314 doctors listed with College of Physicians and Surgeons of Ontario “Doctor Search” Tool To find out how many family doctors are accepting new patients along with their current status.

About half of the families were not practicing medicine at the time of publication. It appears that a handful of people have retired or given up medicine altogether. Some lists seemed out of date in other ways.

None of the 125 doctors actively involved in family medicine told CBC News that they were accepting new patients from the general public. Two dozen doctors are accepting new patients but only from a certain category: newborns, military personnel, members of universities and other institutions.

“It’s really frightening – many people feel lost, abandoned, betrayed by the system,” said Dr. Joy Hatley, a family physician in Kingston and president of the Ontario Medical Association.

The provincial health ministry says that Kingston is actually doing better than most cities in the province because, as of 2020, there were 16 family doctors for every 10,000 residents – above the provincial average of 10.2.

Payment system rules limit problem solving ability

Hatley says the city will have to “work” around any provincial designations to help bring more family doctors into the community due to shortages in more rural communities, especially northern Ontario.

The solution may sit within existing regulations around the business model for family physicians. The city has reached its legal limit of doctors’ offices operating under the “capitation model” where doctors receive a base rate for each patient on their roster.

That model is heavily controlled by the province. Right now, no new clinics can open in Kingston under this model because the city has not been designated as an area with high physician needs.

Meanwhile, fee for the service clinics are allowed to open anywhere. Under this model, doctors are paid by the province for each office visit, test or procedure. To survive, physicians work through large numbers of patients simultaneously and run a business.

According to Dr Michael Green, Associate Professor of Family Medicine and Public Health Sciences at Queen’s University, this restriction on the capitation model is “not a helpful policy solution”.

Why 1 Ontario community is facing a severe physician shortage | CBC News
Dr. Michael Green, associate professor of family medicine and public health science at Queen’s University, says Ontario needs to explore alternatives to the fee payment model for the service. (Submitted by Michael Green)

Green says clinics operating under the capitation model, such as the Family Health Network, attract more family doctors, including new graduates from Queen’s, who turn to clinics with all the bells and whistles to instill confidence. grow.

Those clinics often include nurse practitioners, mental health workers and pharmacists, as well as complementary services that reduce a therapist’s workload.

“It would also allow doctors to take on a few more patients because they would have additional team support,” Green said.

For now, Richardson continues to rely on walk-in clinics that don’t provide continuity of care and as he describes it, “every step of the health care process is a little daunting.”

The City of Kingston has earmarked $2 million to attract family doctors. Each new physician who has established a roasted practice for at least five years will be eligible to receive up to $100,000.

The city expects the incentive program to bring at least 15 new family doctors to the area within eight years.

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