Numbers stagnant after a decade of courting GPs

Physician recruiter says family health team freeze, distance from Toronto make Hamilton a tough sell on new doctors

THE NUMBER OF FAMILY doctors in Hamilton has gone up by roughly two per cent in more than a decade of dedicated recruitment.

“I didn’t expect to be here 13 years later still recruiting,” said Hamilton’s physician recruiter Jane Walker. “I expected us to be in a much better position. The competition for physicians is fierce.”

There are now 352 family doctors in Hamilton compared to 345 in 2005.

Recruitment hit its peak in 2013 with 367 doctors.

But the number of family doctors has been stagnant, hovering around 350, for the last three years, according to a year-to-year report that will be presented to the city’s Physician Recruitment and Retention Steering Committee Tuesday afternoon.

“It feels like we’re treading water or going down slowly,” said Walker. “It is this continual battle to try to stay afloat.”

A big part of the problem is the overwhelming number of retirements. As of July, there will be 20 doctors retiring this year with only 13 recruited so far to replace them.

“We’ve still got a lot of older physicians and they continue to retire at a great rate,” said Walker. “Recruiting new people continues to be a struggle.”

Walker said she’s managed to more than double the number of physicians in their 20s and 30s practising in Hamilton to 73.

“There are some glimmers of hope,” she said. “When we started out we had more people of retirement age than young people and now that is reversed.”

But there are still 47 family physicians over the age of 65 practising in the city and

many of them have solo practices that don’t appeal to new medical graduates.

“There is a complete disconnect between where new grads train and what facilities are like in the community,” said Walker. “The new grads are training in team environments and group practices with all the resources right there for them. When they graduate, a lot of our practices are solo offices run out of an old house that has been converted into an office. It doesn’t have the allied health-care providers there. New grads look at that and say, ‘No, that is not what I want’.”

Making things worse is that the province clamped down on doctors joining or creating family health teams just over a year ago. The popular way to practise has made Hamilton a desirable destination until now because the city is considered a leader in this type of team-oriented primary care.

Under the new rules, no new family health teams can be created and doctors can only join those in existence if replacing a retiring physician. The exception is 20 entrants a month to family health teams in underserviced areas of the province.

“If I could take some of those fee-for-service practices and convert them into family health team practices that would be fabulous,” said Walker. “I would be able to recruit people for those. But that’s not on the table right now.”

The other big issue is that doctors and their families want to live closer to Toronto, particularly in Oakville.

“That’s the biggest factor,” said Walker. “If someone has the choice between Oakville and Hamilton, nine times out of 10 they will pick Oakville.”

Part of the draw is better jobs in Toronto for the doctor’s spouse.

“The economic opportunities that exist in Toronto are an area we can’t compete with,” said Walker. “You get a rejection and you get someone who says, ‘I’m sorry, I’m taking that job in Toronto’ which I hear a lot.”

But some of the decision revolves around more modern amenities, particularly for their kids. “They like the lifestyle and the schools,” said Walker. “If you take a look at some of the schools in Burlington and Oakville, the facilities they have are newer.”

But Walker is not giving up. She plans to continue to aggressively recruit to try to stay ahead of the retirements.

“You can’t drop the ball,” she said. “You just have to keep going. It’s still pounding the pavement, getting out there to conferences, getting in touch with the young physicians and doing presentations at the university. That sort of competition for their attention is still at a much higher level than I would have expected it to be.”