Ontario's family doctor shortage will 'get worse' without immediate intervention: experts

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As Ontario politicians scramble to come up with plans to address Ontario’s doctor shortage, the situation is likely to “get worse before it gets better,” the president of the Ontario Medical Association says.

The number of Ontarians without a family doctor in 2024 eclipsed 2.5 million, according to the Ontario College of Family Physicians. The list has grown by 400,000 since 2020 and most experts agree that the trend is likely to continue in the New Year.

In fact, the OMA has warned that by 2026 there could be 4.4 million Ontarians without a family doctor, partly due to the fact that about 40 per cent of family doctors in the province today are considering retirement in the next few years.

“I meet people almost every day who can’t find a family doctor,” OMA President Dr. Dominik Nowak told CP24.com this month.

“Nearly one in four people in this province are living through it right now and unless the province acts now and gets things going now, it’s going to get worse before it gets better.”

The Ford government recently released plans to address the problem, including hiring former federal Liberal Health Minister Dr. Jane Philpott to lead a new “primary care action team.”

The team’s “mandate,” the province said, is to connect “every person in Ontario to primary care within the next five years.”

Nowak called the decision to hire Philpott a “bold first step.”

“What the government now needs to do is implement what Dr. Philpott is going to recommend,” he said.

“It can’t just be a smart political move and about a report in a few years, it has to be action on the ground that people feel, that doctors feel within 90 days.”

He also applauded the provincial government for expanding the “Learn and Stay” program that covers tuition and other educational costs to include students who commit to becoming family doctors in Ontario.

The anticipated price tag for the program, which begins in 2026, is $88 million and will include 1,360 eligible undergraduate students. The province estimates that this program will likely connect 1.36 million more Ontarians to primary care.

“I think that’s an ambitious move. It’s going to help us get there,” Nowak said.

But Nowak said Ontarians can’t wait years to see meaningful change as there is already a “big strain” on the province’s health system.

For its part, the OMA, has said that Ontario needs 3,500 new family doctors to start to address the problem.

“Right now we have a workforce that’s under a lot of pressure, a population that’s aging. More people are living longer sicker and that’s from the successes of medicine and public health,” he said.

“People are feeling the uncertainty and the pain of not being able to get the care that they need right now.”

Nowak said the province needs to move toward a team-based approach that ensures every family practice is supported by nurses, pharmacists, and other health professionals “working together.”

“That’s the kind of care that saves the healthcare system money in the long run,” he said.

In a statement, Hannah Jensen, a spokesperson with the Minister of Health, said the province has increased its “investment in connecting people to primary care by 50 (per cent)" since 2018. 

“We are not stopping there. We have launched the largest medical school education system expansion in 15 years, made historic investments to stand up more primary care teams, enhance digital tools, and break down barriers for internationally-trained doctors, through programs like Practice Ready Ontario to add 100 new family physicians in rural and northern communities and we are making progress to connect every person to a primary care,” Jensen said.

She accused the OMA of trying to score “cheap political points” during contract negotiations.

“While the Ontario Medical Association continues to try to score cheap political points when we are close to an agreement at the bargaining table to expand access to care in Northern Ontario as part of the first year of the Physician Services Agreement, our government is taking action to ensure people are connected to the care they need, when they need it, no matter where they live,” Jensen said.

“The facts speak for themselves, Ontario leads the country with the highest number of people attached to a primary care provider, the largest physician workforce, and the highest compensation rates. This year’s Canadian Resident Matching Service (CaRMs) also shows students want to become doctors in Ontario, and that doctors want to practice in Ontario with 100% of Ontario’s residency positions filled.” 

Ontario Liberal Leader Bonnie Crombie has said expanding team-based care is a priority for the provincial Liberals, promising to “modernize family medicine’ if elected.

The new Liberal leader released her plan to address the shortage in December, stating that the Liberals would create two new medical schools and expand capacities in existing post-secondary institutions as part of an effort to double the number of medical school spots and residency positions.

The Liberal leader also vowed to “stop penalizing patients and doctors if they seek care at walk-in clinics.”

Crombie, who released her plan amid speculation that an early provincial election could be called this spring, also vowed to help make appointments available on evenings and weekends.

“You can’t find a family doctor. Wait times have exploded. And hospitals are actually shutting their doors to people who need help,” Crombie said in a written statement released earlier this month.

“You deserve to have a trusted relationship with your doctor who is available and invested in the best interest of your health – no matter your age, health conditions, or where you live.”

‘Real system failure’

Dr. Andrew Boozary, a primary care physician and the executive director of the Gattuso Centre for Social Medicine at University Health Network, called the situation “dire,” noting that the current system is both “inaccessible and inequitable.”

“If we don’t make major inroads and some real commitments and investments ASAP, like right now, I think this is really an issue that will only continue to get worse and I think in really drastic ways,” he said.

“It’s really hard… to call this a universal healthcare system when 25 per cent of the population cannot access primary care,” he said.

He noted that the problem is felt across the country, with data suggesting that more than 6.5 million Canadians do not have access to primary care or a family doctor.

“I’m reticent to use the word crisis because I think people in public health, we use it a lot, and people get fatigued and tired, but when you do see reports of more and more people getting diagnosed with cancer in the emergency department, that is real system failure when that’s the first place that you’re hearing about a life-altering condition or diagnosis,” he said.

Boozary said the current situation playing out in primary care has a knock-on effect in other parts of the healthcare system.

“We see that whole continuum, all of these issues that have now been bubbling up to a point where there really is no looking away from this in the healthcare system,” he said.

“We’re talking about emergency department pressures, hospital bed pressures, things that are happening in long-term care. Really we need a fundamental fix for primary care and that’s going to mean more healthcare teams, that’s going to mean better access both in rural and city locations for people who need primary care.”