Wanted: family doctors
Community leaders roll out the welcome mat to prospective MDS — and their partners
IF YOU LIVE in Waterloo Region, chances are you or someone you know has had trouble finding a family doctor. As it stands today, close to 20,000 people in Kitchener and Waterloo do not have access to a general practice physician.
Based on the Ministry of Health and Long Term Care’s recommended ratio of one physician per 1,380 citizens, Kitchener and Waterloo are short roughly 15 full-time doctors.
It’s a problem that may get much worse. >>
>> Roughly 25 per cent of local physicians will reach retirement age within the next five years and with a projected population growth of close to 44,000 over that same time, there will be a potential need for an additional 32 family physicians or roughly 6.4 new practitioners with each coming year.
Perhaps if we could design, build, program or manufacture new physicians, this wouldn’t be an issue. Regionally, we’re good at making things. But attracting new physicians takes a degree of self-promotion — not traditionally a regional forte.
“Years ago, before we started this, and before the medical school came in, there was a perception, ‘What is K-W?’” says Mary Sue Fitzpatrick, vice-president of Family Physician Resources and Health Advocacy with the Greater Kitchener and Waterloo Chamber of Commerce and the straw that stirs the drink in a co-ordinated effort to actively recruit more family doctors to the area.
Stylishly dressed, warm and engaging, Fitzpatrick is a “people person,” and a natural choice to make a good first impression with sought-after physicians. For her, it’s not about the hard sell. “To stand up and say, ‘This is the most amazing community in the world,’ ” she says, “we don’t do that. For us, it is all about relationship building.”
What Fitzpatrick and the chamber do is let the community and its people sell itself, by creating a welcoming and hospitable environment for potential family doctors where they can meet peers and weigh their options.
There are lots of variables involved, and the stakes are high. Doctors, who make lifeand-death decisions every day, also decide where they wish to practise. With the Toronto area being a huge draw, the health of our citizens may just rest in our ability to offer a lifestyle that suits not only doctors, but their entire family.
For Fitzpatrick and the chamber the culmination of their efforts is the annual “family medicine residency weekend.”
“We invite up to 20 family medicine residents and their partners,” explains Fitzpatrick. “The doctors tour the facilities here and practice opportunities are discussed and the partners see the community. We have local doctors sit down and discuss what it is like to work here.”
They learn about local business bellwethers like Open Text, and hear talks by community cheerleaders such as Communitech’s Iain Klugman. The weekend’s highlight is a dinner, attended by 60 to 70 prospective physicians, their partners, local leaders and established doctors.
That part of the recruitment push seems like common sense. But where Fitzpatrick, the chamber (which pays for all travel and expenses) and their corporate and municipal partners really showcase their strategy is by targeting the physician’s entire family.
“We try and have someone who is in the same career as the partner,” Fitzpatrick says. “So it is very informal. We usually recruit doctors that way. We have been very successful.”
For Dr. Joanna Zorzitto, a physician successfully wooed by Fitzpatrick and the chamber, the recruitment weekend played a large role in selecting Kitchener as her place of practice.
“There was nobody else who did a whole weekend like they did here,” she says. “All of the other ones that I went to were more one-on-one visits that were set up through the Health Force Ontario person who was designated to that area.”
Zorzitto grew up in Waterloo, though there was no guarantee she’d return here to practise. She also considered Fergus, Elora and even spent time in Wawa as a family doctor. All needed her services, but there was something our community could offer that the others couldn’t.
“Obviously it’s important for the physician to have a job, but also their partner. They need somewhere to work when they get here too,” she explains.
With a below-average unemployment rate, the region is relatively flush with jobs for professionally minded couples. With tech start-ups, insurance companies and universities, a physician’s partner generally has a good shot at finding work here.
“He works at Sunlife and Mary helped him get the job there,” says Zorzitto of her husband. “He’s actually a teacher, but they weren’t able to help him get a job teaching, which was unfortunate, but she still did help him get another job in the meantime.”
In November, when prospective doctors and their families arrive from all across the country for the Family Medicine Residency Weekend, they often stay in rooms provided by another corporate partner, the Waterloo Inn.
“We had a couple hundred employees and they were short of doctors,” says Mary D’Alton, president and managing director at the Waterloo Inn. “If you are in a community, and your staff can’t get doctors,
and you are not doing something to try and make it better, then you shouldn’t be complaining.” For D’Alton and the program’s other corporate sponsors, the physical health of our community correlates to its economic health. A workforce that spends more time doing their job, and less time sick, injured or travelling long distances for medical care, is a productive one. D’Alton sees the physician recruitment program, not as a stand-alone effort, but rather one facet of a growing community awareness that in an increasingly competitive global economy simply providing jobs is not enough. “We’ve also been very supportive of the education system here in town,” says D’Alton who also notes that she sees a similar benefit with organizations like the Creative Enterprise Initiative. These co-ordinated, community-focused programs are all pillars functioning to help elevate our community to a position of desirability. It’s something Fitzpatrick credits to the region’s “barnraising mentality.”
Raising barns as a community is definitely effective, but someone still has to buy the lumber. Providing much of the Physician Recruitment Program’s $140,000 annual budget are large local corporations such as BlackBerry, Manulife, Sunlife and Cowan Insurance Group. Their involvement seems to echo D’Alton’s assertion that businesses here understand that a healthy community serves to help the entire economy.
