Finding — and keeping — family doctors
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Today is World Family Doctor Day, a day we would normally spend celebrating the invaluable contributions made by family physicians. However, this year, we must acknowledge and commit to addressing the unprecedented challenges they are facing.
Canada has one of the largest physician shortages among developed nations, and within our country, Manitoba faces one of the most significant shortages. According to the Canadian Institute of Health Information, there are only 109 family doctors per 100,000 residents in Manitoba. We need over 200 more family doctors just to reach Canada’s national average, an average that is clearly not meeting the needs of patients across the nation.
The consequences of this crisis in family medicine are felt hardest by patients, with over 150,000 Manitobans unable to find a family doctor, while many others wait longer than they would like for an appointment.
What is even more concerning than the current shortage is where it is going. It appears we are in the middle of a mass medical resignation. Preliminary results from our Doctors Manitoba annual physician survey indicate 52 per cent of family doctors are considering retiring, relocating their practice out of Manitoba, or reducing their clinical hours within the next three years. Over 70 per cent of family medicine practice owners are concerned about how they will keep their clinic open if nothing changes.
Where did this shortage come from, and what’s needed to fix it?
The pandemic contributed to the current situation, to be sure, but our alarming shortage was growing for many years before COVID-19 arrived. Medical school training has been capped at the same level for about 15 years now, and has not kept up with Manitoba’s significant population growth.
Over the same period, family doctors have seen mounting pressures. Family physicians have a growing number of patients with complex and chronic medical conditions and they work in an increasingly complex health-care system that is more difficult to navigate. Doctors are facing escalating operating costs in their clinics and an increasing amount of paperwork and administrative tasks that diverts their time from patient care. It is no wonder that 54 per cent of family doctors are experiencing high levels of burnout.
This is a massive problem that has been building for many years, and it can’t be fixed overnight. But it can be fixed through collaboration and partnerships. With the very real threat of losing so many family doctors, the best physician recruitment plan must start with a solid retention strategy.
Doctors Manitoba has developed proposals to address this crisis by consulting family doctors and looking to other provinces and countries for ideas. The government, to its credit, is already acting on some of our advice to recruit and retain more family doctors.
They have implemented all but one of the physician-focused actions outlined in their health human resource action plan released six months ago. This includes expanding tools that facilitate communication and collaboration among physicians, a new joint task force to reduce administrative burdens, funding to expand supports for burnout and distress, and a substantial expansion in medical school training.
However, the most promising component of the government’s action plan remains pending — a stabilization support payment. This has tremendous potential to immediately help retain the doctors we have. Other provinces have made similar moves, and we want to ensure Manitoba isn’t an outlier in the middle of an international physician shortage.
Support to stabilize physicians’ practices will help in the short term while we work with the government on more fundamental changes to how family medicine practices are funded and operated, ultimately to help improve access for patients.
As we have seen in other provinces, doctors here would be better supported with a shift in funding models that offer more predictability and, most importantly, allow doctors to spend more time with each patient. This must be complemented with an aggressive expansion of team-based care options within family doctor clinics to expand their capacity to serve more patients. We have shared these ideas with the government. We believe they understand the urgency of this crisis and the need for swift action.
So, on this World Family Doctor Day, let us not only honour the dedication and expertise of family physicians but let us resolve to delivering the necessary immediate and longer-term support and resources our family doctors need. Together, we can ensure they feel valued, respected, and equipped to better serve our communities. This, in turn, will attract new physicians to the province as they witness the transformation of family medicine into what could be the leading model in the nation.
Dr. Michael Boroditsky is the president of Doctors Manitoba and practices medicine as an obstetrician gynecologist.