Ontario election puts London's doctor shortage under the stethoscope

Back in 2014 his doctor of 30 years retired, leaving MacDougall to rely on walk-in clinics for his health-care needs. 

"They refill my prescription and set up tests but you can only pretty much have them deal with one concern and that's all," he said. "There's no continuity of care." 

MacDougall's lack of a primary care doctor is a concern that grows each year, along with his health challenges. He continues to deal with the lasting effects of a spine infection he suffered back in 2009.  

"I can't be on my feet too much," he said. "The back problem is reasserting itself," he said. 

Also reasserting itself in the early days of the Ontario election is a pressing shortage of primary care doctors. Based on numbers from the Ontario College of Family Physicians, MacDougall is one of an estimated two and a half million Ontario residents who don't have a primary care physician.

Leaders of all four major parties mentioned the doctor shortage in their campaign kick-offs on Tuesday.  

It's a problem Andrea Loewen has been dealing with for years. She and her husband own a family care clinic in London. She also heads the Middlesex-London Ontario Health Team's efforts to recruit and retain doctors. 

"This needs to be the No. 1 priority of the parties," Loewen said. "This has been something that's been going on for a very long time and we haven't had system improvements. This election is an opportunity for the people of Ontario to demand those improvements." 

Loewen said the doctor shortage is a problem with multiple causes, which in conversations with political leaders she groups into three main "buckets":

1. Training: Loewen said there's a need for more doctor training spaces in Canada and ways to remove barriers for doctors who've trained elsewhere to come here to work. 
    
2. Administrative support:  Loewen said family doctors in a clinic setting face huge costs and time demands to deal with administrative work that takes away from patient care. "The 'admin burn' is crushing them," she said. 
    
3. Lack of salaried jobs in family medicine: Loewen said doctors interested in family medicine but not keen to take on the cost and challenges of running a private clinic don't have a lot of options. "They want a salaried position," she said. She said those salaried positions are almost impossible to find.

Loewen estimates the cost of getting the fixes started to be about $3 billion.

It's a lot of money, but Loewen said it will save money in the long run, in part by cutting down on emergency department visits. She estimates that about 100,000 Londoners currently don't have a primary care doctor. 

"Every resident needs to contact those people running and say 'Your party needs to come up with a viable plan, not just  promises,'" said Loewen. "I see all these new residential buildings going into downtown London, not one of those people moving in to those buildings is going to get a family doctor." 

What the parties are saying?

In the days leading up to the election, Doug Ford's government announced $1.4 billion in new funds for a primary health-care plan to connect two million people in the province with a primary care provider.

In a campaign stop in London on Thursday, Ford touted that plan, but also said "we need to do better." 

"We're going to make sure that every single person is connected to a family doctor," he said. 

Liberal Leader Bonnie Crombie has made the doctor shortage a key part of her campaign, which she kicked off while standing in front of a Barrie, Ont., hospital wearing a hat that said "Real leaders fix healthcare." 

To deal with what they say is a "dire crisis" in primary care, the Liberals are planning to invest $3.1 billion to attract and retain 3,100 family doctors by 2029. A Liberal backgrounder on the issue says they also plan to help doctors avoid getting bogged down in administrative work through the use of technology and the creation of supportive care teams. 

NDP Leader Marit Stiles has said Ford has fallen down on managing health care, a core responsibility of any provincial government. The party's health critic has said Ford is using the Trump tariff threat as a distraction from his record on health care. The party pointed to a situation in Walkerton, Ont., early this month when people lined up for hours in freezing temperatures for a chance to get their names on a new doctor's patient list. 

The NDP introduced a legislature motion in the spring to connect more people with doctors. However, the NDP hasn't put a dollar figure on how much they're willing to spend to address the doctor shortage.

John MacDougall, the London resident still seeking a doctor, said the parties need to put politics aside and fix the problem. 

"They've been plenty of solutions if somebody would just institute them, not posture or blame the previous government,"  he said.