Re­cruit­ing physi­cians a con­stant strug­gle

Hamil­to­ni­ans have ‘av­er­age’ ac­cess to doc­tors, re­port says

The Hamilton Spectator - - FRONT PAGE - NATALIE PADDON

HAMIL­TON HAS “AV­ER­AGE” ac­cess to fam­ily doc­tors com­pared to other cities across the prov­ince but more doc­tors in fam­ily health teams, ac­cord­ing to a new re­port.

But the city still has a short­age of 44 fam­ily doc­tors de­spite more than a decade of ded­i­cated re­cruit­ment, says Hamil­ton’s physi­cian re­cruiter.

The re­port — pub­lished Tues­day by the In­sti­tute for Clin­i­cal Eval­u­a­tive Sciences (ICES) — ex­am­ines ac­cess to pri­mary-care physi­cians across On­tario based on ge­og­ra­phy, tak­ing into ac­count the num­ber of doc­tors in a given area com­pared to pop­u­la­tion, the travel time it takes to reach them and their model of prac­tice.

“We kind of start with the ba­sics here,” said Dr. Rick Glazier, who is a sci­en­tist at ICES, a fam­ily physi­cian at St. Michael’s Hospi­tal in Toronto and one of the re­port’s au­thors.

“Ob­vi­ously, if the provider who’s near you is not tak­ing new pa­tients or doesn’t speak

your lan­guage or isn’t avail­able the hours when you’re avail­able, that’s an ad­di­tional prob­lem.”

Some of the find­ings were not shock­ing, Glazier noted, such as ru­ral com­mu­ni­ties typ­i­cally ex­pe­ri­enc­ing longer travel times and more dif­fi­cult ac­cess than their ur­ban coun­ter­parts.

But the “huge” vari­a­tion in the type of care avail­able across the prov­ince came as a sur­prise, he said.

For in­stance, close to half of Hamil­ton res­i­dents have ac­cess to a fam­ily health team, but in Brant­ford, that num­ber is be­tween five and 10 per cent. It’s a sim­i­lar sit­u­a­tion com­par­ing Guelph to Kitch­ener-Water­loo, Glazier said.

The prov­ince clamped down on doc­tors join­ing or cre­at­ing fam­ily health teams just over two years ago, so no new fam­ily health teams can be cre­ated and doc­tors can only join those in ex­is­tence if re­plac­ing re­tir­ing physi­cians. The ex­cep­tion is 20 en­trants a month to fam­ily health teams in un­der­ser­viced ar­eas of the prov­ince.

This has made re­cruit­ment even more dif­fi­cult be­cause al­most ev­ery sin­gle res­i­dent trains in this team-based model, said Jane Walker, the city’s physi­cian re­cruiter.

De­spite re­cruit­ing 272 fam­ily doc­tors over the past 12 years, Hamil­ton is back to where it was at in 2005, largely be­cause of a wave of baby boomers re­tir­ing since 2013.

Cur­rently, there are 345 prac­tis­ing fam­ily physi­cians in Hamil­ton — a mar­ginal in­crease from 342 at this time in 2016, she said.

“I don’t take a lot of com­fort in that just be­cause we have so many physi­cians that are re­tir­ing,” she said, not­ing it’s been more than the av­er­age over the last sev­eral years.

This year alone, 21 new fam­ily doc­tors have started prac­tis­ing lo­cally since De­cem­ber, but 18 have left the prac­tice through re­tire­ment, a move, ill­ness or chang­ing spe­cial­ties.

While an­other four physi­cians could start be­fore the end of the year, an­other 10 could leave, mean­ing the city will likely have fewer than 345 fam­ily doc­tors at the end of 2017, she said.

“It’s a num­bers game,” Walker said. “It’s try­ing to stay on top of it.”

Cer­tainly, ar­eas of the city tend to feel the im­pact more acutely than oth­ers, such as the south Moun­tain, Bin­brook and Flam­bor­ough, which have seen pop­u­la­tion in­creases in re­cent years of­ten due to new de­vel­op­ments.

“They don’t have enough physi­cians there,” she said.

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