We hear disturbing stories about the doctor shortage in this province and across the country.
According to recent statistics, 2.2 million Ontario residents do not have a family doctor. And it’s not a problem confined to someone else’s backyard. In Elgin county last year, at least 7,000 residents are without a family doctor.
Quite often, it is individuals most vulnerable who have no access.
Just under 2,000 residents with the lowest incomes are particularly hard hit.
About 750 of those have mental health issues and approximately 360 have diabetes.
A condition that requires regular blood tests and medication renewals.
Many of these individuals end up in the emergency department because they have nowhere else to go.
“If you don’t have a family physician and you have an issue that needs to be addressed, you end up sometimes getting referred to a specialist for care that doesn’t need to be provided by a specialist and that just lengthens the wait list for everyone.”
At the beginning of May, we had an insightful conversation with Dr. Kellie Scott, a St. Thomas family physician.
She is also a member of the St. Thomas Elgin Health recruitment partnership.
Dr. Scott confirms the program has enjoyed success, with a caveat.
“We already had a deficit (of physicians) so we’ve just sort of been keeping up replacing retiring ones without actually getting new ones to take care of the people who don’t have a physician.”
Dr. Scott noted some physicians have delayed retirement with some working well into their 70s because there is no one to assume their patient list.
And, with many assurances of late that infrastructure will be in place for the new VW gigaplant – things like roads, provision of energy, water and sewage – but can’t say we’ve heard much about the expansion of health services for the bump in population.
And then there is what Dr. Scott calls migration.
“In my practice, I have 1,500 patients (with about 5,000 patients at her four-physician clinic) and about 600 of those 5,000 don’t live in Elgin because people might move to another municipality and they can’t find a doctor there so they stay connected to doctors locally.”
One of the major resource drains in the healthcare system is administrative work.
Dr. Scott provides an example.
“I’m seeing patients face-to-face, on the phone or virtually about 25 hours a week.
“The statistics show, on average, family physicians are doing 19 hours of administrative work (per week).”
A lot of that administrative work is done after hours, stresses Dr. Scott.
“I do love my job but it’s hard to maintain that enthusiasm sometimes. I still think it’s a great career, but what we love about our job is seeing patients and taking their history and trying to understand what may be going on and solving problems for them.”
An additional 12 to 15 hours a week she estimates.
The culprit is inefficiencies in the healthcare system itself such as outdated digital systems.
So, what needs to be done and where do you begin?
Dr. Scott points to the decline in the number of students seeking to choose family medicine.
“That’s often because of the administrative burden.”
Thus the need for a centralized referral system where you could be pointed toward a specialist with a shorter wait list.
She stresses, “I do love my job but it’s hard to maintain that enthusiasm sometimes. I still think it’s a great career, but what we love about our job is seeing patients and taking their history and trying to understand what may be going on and solving problems for them.
“Because for every new patient I take on, I’m further diluting myself with the patients I have.”
“Every job entails paperwork . . . but definitely the balance has shifted.
“And the word burnout gets used a lot and that sort of implies there is something the person can do to improve that.
“It’s very distracting to have a patient in front of you that you know what they need, but you can’t access it for them.
“That’s frustrating and distracting for all healthcare providers.
“I would love to take on more patients and help more people . . . and it’s awful to say no, we can’t.
“Because for every new patient I take on, I’m further diluting myself with the patients I have.”
Is there a reason for optimism?
“There has been a recent announcement from the government about more funding going into team-based care, but I would like to see that more equitably distributed.”
“There are too many people in St. Thomas and Elgin without access to a family doctor, partly because there are not enough of us, the administrative work, inefficiencies in the system and so I hope there are investments in digital solutions to make processes more efficient.”
A sentiment echoed by Kimberly Moran, CEO of the Ontario College of Family Physicians.
“We can see that in Elgin and across Ontario, people are suffering from inequitable access to family doctors and this government has the ability to change the course of healthcare for millions of Ontarians.”
Dr. Scott concludes, “I think we need to look at the kind of incentives we might offer compared to some other communities.
“Because many communities are in the same situation.
“There are too many people in St. Thomas and Elgin without access to a family doctor, partly because there are not enough of us, the administrative work, inefficiencies in the system and so I hope there are investments in digital solutions to make processes more efficient.
“Locally, it would be important as well to let people know if you don’t have a family doctor, you can call 8-1-1 (the provinces tool introduced in 2022 to connect people to nurses and other health services from anywhere at any time).
CLOSE A LANE, CREATE A CULTURAL SPACE
With Westlake-Evans Civic Park taking shape adjacent to the library and a proposal is before city council on Monday (May 8) to allow for a seasonal arts and culture venue in the downtown core.
C.J. Allen, on behalf of Good Vibes Community Association, is seeking council’s permission to close the laneway that connects the city hall parking lot to St. Catharine Street.
The closure would be in effect from May 19 through to Sept. 9 and allow for pedestrian access to the Talbot Street businesses with rear entrances.
It would also allow for the creation of a cultural space during the summer months that could include an outdoor patio or bistro with live music; permit space for a food truck on Fridays and Saturdays; make a space available for artisan vendors to sell their products Saturday afternoons; live mural painting at the same time; and other cultural activities and programming to be determined.
Good Vibes Community Association would provide volunteers to clean and maintain the laneway.
Should council choose not to close the laneway for this period of time, Allen is asking council to consider a closure on Fridays from noon to 11 p.m. and Saturdays from 10 a.m. to 11 p.m.
Last year Jeff Bray, the city’s director of parks, recreation and property management, toyed with a similar concept involving the closure of Curtis Street for special events.
With the proximity of the Horton Farmers Market, it would create a vibrant atmosphere to attract residents and visitors downtown for an extended period of time.
Good Vibes Community Association was the driving force behind last September’s Summer Harvest Festival in Pinafore Park.
He appeared before city council in January of this year to deal with several concerns related to community events.
In particular, “bureaucratic and redundant red tape and restrictive bylaws.”
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FUN AND GAMES
A donation of close to half a million dollars will create additional recreational opportunities at Burwell Park.
Former city resident Cyril Goddeeris has arranged for a financial gift of $442,000 which will be used to construct a pair of basketball courts and four pickleball courts at the northside park.
Also to be purchased are six professional-level basketball nets, four to be installed at 1 Password Park and the other two at the Joe Thornton Community Centre.
Work on the courts is expected to begin this month with the project scheduled to be completed by August.
Cyril Goddeeris, a St. Joe’s High School grad, is a partner at Goldman-Sachs in New York and minority owner of the NHL’s Vegas Golden Knights.
FOR THE CALENDAR
Although final approval on federal funding through the Rapid Housing Initiative is expected by June 15, the YWCA St. Thomas-Elgin is ready to break ground on Project Tiny Hope.
Executive Director Lindsay Rice stresses rather than wait until June, “it is imperative that our work continues to further develop the land and install services in preparation for the future build.”
She continues, “by getting a head start on this phase of construction it will then allow us to maintain our
timeline of having our first ten residents move in by December 2024 . . .”
So on May 15 at 11 a.m., the public is invited to join YWCA St.Thomas-Elgin, Doug Tarry Homes and Sanctuary Homes as they break ground at 21 Kains Street “in a moment that will mean so much to so many in the near future as there will be no tiny steps for Tiny Hope.”
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And a reminder, I can be heard weekday afternoons as news anchor and reporter on 94.1 myFM in St. Thomas. As always, your comments and input are appreciated.
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