Ontario patients should send a thank you note to President Donald Trump and Quebec Premier François Legault.
First it was news that American doctors, fearful of the political turmoil in the U.S., were choosing to practice in Ontario. So far, almost 300 have been cleared to do so.
Then Legault passed legislation tying doctors’ pay to meeting performance targets, despite the fact that doctors have little control over access to the hospital services and diagnostic equipment they need to treat patients. He then added insult to injury by threatening to impose fines of $500,000 a day on any doctor who tries to challenge the law.
So far, his approach has caused over 260 physicians to seek Ontario licenses to practice.
Given the urgent need for more family physicians in Ontario, one can only cheer on both political leaders.
As many as 2.5 million Ontarians are without a family doctor, the patient’s critical gatekeeper to the healthcare system. Some estimates predict over four million might be without primary care within the next year.
The reasons for this are not a secret. First, health needs are growing rapidly as the population ages.
Given how long it can take to educate and train a doctor, particularly a specialist, it was no surprise when the number of new doctors did not meet the growing needs of the population.
But the other major reason is simply doctor burnout. Doctors are being asked to carry an increasingly large administrative burden – estimated to take up as much as 20 hours a week.
The growing costs of running a family practice – office overhead, equipment purchases, support staff – have not been reflected in a doctor’s take home pay either. The situation is compounded when pay structures favour specialists over family doctors.
Pressures within the system also weigh heavily on both a doctor’s time and his or her stress level as they fight to access speciality care and diagnostic services for their patients.
And as if that were not enough, doctors, like the rest of us, are aging and if they can, retiring early.
Add it up and you have a recipe for a serious problem. Scenes of people lining up for hours trying to sign up when a new doctor comes to town have only underlined the point.
But there is some good news. Ontario’s “Primary Care Action Plan,” designed to connect more patients to a family doctor, seems to be working.
It’s first target, connecting 235,000 patients to a doctor by the spring of 2026, is well on its way to being met. The wait list of patients on the “Health Care Connect” list has been reduced by half and progress is continuing.
How is this happening? The province’s approach is multi-faceted. First, it is investing $2.1 billion to connect approximately two million patients to a primary care team by 2029. Part of the funding is establishing new health teams so that other health professionals, like nurse practitioners can join in, ensuring patients get a variety of services in one location.
Ontario has also added nearly 20,000 physicians to its health workforce, including a 14 percent increase in family doctors. This has included expanding medical school spots, as well as welcoming those physicians who are coming from the U.S. or Quebec.
The government has also reached a new pay deal with the Ontario Medical Association (OMA) which will help. It includes a 10 percent pay raise in the first year, pay for administrative work and providing after hours care and financial incentives to take on new patients.
The OMA, which is responsible for negotiating with the government on behalf of doctors is cautiously optimistic. Dr. Zainab Abdurrahman, OMA president was quoted as saying “…we’re hoping, with these modernizations, that they will see this as a good option and they will start opening practices as well.”
Dr. David Barber, chair of the OMA’s family practice section was also cautious. “The measure of success…is going to be the number of doctors that move back into cradle-to-grave comprehensive care and the number of residents who actually choose to go into comprehensive care.”
Time will tell but so far, so good.
Janet Ecker is a former Ontario Finance Minister, Minister of Education, Minister of Community and Social Services and Government House Leader in the governments of Premier Mike Harris and Premier Ernie Eves. After her political career, she served as the founding CEO of the Toronto Financial Services Alliance, a public-private partnership dedicated to building Toronto region into an international financial centre. She currently sits on a number of corporate and non-profit boards, agencies and advisory committees.
Ms. Ecker received the Order of Canada for her public service contributions and was recognized as one of the “Most Influential People in the World’s Financial Centres” by Financial Centres International. She also received a “Canada’s Most Powerful Women: Top 100 Award” from the Women’s Executive Network and the Richard Ivey School of Business, among other awards. She is also one of the founders of Equal Voice, a national, multi-partisan organization working to elect more women.
