Ontario’s doctors say Ontarians deserve access to team-based primary care

TORONTO, Oct. 12, 2023—Every Ontarian should have a family doctor and a well-co-ordinated health-care team supporting them when and where they need it, the Ontario Medical Association recommended today.

At least 2.2 million Ontarians don’t have a family doctor. This means that too many Ontarians lack preventive and primary care and have difficulty accessing specialist and diagnostic care. This creates further issues in the system, such as emergency department overcrowding and hallway medicine in hospitals.

As part of a package of solutions to fix the crisis in family care released today, the OMA is calling on the provincial government to give all family doctors and their patients access to government-funded primary care teams including nurses, administrators and other health-care workers. Only 30 per cent of family doctors practise with government-funded team-based support, meaning more than two-thirds do not.

“Fixing the crisis in primary care will not happen overnight, but maintaining the status quo cannot continue,” said OMA President Dr. Andrew Park. “The strains on the health-care system have ballooned over the decades. It will take decades to fix these issues, but we must start somewhere. And we must start now.”

A new OMA report, Prescription for Ontario: Doctors’ Solutions for Immediate Action, says the two highest-priority solutions the Ontario government should act on to make a dent in the crisis are:

• Expanding access to team-based primary care for all Ontarians when and where they need it
• Building a northern and rural physician workforce strategy and licensing more internationally educated physicians

The report also includes recommendations for addressing the growing burden of unnecessary administrative work on physicians, increasing home and community care, and tackling hospital overcrowding.

The OMA envisions these new primary care teams should be tailored to meet the needs of patients in different communities. They should include at least a physician, nurse, administrator and at least two other inter-professional care providers, such as a social worker, registered dietitian, nurse practitioner, physiotherapist, pharmacist, specialists and mental health professional and/or outreach worker.

“Each member of the team has a unique set of skills that complement one another, rather than compete with one another,” said Dr. Park. “Let’s allow doctors to be doctors, nurses to be nurses, and have other health professions focus on what they do best for patients. Together, we can ensure patients are getting the best care possible.”

Health-care teams also need access to locum support – the equivalent of a substitute teacher in the school system – so patients still have access to physician care when their doctor is away and don’t have to go to a walk-in clinic or emergency department.

The OMA is also calling for a workforce planning framework to understand how many physicians are needed in Ontario now and in the future, what types of physicians are needed and where. New data released today by the Ontario College of Family Physicians and the INSPIRE Primary Health Care research collaborative shows a drop in the number of doctors choosing to practise comprehensive family medicine.

Dr. Park noted the physician shortage is particularly acute in Ontario’s rural and northern communities due to chronic recruitment and retention challenges. The Northern Ontario School of Medicine University said communities in northern Ontario are actively recruiting more than 350 physicians, including more than 200 family doctors. This does not reflect actual health-care needs, which are increasing.

“Patients in the north face persistent inequities in the care they receive and in their health outcomes, compared to people living in other regions of the province,” Dr. Park said. “Focused action from policymakers to resolve the physician shortages could help bring stability and begin to address the health gaps in the north and increase access to family doctors for Ontario patients. “