Physician incentives

Budget plea by Family Health Team successful

This year started out with 800 unattached patients in Prince Edward County, meaning those without a family physician who want one. Right now, today, that figure has already jumped to1,750. “By early July, we will have almost 4,000, and by the end of October, we will have 5,500-plus,” said Dr. Elizabeth Christie, family physician with the Prince Edward Family Health Team. “Next year, we expect to have 4,000 to 5,000 more unattached patients, and the year after that 2,000 to 4,000 more.” The lack of doctors wanting to come to Prince Edward County, and the increasing difficulty in recruiting physicians was one of the more serious issues discussed at last week’s 2022 council budget deliberations. “In the next 10 months, we need five doctors, we actually need seven or eight, but we are hoping to get five doctors,” said Christie. “People don’t appreciate just how big this problem is going to be: more than 20 percent of our population will be without a doctor in just 10 months.” She added that half the population of the County will likely have no doctor by the end of 2024 if dramatic action is not taken.

In a deputation to council Wednesday, Dr. Christie addressed the issue of relocation funding for physicians in an effort to recruit physicians to practice family medicine in Prince Edward County. As associate lead with the Family Health Organization, the doctor’s organization contracted with the Ministry of Health to serve Prince Edward County, Christie painted a stark yet enlightening picture of just how difficult it is to attract new family doctors to the County, but also the very real consequences of having so many aging residents living without a family doctor. Her impassioned deputation came on the heels of Dr. Anne Nancekievill’s deputation in December which spoke to the same issue where it was indicated $150,000 would be required as incentive to attract doctors.

Friday saw council pass a motion that provided an additional $120,000 ($30,000 already in reserve) for a total of $150,000 in the 2022 operational budget to support physician recruitment.

A $100,000 incentive bonus would be paid to five new physicians over a five year period. The motion carried 12 to 2 in a recorded vote with Councillors Bolik and MacNaughton opposed. Further, the motion recommended the commitment continue annually through to 2026. Mayor Steve Ferguson noted that while council have known the problem has been coming for some time, he said the magnitude of the problem is accelerating. “Our responsibilities are to the residents of Prince Edward County and the well-being of our community,” said Ferguson. “We cannot lose sight of just how important this is.”

While Christie said the issue requires a multi-pronged approach, she said a firm commitment from the County was needed for at least $150,000 per year for the next five years to be anywhere near competitive. “There is likely going to be a bigger ask next year as there are going to be more doctors and we are likely going to be looking at this over the next eight years,” said Christie. “We have an opportunity to reinvigorate our medical community and stabilize health care for decades to come with a very small investment by the municipality; if we decline this opportunity, we do so at our grave peril.” While she noted the system is failing, she outlined some solutions to attract small town doctors. “We need concentrated efforts on helping them through school, getting them into university and medical school and so on,” she said. “We can fix this issue, we can make Prince Edward County the most attractive to come and work and play as a doctor: we must, if we fail, we will have a very, very ugly snowball.”

In her presentation, Dr. Christie indicated it came down to the financial incentives offered to new graduating physicians and how Prince Edward County, a place that was once very attractive to new recruits for its rural charm and many unique qualities, is now struggling to attract family doctors.

A changing County, one where real estate has become unaffordable for many, and rented accommodation is not only in short supply due to many properties becoming short-term accommodations, but is very expensive, are several factors hindering the process. However, it is the County’s inability to keep up with neighbouring communities who offer larger financial incentives that is key to help draw physicians here according to Christie. The problem the County is currently experiencing is a new one. Christie mentions that for decades, it was relatively easy to recruit doctors to the County. “In the past five years in our work at recruiting, we have managed to recruit no fewer than 11 new physicians, but the pace of departures has increased and we have not been able to keep up,” she said. “Despite working for years on recruitment knowing of the impending departure of at least 11 more physicians, we have succeeded in attracting only four doctors in the last two years.”

Christie spoke to the role County physicians play, emphasising some of the unique features of a physician in the County, something unique to rural areas. In addition to clinic hours, she points out doctors also staff walk-in clinics, the emergency department and in-patient ward, long-term care homes and hospice, they make house calls and attend home-based palliative care. “Some of us are part-time coroners, some of us are long-term care medical directors and most of us are collaborating with the family health team allied health professionals in patient care.” She added that non-clinical responsibilities are enormous, where most physicians are associate professors with Queen’s University teaching medical students and residents.

Concerns around staffing a new hospital were also raised. “We are gravely concerned about the future of the proposed new hospital, if there aren’t enough doctors to staff it, we just don’t know what’s going to happen.” She said they were also gravely concerned about the future of the emergency department. “We are gravely concerned for the community, the risk to the development plans that are underway, for tourism as the word gets out that this wonderful health care system of Prince Edward County isn’t so wonderful anymore.” Addressing how and why this has happened, Christie outlined there were lots of factors, such as aging baby boomers, the pandemic, young new graduates being reluctant to settle in one place, fewer medical students choosing family medicine and the elderly population (double that of the provincial average) in Prince Edward County which requires more work. Thirty-three percent of the County is over 65 years old compared to the provincial average of 17 percent. Christie calls it a supply problem. “Basically, the pendulum has swung in the wrong direction, we are caught in a much bigger problem and then we combine that with our new own local disadvantages.”

The February 2 to 4 Council operating budget deliberations are available for viewing on the County’s YouTube channel.