Primary Care, Primary Concern
Ottawa doctors come together to offer solutions to the region's crisis
The January closure of three doctor’s practices in Orleans (and more on Ottawa’s horizon) are continued warning signs of the precarious state of our region’s primary care system.
These are among the more than thirty local family doctors who have “taken down their shingles” since 2020. And while the numbers are alarming, these are symptoms that have not gone undiagnosed. (see sidebar)
The root causes contributing to the current crisis of primary care in the Ottawa region include:
An increase in the population in Ottawa, including children and refugees.
An aging population with more chronic conditions and increased complexity.
Chronic underfunding in primary care leading to limited and inequitable access to team-based care models.
Issues with retention and recruitment of family doctors: A worsening work environment, staffing challenges, and increased administrative burden. We have fewer and fewer family doctors working in comprehensive practice. There are fewer new graduates selecting family medicine.
Members of the OHT - ÉSO Primary Care Partner Table decided to propose solutions to not only preserve existing primary care capacity but lead to a full recovery.
A staggering 134,000+ people in our region are not attached to primary care providers. This is almost the entire population of Kingston.
In addition, many of these individuals and families are from equity-deserving populations (refugees, newcomers, 2SLGBTQIA+) already facing disproportionate poorer health outcomes.
Unattachment to primary care is correlated with:
Increased use of acute care resources for mental and physical health issues
Poor care coordination
Decreased access to preventative care (e.g., vaccination, cancer screening)
Decreased access to chronic disease management support (e.g., diabetes)
Increased illness incidence and severity of illness in the community
For professionals who have dedicated their lives to helping people get well, the situation needs to change.
And the OHT - ÉSO Primary Care Partner Table has some ideas.
In collaboration and consultation with:
Archipel Ontario Health Team (including Dr. Elie Skaff and Elizabeth Tanguay) and the
Ottawa Valley Ontario Health Team (including Dr. Richard Johnson and Karen Simpson),
a working group comprised of Ms. Kelli Tonner, Dr. Ben Robert, Dr. Alison Eyre, Dr. John Brewer, Dr. Danielle Brown-Shreves, and Dr. Clare Liddy (supported by Dr. Riva Levitan, Dr. Aly Abdulla, Dr. Marie-Claude Gagnon, Nurse Practitioner Joanna Binch, Nurse Practitioner Dana Sydney and Nurse Practitioner Hoda Mankal) made their case with a strategy.
Reduce practice closures by modifying existing policies, reducing administrative burden, increase access to after-hours/urgent care support, increase access to allied health.
Increase MDs and NPs choosing to practice family medicine by offering retraining opportunities, ability to practice in different PC models. Enable readiness to practice assessments for IMG.
Reinforce existing primary care practice by ensuring easy referrals/patient pathways, automating processes for efficiency, centralize screening and assessments for community services.
Revitalize primary care delivery to match Ottawa’s growing diverse population by investing in neighbourhood-based, integrated, team-based primary care.
Implement Primary Care neighborhood model of care guided by equity of access; led by the patient and primary care community in collaboration with acute care sector partners.
The working group’s recommendation is an investment to be directed toward operational funding for team-based care and capital infrastructure funding for revitalizing and expanding clinical spaces.
This stepped plan allows for movement in some areas immediately, with further actions to come further down the road.
The working group is excited to hear responses from stakeholders and begin on the road to recovery for Ottawa’s primary care services.