City Council voted Tuesday night to support the establishment of a multi-stakeholder working group to advocate for the Kingston region’s designation as a high-need community for family physicians with the Ministry of Health.
“This stakeholder group will work closely with a newly formed Ontario Health Team on a regional approach to bring more family physicians and more primary care options both to Kingston, and the surrounding region,” said Mayor Bryan Paterson in his “Horseshoe Highlights” summary of the council meeting on Wednesday, Dec. 2, 2020.
The province sets the maximum number of family physicians that can operate in a municipality using a rostered compensation model, which pays doctors a lump-sum per year, per patient. Although this a report shared with council on Tuesday, Dec. 1, 2020 revealed a dire shortage of family physicians, Kingston’s provincial designation needs to change before more rostered family physicians can operate here.
“This is an urgent problem because consistent access to high-quality family medicine is fundamental to maintaining the health of citizens and integral to a well-functioning and economically vibrant city,” said the report, authored by registered nurse Debra Lefebvre, Dr. Veronica Legnini, Dr. Elaine Ma, Tarek Hussein of the Greater Kingston Chamber of Commerce, Nicholas Cofie and Alec Ross.
Surveying 312 physicians in the area, and drawing on other data, the report revealed that 28,746 residents living in the Kingston region may be “unattached” to a local physician, or forced to see physicians outside the Kingston region. Underrepresented groups, such as Kingston’s Indigenous people, vulnerable persons, Black, Francophones, and military families were also noted to have limited access to family physicians.
According to the Ministry of Health, the recommended “panel size” or number of patients per family physician is 1,380. Therefore, the report concluded that as many as 20 more family physicians are needed in the Kingston region to serve patients.
Based on an analysis of patients’ postal codes provided by six family medicine clinics and Kingston Community Health Centres (KCHC), as many as 43,980 patients attached to Kingston-region physicians live outside the region.
“So that a shortage of family physicians in the surrounding communities is helping contribute to our shortages here in our city,” Mayor Paterson said.
Of the 312 family physicians who received the study, 173 of them do not practice family medicine in the community but are engaged in other activities such as teaching, research, student heath, or sub-specialized areas of family medicine. This leaves a net 139 active physicians practicing comprehensive family medicine in the Kingston region.
The physician survey also revealed that 21 family physicians plan to retire in the next three to five years, and that 17 plan to retire in the next six to ten years.
“We can see this is a complex state of affairs,” said Councillor Rob Hutchison. “Now we seem to have a new direction based on solid research.”
The report was delayed over five months due to the pandemic, which staff said limited access to family physicians for survey data gathering.
According to the motion approved by council, the new working group will strive for the adoption of a more collaborative and comprehensive planning approach to physician recruitment and retention. It will also explore the launch of a physician graduate support program to capitalize on the MOH’s New Graduate Entry Program which could include both financial and non-financial incentives.