SGEM Xtra: Doctor, Doctor – We Need More Family Doctors

Date: December 12, 2023 Reference: OCFP News. More Than Four Million Ontarians Will Be Without a Family Doctor by 2026. Nov 7, 2023 Guest Skeptic: Dr. Mahaleh Mekalai Kumanan attended Dalhousie University for her undergraduate studies, Master of Health Administration degree and medical school before completing her residency at the University of Western Ontario. She is currently the President of the Ontario College of Family Medicine (OCFP). This is an SGEM Xtra. I had the opportunity to interview the President of the OCFP about the current state of family medicine and some possible solutions. Please consider listening to the SGEM Podcast and hear what Dr. Kumanan has to say. It has been an interesting couple of months. The College of Family Physicians of Canada (CFPC) in September widely communicated they were going to implement an additional year of training for family medicine residents. There was an outcry from individuals and organizations (SRPC, CFMC, RDC, OMA & Ministers of Health) asking the CFPC to pause and reconsider. This included a statement from the OCFP. To its credit the CFPC listened, reflected, and responded in a very appropriate way. The CFPC President (Dr. Mike Green) apologized and announced they are not implementing an additional year of training. This took a great deal of insight and humility. Well done CFPC. Now it is time to address some immediate issues with Family Practice. Some listeners may be wondering why we are discussing this on an emergency medicine podcast. Well, it is because we are all on Team Patient. Family Medicine is the foundation of healthcare. Without strong primary care patients will eventually end up in the ED. I suspect Ontario is not the only province and Canada is not the only country struggling with these problems. As of September 2022, data by INSPIRE-PHC posted on the Ontario Community Health Profiles Partnership (OCHPP) shows nearly 2.3 million Ontarians are without a family doctor – that’s up from 1.8 million in March 2020, or up from 1.6 million in 2018. INSPIRE-PHC research, led by Dr. Kamila Premji, also shows 1.74 million Ontarian's have a doctor who is nearing retirement. In addition, the number of medical school graduates choosing to pursue family medicine is the lowest it’s been in 15 years. Using updated research, the OCFP now predicts that Ontario will exceed its previous forecast as the crisis in family medicine intensifies. Approximately 1 in 4 Ontarian's – or 4.4 million – will be without a family doctor by 2026. OCFP: Three Solutions to the Crisis Ensure Ontarians have a family doctor working alongside a team, so patients can get the help they need faster. Improve the accessibility of care by increasing the time that family doctors can spend providing direct patient care. Ensure every Ontarian has a family doctor by recruiting and retaining more family doctors within the province. Research shows that patients with access to comprehensive team-based primary care, led by a family doctor, have better health outcomes, fewer visits to the hospital/emergency department/specialty care, and overall are more satisfied with their care. The Ontario government needs to commit to ensuring every family doctor and their patients have access to a team. Ontarians who have family doctors working in teams have far greater access to the care they need because their physicians are supported by nurses, pharmacists, dietitians, social workers and more. Having easy access to a team of health care providers led by a family physician means patients can get the right care from the right provider – and frees up time for family doctors to focus on patients that most need their expertise. Right now, 70 per cent of family doctors and their patients do not have access to team-based support. The second solution the OCFP suggests is to improve the accessibility of care by increasing the time that family doctors can ...