City’s taskforce bringing family doctor shortage to the Ministry of Health

The Kingston Area Health Care Taskforce is preparing an appeal to the Ministry of Health to make it easier for family doctors to practice in Kingston. 

“Kingston’s had a family physician issue for as long as I can remember,” said Dr. Veronica Legnini, who has been practicing family medicine in Kingston for 10 years. Her mother was a family physician before her, and Legnini studied family medicine at Queen’s University. 

Debra Lefebvre, a practising registered nurse with years of experience in Kingston health care, agrees.

“The [health care] community, the City, as well as the Kingston Economic Development Corporation have received numerous calls from residents within the city seeking physicians. It’s extremely difficult for anyone to gain access to primary care,” she said. 

“Then people end up overloading emergency room utilization or going without care entirely. That leads to extreme burden on the health care system over all.”

Dr. Legnini and Lefebvre are both part of the City’s Physician Recruitment Team, on the Kingston Area Health Care Taskforce. They estimate that 15,000 people in Kingston currently do not have access to a family doctor. 

The taskforce is surveying local family doctors about their workload and capacity, to gain a clearer picture of local supply and demand for primary care. 

“The Ministry [of Health] (MOH) thinks we have about three hundred family docs in the region,” Dr. Legnini explained, noting that is the maximum number of doctors the MOH will allow to operate using a rostered compensation model, paying doctors a lump-sum per year, per patient. 

This is the easiest, best-supported and most viable way to run a family medicine clinic Dr. Legnini said. 

“A few years ago Kingston lost the ability to add family physicians into that model,” she said. “Based on the numbers the Ministry has, we were deemed to be fully serviced at that point.”

However, three hundred is just the number of doctors registered in Kingston postal codes, she said, and does not accurately convey the availability of family health care in the community.

 “I’d say less than half of [those doctors] are practicing in comprehensive primary care.” Dr. Legnini said. Many family physicians work part-time, she explained, and pursue other specialities like palliative care, sports medicine, or psychotherapy. 

“Over the years, primary care has been less and less well-supported in terms of infrastructure support from the Ministry,” she said, explaining this has pushed doctors down other avenues in their careers. “It’s gotten significantly worse, particularly over the past 10 years.” 

“We’re conducting a survey of all physicians to attempt to come up with a truer number of physicians who are engaged in family practice,” Lefebvre said.  

The MOH does not prevent doctors from setting up fee-for-service health care clinics.

“You can set up shop tomorrow as a fee-for-service doctor,” Dr. Legnini said. “It is going to be a lot harder to make your practice viable in that model.”

New medical school graduates for the last 10 years have almost exclusively trained in the roster model.

“So when they graduate they are really not comfortable doing fee-for-service,” she said. 

Health Care Connect registration

The Kingston Healthcare Taskforce is also encouraging people in Kingston who do not have a family doctor to register with Health Care Connect (HCC), the MOH’s database of people seeking primary care. 

That will help the Taskforce make their case, Lefebvre said, by showing the demand. 

“This is a two-pronged approach,” Lefebvre said. “We’re very hopeful we can encourage people to access HCC. That gives us a truer picture of how many people are without a physician.”

Health Care Connect stipulates that people must “de-roster” with their current doctor before they can register, which Lefebvre and Dr. Legnini said creates confusion, and scares people off.

“That doesn’t mean your doctor can’t still take care of you,” Dr. Legnini said. She gave the example of a family moving from Ottawa to Kingston, but staying on their previous doctor’s roster rather than join the two-year provincial wait list. “You can go off the official roster without severing that relationship,”  she explained.

People in Kingston without family doctor can register themselves and their family members with Ontario’s Health Care Connect by phone or online.  Have your Health Card ready and call 1-800-445-1822.