The local physician-recruitment effort didn’t always have this kind of support. It formally began back in 1998 when the disparity between physicians and patients was double what it is today. With 40,000 people in the region without a doctor, a volunteer task force was assembled to explore ways to close this gap.
By 2006 the task force had evolved into the official Chamber Health Care Resources Council. Generally, the initiative has not actively recruited specialists. Specialist recruitment is done mainly by the local hospitals.
The chamber’s program also does not recruit doctors to Cambridge, which has its own recruitment initiative, Doctors 4 Cambridge. Donna Gravelle, the recruitment co-ordinator for the Cambridge and North Dumfries Doctor Recruitment Committee is facing many of the same challenges as her compatriots to the north but has had slightly more success.
“We don’t have wait-lists anymore,” says Gravelle with cautious optimism. From 2008 to 2012, Gravelle and the committee>>
>> have attracted 27 new physicians to Cambridge. However, due to retirement and relocation, Cambridge lost 13. Still, the net gain of 14 doctors is positive, but not a total victory.
“Work-life balance is important for new doctors,” says Gravelle, who estimates that it takes 1.5 to two new physicians to replace one retiring doctor who has traditionally carried a much larger patient roster.
Doctors 4 Cambridge has a three-year head start on Kitchener and Waterloo’s efforts, and it benefitted from several extra years with under-served status. But it serves as an encouraging bellwether that recruitment initiatives are working.
According to Fitzpatrick, since 1998, the program has helped attract more than 150 physicians to the Kitchener and Waterloo areas. Last year, eight doctors were recruited, and so far this year three have agreed to practise here.
The program is much more than mere wining and dining. Beyond fostering personal and professional connections, the program works with local developers to create private or community-owned medical centres.
The chamber has worked with McMaster University on programs to engage family medicine residents and medical students coming out of the Michael G. DeGroote School of Medicine in Kitchener. “If they tend to train here, they tend to work here,” says Fitzpatrick.
They have also helped champion the Medical Centre opening at The Boardwalk in Waterloo, which aims to attract 25 family doctors interested in working as a team.
Zorzitto, who practises with several other doctors as part of the New Vision Health Team in south Kitchener, says: “As a family doctor, being able to work in a family health team is a really big benefit. You have access to all these allied health professionals, and for me having access to all the other physicians who work here with more experience than me has been really helpful
To stand up and say, ‘This is the most amazing community in the world, we don’t do that. For us, it is all about relationship building.
Mary Sue Fitzpatrick, describing the local strategy for recruiting doctors
to just support me over my first couple years of practice.”
It’s something that Fitzpatrick understands very well. “Whether they are male or female, younger physicians want a work/life balance,” she says. “They will roster fewer patients. And unlike established physicians, they don’t want to set up a practice, they don’t want to set up a space and hire the staff and buy all of the equipment.”
Zorzitto says working with a team is better for her and for her patients. “If you’re in a rural community, you feel much more obligated to work all the time and to take on new people. And I feel like we have good support from the specialists who work here too, so that’s really helpful.”
Gihan El Mokadem is a recent immigrant from Egypt (via Oman) where she worked as a family doctor. She and her husband moved to the Toronto area to make a better life for their children, and currently she is finishing her first year of residency in Kingston.
El Mokadem is what is known as an International Medical Graduate. In order to be fully licensed to practise medicine in Canada, such graduates must commit to what is known as a return of service agreement whereby they assent to work in an under-served community for a period of time (usually five years). The agreement was established to lure doctors to remote areas that are chronically short of doctors.
Due to its rapid growth, and changes to government policy, Kitchener and Waterloo have recently been both eligible and ineligible as an appropriate community for International Medical Graduates. Currently it is eligible — something the Physician Recruitment Program is taking advantage of by assisting those graduates with Return of Service Agreements.
This is good news for doctors such as El Mokadem. “I don’t want to go to an area in the north where I don’t know anyone and start a life from the beginning and make new friends,” she says. “It’s too hard.”
At the time of our phone interview, El Mokadem was about to take a trip to Kitchener and Waterloo. She wouldn’t be seeing the sights. She would be meeting with local doctors to discuss possibly joining one of their practices.
Though she hasn’t decided where she will work, her choices have been narrowed down to our area, Oakville or Milton. Working in our favour is the fact that El Mokadem has a daughter studying planning at the faculty of environment at the University of Waterloo. She also has a younger son who has applied to engineering at Waterloo.
Though she may decide to practise here, El Mokadem does not plan to move to the region. She and her husband have already made connections in the Toronto area and her husband owns a business there.
“Waterloo is very close to the area where I plan to live, Oakville-Burlington,” she says. “I would like to live in an area where I can have friends, and a social life. My friends are within that area. I could get a house in that area and at the same time I can work there.”
Though polite and agreeable, El Mokadem doesn’t pretend to know a lot about the regional culture, our pride in innovation, or any “barnraising mentality” here. She’s simply looking for people with whom she feels comfortable practising medicine. So if our efforts to attract physicians are really about,” relationship building,” as Fitzpatrick says, we’re on the right track.