City of Ottawa committee approves plan to attract new family physicians

Ottawa councillors have approved a 10-point strategy to attract new family doctors to the capital. CTV’s Austin Lee has the details.

A City of Ottawa committee has approved a plan to attract new family doctors to the capital, as the city faces a shortage of approximately 270 practicing family care providers.

The finance and corporate services committee met Tuesday to discuss the “Primary Care Provider Recruitment and Retention Strategy,” a 10-point strategy to recruit and retain primary care providers.

“In Ottawa, at least 165,362 residents were without a provider in 2022, a number that has risen, with marginalized groups disproportionately affected,” staff said. “Estimates from the primary care sector suggest Ottawa needs 270 new primary care providers, not including pending retirements. While health care is provincially managed, access to primary care affects Ottawa’s livability, economic growth, and ability to attract new residents.”

The plan includes creating a primary care recruitment ambassador, implementing a strategy to attract new doctors and calling on the Ontario government to lift the five-year restriction on international medical graduates practicing in Ottawa.

Here is a look at the proposed 10-point strategy:

1. Create a Primary Care Recruitment and Retention Ambassador position.
2. Join the Eastern Ontario Physician Recruitment Alliance to allow the city to leverage a network of resources and expertise necessary to advance Ottawa’s primary care recruitment objects.
3. Advocate to the Ontario government for policy changes that will remove barriers to physician recruitment in Ottawa, including the five-year restriction on international medical graduates practicing in the capital.
4. Contribute to the development of non-profit medical clinics by exploring opportunities to contribute land or space for the creation of new or expanded non-profit medical centres
5. Develop a centralized database to help candidates find and apply for full-time, part-time and locum positions.
6. Design and implement a targeted recruitment plan that would target medical school and residency programs, nurse practitioner programs.
7. Assist physicians in preparing proposals and navigating the Ontario Health application process to expand or establish new Family Health Organizations, Family Health Teams, Family Health Networks, and Family Health Groups.
8. Undertake a review to streamline internal and external facing City of Ottawa administrative policies and employee benefits that require consultation with primary care providers
9. Collaborate with Ottawa Public Health to identify ways to improve access to primary care.
10. Identify partnership opportunities between City of Ottawa departments and the primary care sector.

City staff say Ottawa is at a disadvantage.

“Existing provincial policies disadvantage Ottawa by barring International Medical Graduates from practicing here for five years, and by limiting physician partnerships beyond five kilometres, which is a greater hindrance for larger geographical communities like Ottawa and disadvantages Ottawa’s rural communities disproportionately,” staff said.

“Despite Ottawa’s strong quality of life, these systemic barriers, along with national shortages, negatively impact the number of primary care providers practicing in our city.”

Mayor Mark Sutcliffe reiterated those challenges, telling CTV News Ottawa the city plans to advocate for changes to those limitations.

“We are four-and-a-half times the size of Toronto, we have a significant and vibrant rural component to our city. We have rural villages that, in other regions of the province would be on their own or would be separate from the big city,” he said.

“Those [rules] might make sense in Toronto, or Hamilton or Windsor, but they don’t really make sense in Ottawa because we have this huge rural component and a family doctor choosing to serve in Navan or in another rural village in Ottawa is more like a family doctor choosing to serve in a rural village that’s outside a major municipality.”

Ottawa’s director of Strategic Initiatives Office said Ontario is investigating $2.1 billion in a Primary Care Action Plan to attach every Ontarian with a primary care provider by 2029.

“The issue is to why there is a primary care shortage is multi-faceted and it’s exacerbated by population growth, increasing complexity of patient care and administration burden, a retirement wave of existing family doctors worsened by the COVID-19 pandemic, restrictive or inadequate funding models, shifts away from comprehensive family medicine and generational changes in workload and patient volumes,” Will McDonald told councillors.

McDonald said the 10 actions in the report will “position the city” to take advantage of provincial initiatives.

Staff say funding is available within existing resources to support the creation of a Primary Care Recruitment and Retention Ambassador for a two-year pilot project. The ambassador would have an annual budget of $40,000 to join the Eastern Ontario Physician Recruitment Alliance and implement other parts of the recruitment plan.

The plan passed unanimously. City council will vote on it on Oct. 22.

Financial incentives

While communities like North Grenville and Kingston offer financial incentives to family doctors to move to the community, city staff are not recommending the city provide incentives to attract doctors.

“Incentive programs operated by municipal governments are not without controversy, as it pits municipalities against each other and the municipality offering the most money usually wins,” staff said. “The use of incentives is a practical approach for small, rural and remote communities that require only a few providers and would not see a natural migration of sufficient physicians to their community.”

The report adds the City of Ottawa would be in contravention of the Ontario Municipal Act if select for-profit business owners or individual physicians were provided a financial incentive or reduced/free public land/clinic space, while others were not.

McDonald said the City of Ottawa does not have recruitment challenges like smaller communities.

“Primary care providers want to and do live here. Our challenge is to make it easier for them to stay in comprehensive family medicine and remain in Ottawa to do it,” McDonald said.

North Grenville launched the primary care incentive program in 2023, offering doctors around $100,000 over five years in exchange for a commitment to practise locally, roster around 1,000 patients and take shifts at Kemptville District Hospital.

City in unique position

Those in the healthcare sector say Ottawa is in a uniquely difficult position, with far too many residents who are unattached, meaning they are without a primary care provider.

“It used to be the historical thinking that it was the rural and remote areas that were underserved, but actually, our biggest unattached rates are in the urban areas. So, strategically, we’ve started to address the remote areas and getting them access to family physicians, but we haven’t really concentrated on the inner city urban areas which are now where we are seeing the greatest deficit in terms of unattached rates,” said Dr. Melissa Forgie, interim dean of the Faculty of Medicine at the University of Ottawa.

“We have one of the worst attachment rates in the province by far and our numbers are over 200,000 who are unattached.”

Forgie calls Tuesday’s approved 10-point strategy ‘an amazing step forward’, highlighting the ripple effects of a large population of residents without primary care and the impact that has on the entire healthcare system.

“The effects really are profound and so, to see the city leaning in and wanting to partner with us and address this issue is tremendous and we have been poised and had been waiting for this kind of opportunity for a long time,” she said.

“It’s a really difficult job. There are really complex patients, there are issues with remuneration, it’s sometimes an issue where there are just more attractive areas to practice.”

Dr. Forgie also pointed to a recent funding announcement from the Ontario government aimed at expanding teaching clinics including one at the University of Ottawa.

In May, the province introduced legislation to invest $300 million to expand teaching clinics, paving the way for the faculty of medicine at uOttawa to bolster its roster of family medicine residents from 170 to 200.

“We now finally have the commitment from the ministry [of health] and it’s not an insignificant amount of money. They’re giving us a fairly large sum for teaching clinics,” said Forgie.

“These are clinics that are going to be training new physicians, but practicing physicians work and see patients while they train them so, that has happened at the same time as medical schools are increasing enrollment targeted to people who are likely to go into family medicine, we’re increasing family medicine seats, the city is interested in this and so is the private sector.”

With files from CTV News Ottawa’s Austin Lee