NOTL doctor addresses regional family doctor shortage

73,000 Niagara Region residents do not have access to a family doctor, and this number could double within the next two years unless changes are made at the provincial level, said Dr. Iram Ahmed of the Niagara North Family Health Team.

A family doctor, explained Dr. Ahmed, “is someone who has the privilege of staying with you from birth or childhood to adulthood.” They help to navigate the healthcare system and help address changing healthcare needs.

Unlike traditional walk-in clinics where “there is no continuity of care,” she added, “a family physician has all your medical information in one place and understands your health history.”

The Ontario College of Family Physicians (OCFP) is calling on the Ontario government to “cut the paperwork” and support better, more efficient ways of doing things, such as eliminating employer-mandated sick notes and modernizing outdated referral systems, according to a press release from the OCFP.

19 hours of administrative work per week is “time that we could be seeing a patient face to face and providing care,” Dr. Ahmed said.

The OCFP also advocates for more team support alongside family doctors. “It's a team of healthcare professionals who work together with the family physician, so the patient can receive the right care they need at the right time by the right provider,” explained Dr. Ahmed. “For example, a dietician, a social worker or a psychotherapist could be part of that healthcare team, or a nurse practitioner and a registered nurse.”

OCFP would like the government to ensure fair compensation. “Compensation has not kept pace with inflation and does not reflect the complex care family doctors provide,” said OCFP. 

“We are, at the end of the day, small business owners,” said Dr. Ahmed. “We have the rising cost that all small business owners are facing: increasing rent, increasing utilities, increasing cost of supplies, increasing staff salaries. When your compensation is not keeping up with that, then overall you're running a failing business model.”

While two new doctors are currently accepting patients in the Niagara North Family Health Team at two Niagara-on-the-Lake sites, Dr. Ahmed does not see more physicians coming to NOTL to practice in the near future.

“We are a bit remote,” said Dr. Ahmed, “but the issue is much larger than regional.”

She explained that “we have a population where patients are living longer and can have more complicated health histories. Family medicine itself is becoming more complex. Many physicians are retiring or close to retirement and mid-career physicians are burnt out by the systematic strains of administrative work and increasing financial pressures, and so they're leaving family medicine for things that compensate better.” Dr. Ahmed cites as an example a NOTL doctor who left family medicine to retrain as a dermatologist.

“Then our medical students are seeing what's happening to their senior colleagues, the struggles that we're facing, and they're choosing not to practice family medicine. They're choosing to go into other specialties.”

A typical family physician carries 1300 to 1500 patients, “but most carry more,” she said.

Out-of-town residents can access doctors in other regions, but Dr. Ahmed does not suggest this practice because it isn’t practical nor in the best interest of the patient, who may have to drive hours again to see a referred specialist.

OCFP reports that in a survey, 65 percent of family doctors said they plan to leave or change their practice in the next five years.  

Dr Ahmed said that local residents can advocate to the government, their local MPs and MPPs about this issue. “That would be helpful. Sitting down with your family doctor and having a frank conversation about what you can do on a grassroots or in-the-weeds level would be great”

“It is clear that the profession is under enormous strain right now due to system-wide issues. We believe it's possible to turn this crisis around and let family doctors get back to what they most want, which is to be there for their patients,” said Dr. Mekalai Kumanan, President of OCFP. “By supporting family doctors now, we can ensure that Ontarians have access to the kind of quality care they expect for years to come.” 

To request access to one of the two new NOTL family doctors, call the Niagara North Family Health Team.