Nearly 20% of Toronto family doctors planning to close practices in next 5 years, survey finds

With Ontario's health-care system already in crisis, a new study suggests that nearly 20 per cent of family doctors in Toronto will be closing their practices in the next five years.

The research is a major concern for some in the health-care field as it suggests the current problems people have finding a family doctor will only get worse.

"I'm really worried," said Dr. Tara Kiran, the lead author of the study, which was led by St. Michael's Hospital along with Unity Health Toronto and published in the journal Canadian Family Physician.

"There are already 1.8 million people in Ontario who don't have a family doctor. To me, it's a wake-up call that we really need to work hard to address this issue," Kiran said.

More than 1,000 family physicians were surveyed in January 2021. A total of 439 respondents answered questions about their future plans, with 77 doctors — or 17.5 per cent — responding that they plan to close their practice within the next five years.

Nearly four per cent of physicians in that group said they plan to close in the next 12 months.

The study found that the doctors who are planning to leave tend to be older, so demographic retirement trends are a factor. But the research also found that many physicians who say they're on the way out run their own private practices. 

Stress and burnout

Kiran says that model of care involves added financial and bureaucratic responsibilities as well as stress that many younger family doctors are finding hard to handle.

"You're running your own small business. Something as simple as taking a vacation or parental leave can be really hard," Kiran said.

"If you're income drops, which it did for many doctors at the start of the pandemic, that means you're carrying the burden on your own," she added.

Kiran says family doctors may be, for example, transitioning to sports medicine or specializing in fields such as palliative care. 

"They're not thinking of stopping work altogether but they're moving into other areas that they think are less stressful."

The study's findings echo similar surveys done by the Ontario Medical Association (OMA).

The OMA's president. Dr. Rose Zacharias, agrees that family physicians are increasingly concerned with the administrative burden of their practices.

"We know that doctors spend too much time doing paperwork. And that's not what we want our doctors to be busy doing," Zacharias said in an interview.

"The documentation burden for doctors is really burning us out," she added.

To alleviate some of the family doctor shortage, the OMA is recommending licensing more internationally-trained physicians. Zacharias says the organization wants to work with government agencies to develop practice-ready assessments to get more foreign doctors accredited to work in Ontario.

While improved financial compensation would help keep family doctors from leaving the field, Kiran says it will take more than just bigger paycheques.

"It's not just the amount we are paid, but how we are paid and how we are supported in terms of infrastructure that allows us to focus in on the work of family medicine," she said.

Recruiting more doctors a priority, province says

As it stands now, it's difficult to find a family doctor in Ontario. And the lack of a primary care doctor for many patients is a contributing factor in the recent capacity issues in hospital emergency departments.A previous study by Unity Health estimated that 1.8 million people in Ontario do not have access to a family doctor.

The exodus from the field was accelerated during the COVID-19 pandemic, with three times the normal number of doctors leaving the profession during the first half of 2020.

Recruiting more doctors, nurses and personal support workers is a key part of the Ontario government's Plan to Stay Open, a Ministry of Health spokesperson said in a statement to CBC Toronto.

The statement says the government is increasing opportunities and financial incentives for physicians to enter family practices in areas identified as being in high need.

According to the ministry, the Ford government has added 1,800 doctors in family medicine since taking office.