The scarcity of family doctors (primary care) is a major concern for all communities in Ontario.
Approximately 1.8 million Ontarians have no family doctor, and this number is expected to rise to 3 million in 2025 (1 in 5). In the first 6 months of 2022, 180,000 Ontarians lost their family doctor. The reasons are simple: family physicians are retiring (4.9 million Ontarians have family doctors over the age of 55; Covid has caused a lot of stress and burnout; and fewer medical students are choosing to become family physicians.
An aging population requires more of the family doctor’s time, increasing the stress on the system. Every community is looking for a family doctor.
Some communities are hiring search consultants, but with the supply of family physicians dwindling, there is not enough supply to satisfy the growing demand. For the County, this means that there won’t be enough family doctors to satisfy the medical needs of County residents.
What we have in Ontario is a frozen paradigm. There are ways to change this, but it will take time, since all of the necessary changes have to be driven by Ontario Government policy and funding (history tells us that speedy responses are rare, especially in the health care sector). There is no silver bullet, but rather a series of incremental changes that will eventually impact the system.
One such tested and proven concept is the Nurse Practitioner Led Primary Care Clinic. There are 25 such clinics across Ontario, but the Ontario Government has capped the funding of further clinics. Nurse Practitioners (NPs) can do approximately 60 – 80 per cent of what a family doctor does (I have taken a minimum/maximum view from various sources). The Nurse Practitioners Association of Ontario puts it this way: “NPs have the knowledge and skills to deliver the health care services most Ontarians require on a day-to-day basis, and represent an opportunity to relieve strain on the health care system and provide quality care to patients across the province.”
A nurse practitioner led primary care clinic should be considered an option for the County. Among other benefits, it’s cost effective.
Think about having an NP led primary care clinic on Main Street in downtown Picton, staffed by three NPs. Let’s assume each NP has a patient roster of 1000, which would create primary care for 3000 people in the County. This would take the stress off the ER and the need to hire replacements for all the retiring family doctors. This doesn’t mean that you don’t try to attract family doctors, but it might make it easier to attract a family doctor if an NP led primary care clinic was already in operation. Health care delivery must change to accommodate increased demand. The Ontario Medical Association recommends a team approach, which fits perfectly with the nurse practitioner model suggested.
The following is a quote from a patient at a nurse practitioner led primary care clinic: “Since becoming a patient at the nurse practitioner led clinic, my health and quality of life have improved more than I ever imagined. I really value this clinic and the staff who work there (who always show such care for my well-being). Thank you for restoring my trust in health care and for being such an amazing resource to the community.”
Knud Jensen is an advisor in the areas of business, economics, and health care policy.