Ontario failing in bid to boost family doctors

The recent sight of hundreds of people in Kingston lining up for hours in chilly weather for a chance to get a family doctor has vividly brought home the desperation of Ontarians who lack primary care. It is not a good look for Ontario, or perhaps even Canada.

If Health Minister Sylvia Jones and Premier Doug Ford have still not understood people's desperation, those images should put that to rest.

When you think of Canada, you certainly don't imagine it as a place where millions don't have a family doctor, let alone where people line up for blocks to get one. And yet there we were on Feb. 26 and 28, with people queuing, some camped overnight, to do just that. Some 600 lucky ones managed to get a doctor, but thousands more remain in limbo.

The primary care crisis in Ontario has been going on for years; at least 2.3 million people are without a family doctor. Kingston has faced a doctor shortage for some time, but things worsened last year when six doctors retired, adding some 8,000 patients to an already-bulging waiting list. Fortunately, a clinic in town, CDK Family Medicine, announced it had room for up to 4,000 patients, and opened up registration.

That triggered the lineup, and after the first 600 were signed, the clinic paused registration because staff were overwhelmed and it needed to rethink the whole process. This drew criticism from some understandably frustrated would-be patients who think there ought to be a better way. “While we understand some patients are unhappy about the wait-times and we are still learning about how to improve the CDK rostering day experience, we are not the cause of the doctor shortages and there is no automated way to `batch-roster' patients …” the clinic wrote on its website. It said registering patients through multiple channels, including in-person, online, off retired doctors' lists and through referrals by other doctors, is the best way to go, and asked for some understanding.

If you have lined up from dawn, and still can't get in, you'll not be happy. But you can't blame the clinic, which is trying to help and doing the best it can to register as many patients as its resources will allow.

The problem is the overall supply, and Kingston is a mere microcosm of what's happening in Ontario, where the doctor shortage is expected to double over the next two years. In Kingston, more than 30,000 don't have a family doctor while in Ottawa the figure is 150,000. If a clinic opened registration for new patients in Ottawa or any Ontario city, what happened in Kingston would be replicated.

“The recent impressive efforts by the CDK clinic are to be applauded,” says Eliot Frymire, a health-care researcher at Queen's University. “But this situation is really no different in any other community in Ontario, and in many places, it is even more dire.” Indeed, a Sault

Ste. Marie clinic announced in January that 10,000 patients will lose their family physician in May due to the physician shortage and lack of recruits.

The Ontario government has taken a number of steps to deal with the shortage, including boosting medical school intake and investing $110 million to create 53 new primary-care teams. For all that, it is clear that what the government is doing isn't getting to the heart of the problem: poor remuneration, lack of work-life balance, large numbers of doctors retiring or on the verge of retirement, and the decreasing interest in family medicine by medical students.

Recently the government offered doctors a

2.8 per cent wage increase for 2003/24, which many of them have dismissed. “After taxes and overhead, this funding amounts to an extra

$12 a day for the average family physician,” the Ontario Medical Association said. “That isn't going to help hire and retain more family physicians …”

Clearly, whatever the government is doing isn't working and must change. Kingston is a wake-up call the government must answer.