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Kingston, Ontario suffers from a severe shortage of physicians. here’s why

This story is part of CBC’s pop-up new office in Kingston, Ontario. If we need to know that there is something going on in the area, drop us an email.

Mark Richardson and her husband have been on the family doctor waitlist since 2019.

Since returning from the United States to Canada in August 2018, the couple have contacted more than a dozen clinics across Kingston, Ont., To no avail, and this has become of more concern in recent times. Richard suffers from recurring abdominal pain.

“I hope it’s… nothing permanent,” he said. “But I mean, it could be.”

Mark Richardson and her husband Adam Keeping have been waiting for a family doctor since 2019. (Submitted by Mark Richardson)

Richardson’s frustration is familiar to many who live in the Kingston area, which ironically has a premier medical school at Queen’s University and several cutting-edge research institutions.

Despite these benefits, CBC News found that more than 80 percent of family physicians practicing in the city do not accept new patients. The few that are, such as military doctors, are often inaccessible to the general public.

“It seems the biggest obstacle is something that I have no control over,” said Richardson, who works at an astroparticle physics research institute. “And that’s just the number of doctors in the area.”

He is one of nearly 29,000 Kingston patients who do not have a local family doctor – the highest total among the five regions that make up Ontario South East Local Health Services Integration Network, according to a Kingston Area Health Care Task Force Report 2020.

The report also found that Kingston had the highest number of emergency rooms in the region and that the city would need up to 20 more family doctors immediately, while replacing the 38 doctors who are expected to retire during of the next decade.

Meanwhile, Kingston remains excluded from the province designated list of areas of great need for physicians, which critics say only exacerbates the doctor shortage. The communities on the list, which include large cities like Toronto and Ottawa, are exempt from provincial restrictions that prevent doctors from opening new clinics.

“Betrayed by the system,” says the doctor

CBC News cross-checked the 314 physicians listed with the College of Physicians and Surgeons of Ontario “Doctor Finder” Tool with their current status to find out how many family physicians are accepting new patients.

About half were not practicing family medicine at the time of publication. A handful appeared to have retired or given up on medicine altogether. Some lists seemed outdated in other respects.

Of the 125 physicians with verifiable family medicine activity, none told CBC News they were accepting new patients from the general public. Two dozen doctors accept new patients, but only from a certain category: newborns, soldiers, members of universities and other institutions.

“It’s really horrible – many feel lost, abandoned, betrayed by the system,” said Dr. Joy Hataley, family physician in Kingston and president of the Ontario Medical Association.

The provincial health ministry says Kingston is doing better than most cities in the province because, in 2020, there were 16 family physicians per 10,000 people – well above the provincial average of 10. 2.

Payment system rules limit the ability to solve the problem

Hataley says the city will have to “bypass” any provincial designation to help attract more family doctors to the community due to shortages in more rural communities, particularly in northern Ontario.

The solution could be part of the current rules for business models for family physicians. The city has reached its legal limit of physician offices operating under the “capitation model,” where physicians receive a base rate for each patient on their list.

This model is heavily regulated by the province. Currently, no new clinic can open under this model in Kingston, as the city is not designated as a high need area for doctors.

During this time, paid clinics are allowed to open anywhere. Under this model, physicians are paid by the province for each office visit, examination or procedure. To stay afloat, doctors simultaneously treat large numbers of patients and run a business.

This restriction on capitation models is “not a useful policy solution,” according to Dr. Michael Green, associate professor of family medicine and public health sciences at Queen’s University.

Kingston, Ontario suffers from a severe shortage of physicians.  here’s why
Dr. Michael Green, associate professor of family medicine and public health sciences at Queen’s University, says Ontario needs to explore alternatives to fee-for-service models. (Submitted by Michael Green)

Green says clinics operating on the capitation model, like Family Health Networks, are attracting more family physicians, including new Queen’s graduates who gravitate to clinics with all the bells and whistles to build trust. .

These clinics often include nurse practitioners, mental health workers and pharmacists, as well as complementary services that alleviate a physician’s workload.

“It would also allow the doctors… to take on more patients because they would have additional support from the team,” Green said.

For now, Richardson continues to rely on walk-in clinics that don’t offer continuity of care and, as he describes, “makes every step of the healthcare process a little more difficult.”

The city of Kingston has allocated $ 2 million to attract family physicians. Each new physician who establishes a registered practice for at least five years will be eligible to receive up to $ 100,000.

The city hopes the incentive program will attract at least 15 new family physicians to the area within eight years.