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Family doctors in Ontario working more days but more doctors needed

TORONTO, Nov. 24, 2022—Family doctors in Ontario are working more days than they did before the pandemic, despite doctor shortages, burnout and large numbers of patients returning to the health-care system.
“While the health-care system is under enormous strain, family doctors are working harder than ever to help clear the pandemic backlog of care and keep their patients healthy and out of emergency departments,” said OMA President Dr. Rose Zacharias.
Physicians in team-based practices are providing care 235 days a year, up from 221 before the pandemic, according to a new analysis of OHIP billing data by the Ontario Medical Association.
That’s about a 7 per cent increase and means doctors are working more weekends, holidays and days off.
At the start of the pandemic, when most non-emergency health-care services were shut down to prevent the spread of COVID-19, 60 per cent of all health care in Ontario was being done virtually and 40 per cent in person. Virtual care now accounts for 26 per cent of health-care visits, while 74 per cent are in person.
Pediatricians are seeing 82 per cent of patients in person, and 18 per cent virtually -- even during the “triple threat” of respiratory viruses that have hit children especially hard and the current shortage of pediatric pain relievers.
Family doctors are seeing 68 per cent of patients in person and 32 per cent virtually. That is better than the aspirational target in the current Physician Services Agreement between the province and the OMA of 60 per cent in-person care and 40 per cent virtual.
Research shows that virtual care is particularly well-suited for mental health consultations, refilling prescriptions and discussing lab and other test results. When delivered in the appropriate clinical context, virtual care can be just as effective as in-person care or even lead to improved care outcomes, for example, for patients with diabetes, heart failure and urological, neurological and psychiatric conditions.
Significantly, only 5 per cent of family physicians in Ontario are practicing almost exclusively on virtual platforms.
“These numbers tell us that family doctors are not the reason why emergency departments are under such enormous strain,” said Dr. Zacharias. “The record volumes in EDs are due to many long-term structural issues in the health-care system, including the fact that more than 1 million Ontarians do not have a family doctor and many doctors are suffering burnout after three years on the front lines of the pandemic.”
Dr. Zacharias noted that patients are returning to the health-care system in large numbers, catching up on health care they missed during the pandemic. Many are showing up sicker and with more undiagnosed conditions requiring more aggressive treatment. OMA data shows almost 22 million fewer health-care services happened during the pandemic than would have been expected.
Family doctors are triaging and prioritizing calls and appointments, making sure the sickest patients or those with the most urgent needs are seen first. Patients whose conditions do not need to be seen or treated immediately are being asked to wait longer (or may expect to wait longer) for an appointment. Only patients in need of urgent care are being advised to go to emergency departments.
“The current strain on EDs is due to many things, including patients being sicker and having more advanced illnesses,” said Dr. Zacharias. “In addition, one million Ontarians do not have a family doctor. Many patients are in the ED for mental health issues, which have been made worse by the pandemic. And some ED crowding is due to hospitals not having beds elsewhere for admitted patients.”
The OMA has solutions to many of these issues contained in our Prescription for Ontario: Doctor’s 5-Point Plan for Better Health Care. One solution that could be implemented immediately could bring more doctors into the health-care system by next spring.
We need to quickly license more internationally educated physicians who are here now, in Canada, wanting to work as doctors. We have proposed the creation of “practice ready assessment” programs to rapidly assess physicians who have completed their training and practiced abroad over a 12-week period of supervision and direct observation.
Such programs already exist in seven other provinces. They can be used to deploy successful candidates to underserved areas and can be a path for full licensure. With government funding, such a program could be implemented immediately with new doctors in the system by next spring.

About the OMA
The Ontario Medical Association represents Ontario’s 43,000-plus physicians, medical students and retired physicians, advocating for and supporting doctors while strengthening the leadership role of doctors in caring for patients. Our vision is to be the trusted voice in transforming Ontario’s health-care system.

Leslie Shepherd    11/24/2022


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