Several mayors of Ontario have called on the province to prohibit the financial incentives that municipalities use to attract doctors, claiming that recruitment tactics affects communities that cannot increase money – in particular those in rural and northern regions.
But Sault Ste. The mayor of Marie Matthew Shoemaker goes even further, suggesting that the federal government should prohibit the practice of “coast to the coast”.
“I think this should be prohibited across the country in fact,” he said in a recent interview.
Shoemaker said that his city needs 40 more doctors, including 18 to practice family medicine, and although it offers a moving allowance of $ 10,000, it is unable to compete with municipalities that offer doctors tens of thousands of dollars to move.
“We believe that the incentives are bad and we do not agree with them, and we are therefore not at this stage to participate in a competition on incentives because it is a competition that we will lose,” he said.
Shoemaker said he had asked the Ontario Minister of Health to intervene and stop practice at a meeting they had last August. But he said that there does not seem to be an appetite for such a decision in Ontario unless there is “broader acceptance of the prohibition of incentives” across the country.
“We don’t want to become the place that makes us remove all of his doctors,” he said.
A spokesperson for the Ministry of Health said that the government had made big investments to link more Ontarians with doctors, but had not answered a question directly on the question of whether it was planning to ban financial incentives for municipalities.
Shoemaker is not the only one to raise a concern about the use of incitement programs to combat the shortage of doctors from Ontario.
Todd Kasenberg, the mayor of North Perth, also encourages the province to prohibit cash incentives, which he calls an “error”.
“We have entered an arms race and generally there are no winners in an arms race,” he said in an interview.
Kasenberg said that around 3,000 of the 17,000 people in his city north of London, Ontario, are currently without a family doctor. With the retreats expected in the coming years, the doctor’s shortage will be serious if officials cannot recruit quickly enough.
“It is therefore a substantial problem and encountered a lot of frustration in the community, a lot of anxiety,” he added.
He said the city should accommodate four resident doctors from Western University this year. The council approved spending of $ 50,000 to provide housing support to these residents, even if Kasenberg said that he was personally “uncomfortable” with the move.
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He hopes that recruits will stay in town beyond their period of residence.
The mayor of London Josh Morgan and the mayor of Peterborough, Jeff Leal, also publicly criticized the financial incentives of the municipalities for the recruitment of doctors.
The long-term shortage of Ontario primary care providers affects millions of patients in all corners of the province, but defenders say that rural communities are more difficult because they have fewer hospitals and clinics without appointments.
Experts have long warned that the significant financial incentives offered to doctors widen the difference in access to health care between the poorest rural cities and richer urban centers.
Some say that if the incentives could work, in particular in the recruitment of new graduates and medical residents who have education loans to reimburse, they do not serve to remember doctors in these communities.
“I think that it is much more effective to be able, from the point of view of retention, to support new graduates by helping them to manage their schedule, to add the work slowly, to avoid the risk of professional exhaustion,” said Dr. Sarah Newbery, family doctor in Marathon, Ontario, a rural community 300 kilometers east of Thunder Bay.
“If they are too busy from the start, they will not be easy to keep.”
Newbery knows one thing or two about detention – she was one of the six young doctors who moved to the marathon almost three decades and ended the shortage of chronic city doctors.
At that time, Marathon was about to lose his only emergency service and the fate of all the hospital was in the air. The recruitment committee of local doctors even had jute bags ready to cover hospital panels on the neighboring motorway.
“It was probably the most badly served community in the province, perhaps in the country,” said Newbery.
She said that the city had given the whole group $ 10,000 in bonuses – just over $ 1,600 each – and housing support which included two years of free rent for some. But these incentives were not a decisive factor so that Newbery and his partner stay in Marathon for 29 years.
She said that what had kept this group of city doctors was a collective commitment to provide better care to the community as well as an understanding of healthy work and a balance between life. Marathon now houses six doctors and has only one doctor’s position at a time when other rural communities are in health care crisis.
Instead of offering cash bonuses, Newbery suggested that money should be invested to make cities more welcoming and attractive for long -term doctors.
About 525,000 Ontarians who live in rural areas do not have access to primary care, and this number increases four times faster compared to urban centers, according to data provided by the Rural Ontario Municipalities Association.
Christy Lowry, president of the association, said that improving access to health care, recruited doctors and medical workers and ensuring that local emergencies remain operational are “priority” for the association.
“All of these pieces are part of what we are focusing on at the moment, and we can see how the lack of these services has a negative impact on our communities and the well-being of our communities,” she said.
Lowry, who is also the mayor of Mississippi Mills, a rural community east of Ottawa, said that if his city has a modern hospital with a “huge service”, the shortage of primary care providers is a problem for residents, some of whom travel to Kingston to see their doctors.
The association estimates that the municipalities of Ontario spend almost half a billion dollars in health care per year.
“Land taxes should go to basic municipal priorities. They have never been designed to pay health services,” said Lowry in a recent interview.
“The problem is that there is a shortage. (We) don’t have enough, so it becomes this competition between a community and the next one. ”
In northern communities, more than 350 doctors – including more than 200 family physicians – are necessary to fill the ongoing vacancies, and this number is much higher if the retreats expected in the next five years are taken into account, according to Ontario Medical Association.
The former president of the association, Dr. Dominik Nowak, said it was “unacceptable”.
The shortage had led to fierce competition for doctors.
“There are winners and losers when we have a situation like this and often the communities which cannot afford to recruit and preserve are communities in the North and Rural,” he said last month before the end of his mandate.
Nowak said that if municipalities should help create an environment welcoming for doctors and their families, it is ultimately the work of the province to ensure that communities have appropriate access to health care.
“It is a symptom of a greater problem,” said Nowak about incentive programs. “The greater problem is that family practice is no longer considered a viable career choice for new graduates.”
The Ministry of Health said that the province had added 15,000 doctors and increased the number of family physicians by 10% since 2018.
The ministry spokesman EMA Popovic said that the government added nearly 1,500 family physicians to rural and Nordic regions as part of two different programs, including the contribution to doctors trained abroad and the supply of education funds interested in working in these communities.
She said Ontario aims to connect everyone in the province to a primary care provider by 2029 as part of an investment of $ 1.8 billion.
The province recently declared that there would be “significant investments” in the primary care model of the group of rural doctors and the North. There will also be a new program called the Rural Emergency Medicine Investment Fund, which is intended to guarantee the appropriate levels of the staff endowment of doctors all year round, and it replaces a now expired temporary program which prompted doctors to fill these changes in the ERS Rural and North.