Some member doctors of the Ontario Medical Association (OMA) are calling on the Ontario government to step up with better funding and better working conditions to stem the flow of physicians who are quitting their jobs and leaving family practice.
The doctors say they're just small businesses after all and if they can't survive in business, there's no point in continuing.
The comments came out Feb. 15 in an online news conference hosted by the OMA to discuss why so many family physicians are quitting the practice of family medicine because the system no longer works for them.
The session was hosted by OMA president Dr. Andrew Park. He was joined by Dr. David Barber of Kingston, Dr. Natalie Leahy of Whitby and Dr. Dannica Switzer of Wawa.
"The reality is family doctors didn't go into medicine to do paperwork. We want to see patients, we want to help our patients, and that certainly takes away from it," said Dr. Barber who is also a member of the OMA's section on general and family practice working in Kingston.
He said the demands of paperwork include filling out lengthy insurance forms, writing employee sick notes, prescription requests and the demands for paperwork "continues to get worse".
Barber said family physicians are also business people who are struggling in a failed business model.
"Over the last 20 years there has been a 20-per-cent cut in the funding that goes to a family doctor to run that business," said Barber. He said many doctors look at the business numbers and decide to quit family medicine.
Also commenting at the online event was former family physician Dr. Natalie Leahy who canceled her local practice in Whitby and now works as a general practitioner in oncology with the Durham Regional Cancer Centre in Oshawa.
She began her family practice in 2004 but decided to shut it down in September of 2023.
"My reasons for leaving were essentially what Dr. Barber had alluded to earlier," Leahy said.
"I mean, the first thing certainly is the economics of it. Right now in Ontario family medicine is a failed business model."
"Our ability to bill OHIP has not kept up. The amount we're able to bill has not kept up near inflation in the last 10 years," she added.
Leahy said in the past 10 years, the OHIP system has been peppered with billing caps and cuts. She said physicians have been hit hard at the expense of the politicians.
Also speaking out was Dr. Dannica Switzer, who is a graduate of NOSM University in Thunder Bay, but was born and raised in Wawa. She returned to her hometown in 2017, started a family practice in 2019, but quit family medicine in 2023.
That's when the number of local doctors, which used to be seven, fell to three. Switzer said the Ontario Ministry of Health did an assessment and said that three physicians for Wawa was sufficient.
She said the local doctors — who were actually doing the work — felt differently.
"We had multiple rounds of discussion with our Ministry of Health contacts, and they repeatedly refused to provide meaningful long term support to the vacant practices for the missing doctors for the four physicians who don't exist in our town," she said.
Switzer added that the doctors were working under a contract from 1996, which she said has not been meaningfully updated since then, a time when she was a child in elementary school.
She said it was just too difficult to try to keep up with all the demands of being a family doctor in a small town.
"So I made the very difficult decision to close my practice," she said.
Switzer now works as a locum (a temporary physician) who travels to other remote communities to provide contract medical services as required at small hospitals or when the local doctors are out of town.
"So I think now my job is being part time where I choose when I work, and how much and also where I work," said Switzer.
"If we're going to change things in the North, particularly small towns where we have a small group of physicians, rural family, doctors who are doing everything, we need immediate measures to retain these practicing rural physicians who have so much experience and play such an integral role.
As the physicians agreed to take questions from the media, Sudbury.com asked what could be done in the immediate short-term to encourage physicians to stay in their jobs.
Barber said the priority is for the Ministry of Health to provide stabilization funding to family physicians across Ontario.
"You know, as we mentioned, the inflationary pressures on doctors just can't continue. And the doctors need to hear from the government that the government supports them. So some type of stabilization funding to help with overhead would be really important," said Barber.
Switzer agreed and said the ministry needs to provide more active support for those communities where there is an obvious shortage of physicians.
"A second thing specifically for the North is the continuation of emergency department funding, which is set to expire on March 31. This again requires that we can keep the emergency departments open not only on the backs of the local doctors who are still working. We need to be able to attract locums in solving that," said Switzer.
Leahy said financial support for family doctors has to be the priority.
"I think that's probably the number one thing right now, in order for doctors to keep their businesses up and running, and pay their staff and pay their heating bills and their rent and all the expenses that go into running a business. They need money. They need funding. Without that people cannot keep their businesses running," she said.
