At least 10,000 residents of Sault Ste. Marie, Ont., will lose access to their primary care provider as of May 31 as physicians retire or leave, according to a major health provider in the Northern Ontario city, highlighting a worsening family doctor shortage that is hitting remote and rural regions particularly hard.
The loss will leave one in four people in the area of approximately 100,000 people without access to primary care, said Jodie Stewart, chief executive officer and chair of the Algoma District Medical Group, which operates at the Group Health Centre. A further 6,000 patients may also lose access to primary care in the near future, if efforts to mitigate the effects of a severe physician and nursing shortage aren’t effective, Dr. Stewart said.
“We know these people and we know the impact that this is going to have given the fact that we’re one of the largest centres,” she said.
The Group Health Centre is a non-profit charitable organization that provides outpatient primary care, specialty care and other community health services to thousands of residents in the Algoma region of Ontario. Roy Romanow, who led the 2002 Royal Commission on the Future of Health Care in Canada, often touted the centre as a model comprehensive health delivery that should serve as an example for the rest of the country.
Andrew Park, president of the Ontario Medical Association, said patients affected by this move will lose the ability to manage their health, leading them to suffer.
“Their trajectory is going to be more sickness, they’re going to be diagnosed later, they’re not going to have as good an outcome,” Dr. Park said. “This is not unique to Sault Ste. Marie. This is happening all across the province.”
Ontario Health Minister Sylvia Jones declined an interview request. In a statement, spokesperson Hannah Jensen said the ministry had made attempts to find a solution but that it wasn’t possible on such short notice.
Dr. Stewart said the challenges facing Sault Ste. Marie and beyond have been known for a long time. For instance, numerous doctors who planned on retiring have stayed on for years because there’s no one to take their place, she said. But given the enormousness of the health care shortages the centre is facing, it has no choice but to deroster 10,000 patients, Dr. Stewart said.
In a news release published Monday, the Ontario Medical Association issued a warning about the family doctor shortage, noting that 2.3 million people in the province already lack access to a primary care physician. The OMA noted that according to HealthForceOntario, which posts job openings for physicians, there are more than 2,500 doctors currently needed across the province.
Sarah Newbery, a rural generalist family physician based in Marathon, Ont., located on the north shore of Lake Superior, said the crisis in primary care is a major challenge for people in northern regions, who typically have lower life expectancy and worse health outcomes compared to people living in Southern Ontario. A variety of demographic and socioeconomic factors contribute to the worse health outcomes in Northern Ontario. For instance, the average income in Northern Ontario is lower than the rest of the province and there is a higher proportion of people living with complex chronic diseases such as Type 2 diabetes.
“There’s a complexity of patients in Northern Ontario,” said Dr. Newbery, who is also the associate dean of physician work force strategy at the Northern Ontario School of Medicine. “There are challenges of geography, there are challenges in accessing specialist services in northern regions.”
Dr. Newbery said that geographic isolation means that a loss of primary care providers can have an outsized effect on a population in the North because there are fewer options and no other nearby health centres or hospitals who can take those patients on.
“I would say that the situation in the North is really concerning,” she said. “There’s no other hospital. There’s no other walk-in clinic.”
Dr. Newbery said that better retention strategies are one of the solutions needed to address the crisis. Family physicians are often swamped with paperwork and other administrative tasks that mean they aren’t able to give as much of their time to patient care. She said investing in team-based models will help ensure doctors can focus on seeing patients while others can make sure important forms get filled out.
“We need to be able to support family physicians to do that work well.”
Dr. Park echoed those comments, highlighting the importance of investing in team-based care to ensure that family physicians want to stay in their roles.
“Solo family practice is less of a reality,” Dr. Park said. “It’s becoming less and less of a model of practice that new grads as well as the complexity of their patients allow for.”
Carly Weeks