A move to a seniors residence becomes a headache for this North Bay couple without a family doctor

Ken and Dilys Collier, of North Bay, plan to move into a retirement home in early February, but a province-wide doctor shortage has made that more difficult than they expected. 

For the retirement home to accept their application, they need to prove they've never been infected with tuberculosis. That means getting a chest X-ray.

"We moved to Ontario from BC a little more than two years ago and haven't had a family doctor since then," said Ken Collier.

Without a family doctor, Collier said it has been challenging to get a requisition for a chest X-ray.

His wife was accepted as a patient at a local nurse practitioner-led clinic, but Collier said the clinic was not able to order the chest X-rays for them.

"That may have been tied up with the other requirement from the seniors residence that a physician should complete the physician statement and sign it," Collier said.

Nurse practitioners can order X-rays

Nurse practitioners in Ontario are able to order medical imaging though, including chest X-rays.

"They're able to order and interpret tests," said Michelle Acorn, the CEO of the Nurse Practitioners' Association of Ontario.

"That includes blood work, CAT scans, MRI, EKG, chest X-rays, for example. They are able to refer to a specialist the same way their physician colleagues do as well."

Acorn said nurse practitioners can also fill out the forms that a person would need to move into a retirement home setting.

Despite that, Collier said he and his wife were eventually able to connect virtually with a doctor in the Greater Toronto Area at a private clinic. 

But because the doctor is out of town, the X-ray images would need to be mailed to them. 

"Then the doctor will take a few days to review that and figure out if I am clear of any sign of active tuberculosis," Collier said.

"Then the doctor will apparently agree to sign the physician statement to the seniors home, for which he will charge somewhere between $40 and $150."

Collier said he's still worried that the process would end close to their planned move-in date of Feb. 8.

In the meantime, they have to plan for a move without a guarantee they would be accepted into the retirement home.

Dr. Dominik Nowak, the president of the Ontario Medical Association, says difficulty getting a routine diagnostic test shows the consequences that arise from a family doctor shortage in the province. 

The association estimates around 2.3 million Ontarians don't have access to a primary care provider.

"As a family doctor myself, I'm meeting people who haven't been able to find a family doctor in years all the time," Nowak said. "A few months ago, I met someone who's been looking for a family doctor for six years."

Nowak said having access to a primary care provider leads to better health outcomes.

"If you live in the north, your life expectancy is two and a half years shorter, and I believe that's in large part due to lack of access to health care," he said.

Physician recruitment

Ontario's Ministry of Health says the province has added 15,000 new physicians since 2018, which includes a 10 per cent increase in family doctors.

"We have launched the largest medical school education system expansion in 15 years, adding over 100 new undergraduate and residency positions at the Northern Ontario School of Medicine, while breaking barriers for internationally educated physicians through programs like Practice Ready Ontario to add 100 new family physicians in rural and northern communities and have made historic investments to expand interprofessional primary care teams, connecting 600,000 more people to primary care across the province," said spokesperson Hannah Jensen in an email to CBC News.