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London and surrounding Middlesex County aren’t attracting enough new family doctors to keep up with the growing population, let alone replacing those retiring, says a team of health care providers and advocates.
That’s why the Middlesex London Ontario Health Team (MLOHT) is pushing to develop a family doctor recruitment and retention program for the London area.
“We don’t have that proactive recruitment. A lot of our neighbouring municipalities and cities do have those roles, and they’ve operated a variety of different ways,” said Melissa Linseman, primary care transformation lead for London Middlesex Primary Care Alliance, a partner of MLOHT.
While Western University has a medical school and trains new family doctors in the region, there are no consistent processes or resources to encourage them to set up practices here, she said.
More than 65,000 London-area residents lack access to a family doctor for routine checkups, diagnoses and patient referrals, according to the Ontario College of Family Physicians.
Among the factors driving the shortage of family doctors locally and provincewide is that many are aging and set to retire. In Middlesex County, the largely rural area that wraps around London, about 27 per cent of patients have a family doctor 60 or older, MLOHT says.
The health team says Middlesex County has only 50 family doctors serving its population of roughly 88,000. On average, each doctor has a roster of 1,321 patients, nearly 90 patients more than those with practices in London.
Need a family doctor? So do 65,000 others in the London area
Column: Help older physicians keep working
Adding to the problem is “younger, newer physicians don’t tend to roster as many patients as practitioners who’ve been practising for a longer time,” said Amber Alpaugh-Bishop of MLOHT.
And while fewer medical students are choosing to enter family medicine, younger family doctors also are leaving the field for other specialized areas.
“There’s a lot of administrative burden on our family physicians and post-COVID burnout,” Linseman said
“The biggest one we hear is that they just can’t keep up, so they’ve made a lot of choices to either retire earlier, move to part-time work or move into a focused practice for other areas of medicine or research,” she said.
To help tackle the issue, the group is proposing a program to support doctor recruitment through various methods, including advertising available opportunities and clinical spaces, marketing the community as a place to live and providing incentives.
Officials are asking community partners and municipal officials for funding to launch a position dedicated to increasing the number of family doctors in the London region, the fastest-growing metropolitan area in Ontario, according to census data.
The requested grants would cover the program’s annual cost of $200,000, accounting for the position’s salary, benefits, events, travel and other operations, MLOHT said in a report presented to Middlesex County politicians last week. Modelled after a similar program in Hamilton, its budget would be reviewed after three years.
Attracting and retaining family doctors is even more challenging in rural communities, said Middlesex County Warden Cathy Burghardt-Jesson, who doubles as mayor of Lucan, a township north of London.
It was a little more than a decade ago when Lucan – then considered an “under-serviced community” – introduced an incentive for doctors to stay there for three years, she said. “Quite often, we found that, after the three years was up, they would move on.”
At the county council meeting, politicians deferred a decision on the request for $200,000 in three-year funding until this fall’s budget talks.
Burghardt-Jesson said there are still “a lot of unknowns” about how the program would work. She added that despite the need for doctors in rural areas, health care is not a municipal responsibility.
“It’s a slippery slope to go down when you’re asked to make an investment in health care at the municipal level because once there’s one ask and if it’s answered, then likely there’s another one.”
The Local Journalism Initiative is funded by the Government of Canada