OMA Spotlight on Health - Doctor Shortage
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Georgia Balogiannis: In this podcast the Ontario Medical Association looks at current issues of interest in health care. Spotlight on Health gives you all the straight talk. We're Ontario's doctors and your health matters to us. I'm Georgia Balogiannis for the Ontario Medical Association.
On this episode, we speak to OMA past president Dr. Sohail Gandhi, a rural family medicine doctor in Stayner. He talks about the impact of the doctor shortage in Ontario and possible solutions.
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Dr. Sohail Gandhi: It's no secret that there is a doctor shortage in Ontario.But when you sort of delve into the numbers, it becomes apparent just how significant that is.
Currently, Ontario has 2.3 physicians for every 100,000 people in our province and to put that into perspective that ranks us as number seven across the country in terms of provinces. So there are six other provinces that have more doctors per capita than we do in Ontario.
And it gets a little bit more jarring when you look at Ontario as a jurisdiction and you compare us to other developed countries. So, if you look at, say, the OECD countries across the world that have fully developed healthcare systems, that number of 2.3 per hundred thousand would put us at 29th out of 33. So there are a significant number of countries that have better health care systems, better outcomes from their health care, and they all happen to have more doctors per capita.
At this point in time, we know that there are at least a million people in Ontario — at least a million — who don't have a family doctor and we know that this issue is particularly acute in the North and in remote and rural communities, where they really are struggling quite a bit.
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Dr. Gandhi: On a personal note, I can tell you that over the past year or so, I have had some patients who moved away from my community of Stayner for multiple reasons. And the stories that they come back with are actually heartbreaking. A patient of mine who moved to a small community in Windsor, she's been unable to find a family doctor for about a year and I’ve tried my best to manage her virtually. And virtual care is a good idea, in some cases. But when she needed a procedure done, she had no choice but to drive four hours to my town to get the procedure done because there are obviously some things you just can't do virtually.
I've got another family who has a young child about seven years old who has significant medical issues. They moved towards the Sudbury area. And I've been trying to manage those medical issues over the phone, along with help from the pediatricians but, as you can imagine, it's very, very challenging when you can’t see people.
I've got another patient of mine who moved to the Elliot Lake region, which is about a four hour drive from Stayner and again, not able to find a doctor. So these are real people who are left in a situation where they have to travel four, five hours to see a family physician when they need that in-person care because virtual can do some things but can't do everything. And these people are significantly suffering as a result of the doctor shortage in Ontario.
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Dr. Gandhi: To try and get a sense of just how widespread this physician shortage is, the OMA looked at the data from HealthForceOntario, now that's, that’s a government website that advertises posts for physicians.
They took a look at this website on just one day and looked into 12 different cities and four regions across Ontario. And what they found was there was, in fact, an acute shortage in the Northern area. So, out of a total of 1800 openings — so that's 1800 physicians that we need right now as of this moment — there were 150 doctors needed in Sudbury and surrounding areas, there were 70 more that were needed in Thunder Bay.
But there are also some problems in urban centers where we would think would not be quite so short. Hamilton and surrounding areas, for example, needed 200 doctors. The London and surrounding area communities needed 94. Kingston needed 69. And, even in areas like Toronto and Mississauga, there were 639 postings available for physicians in Toronto and 202 in Mississauga, so this is a province-wide issue.
Quite a bit more significant in the North, of course. I would never want to deny the North their needs, but it is a big issue and it's going to cause concern for the people of Ontario for the next decade.
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Dr. Gandhi: We all know that primary care is the foundation for a healthcare system. Family doctors, like myself, our job is to try and prevent disease and we try and keep your blood pressure under control, we try and keep the diabetes controlled, we try to identify colon cancer and cervical cancer and, and breast cancer at early stages, so that the disease doesn't spread and create more healthcare needs.
And when there aren't enough of us, those conditions, the diabetes will turn into heart disease, so that my colleague Dr. Hill will now have to operate. I mean I don't begrudge her the work but I’m sure she’d prefer if she had less patients to deal with.
When you don't treat the high blood pressure, people wind up getting strokes and cost the health system more. So, it's really important to address primary care as well.
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Dr. Gandhi: We do need some more data on exactly what type of doctors are needed, because as medicine becomes more complex it's not quite as simple as just saying, “Well, we need a family physician in this area”. Do you need a family physician who can also work in the emergency department? A family physician who can also do obstetrics? Do you need a general specialist in orthopedics or one that specializes just in hips? We need that data.
We need to support doctors to make sure that there's enough doctors in the right places at the right time. That does mean more medical students and residency positions and to that end I was very glad to see that the current government is increasing the number of medical students spots and creating a new medical school.
That's a great long-term solution, because it takes 10 or 12 years to get a fully trained doctor. So, that will certainly help us 10 or 12 years down the road and I appreciate that, but we need to provide more support for doctors and medical students who work in rural and racialized communities and remote communities and to help them have access to frontline advice, through digital technology that's available today, so they can practice in these communities.
And finally, I would say that we need to figure out a way to let doctors be doctors. Right now physicians are spending a lot of time — I can't really call it paper work anymore because everything is electronic, right. It's all in front of a computer and there are all these electronic medical record systems. But we need to find a way to make this stuff easier for doctors.
My hospital, a year ago, actually switched over to a fancy new electronic medical record system. I gotta tell you it takes me twice as long to see a patient now. And I fully appreciate that this new system provides the hospital with increased patient data and increased administrative data to help them secure funding and all that.
But if it takes me twice as long to see a patient, then that's really doing a disservice to the community. And, quite frankly, there's so many clicks on this thing because I'm always pecking away at the keyboard trying to figure out what the right button is to press.
So that's a basic snapshot of the issues around the doctor shortage.
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Georgia Balogiannis: This podcast is brought to you by the Ontario Medical Association and is edited and produced by Jodi Crawford Productions. To learn more about the Ontario Medical Association, please visit oma.org
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