by CONNIE TABBERT
Editor
WHITEWATER REGION – There’s a physician shortage again, not only in Whitewater Region, but Petawawa, Pembroke and Laurentian Valley.
Pembroke Regional Hospital (PRH) is funding a physician recruiter for two years and a committee has been formed to work with her.
Debbie Robinson, who is reeve of Laurentian Valley, is the physician recruiter. She was on the Upper Ottawa Valley recruiting committee years ago before it disbanded in 2014.
She, along with Dr. Richard Johnson, spoke to Whitewater Region council at its Feb. 6 council meeting about what this committee is working towards.
Dr. Johnson said a year ago, PRH’s lead physician invited staff from the major clinics in the area to a meeting – Petawawa Centennial, West Champlain and Whitewater Bromley.
“We started meeting with the committee from Pembroke hospital and talked about what we could do to improve primary care throughout the region,” he said. “It became clear that recruiting individual physicians was a primary goal because the wait list is starting to creep up again.”
When the recruiting committee was disbanded in 2014, there were no people on the wait list, noted Ms. Robinson.
Dr. Johnson noted there are now between 2,000 to 3,000 people on the wait list with Health Care Connect, a provincial program.
However, it’s believed that number is larger, because many people don’t register with the program and, based on projected physician retirement, that number could grow to as high as 10,000 over the next five years if nothing is done, he said.
Now is the time to “really try and come up with a solution before this becomes even a bigger crisis than what it is now,” Dr. Johnson said, adding, “The potential is there that this situation could get worse if nothing changes.”
Ms. Robinson said, “Unfortunately, over the last four years, numbers are creeping up of people who do not have a family physician, and certainly as municipal councillors, that is not acceptable for our friends, family and neighbours. We hear their stories all the time.”
Dr. Johnson noted there will be no additional funds offered by the committee to physicians opting to come here, as there was in the past. However, he noted there are rural incentives from the province for coming into rural counties.
Ms. Robinson is meeting with recruiters from throughout the area, such as Renfrew, Arnprior and Barry’s Bay, as well as attending recruiting fairs.
The easiest way to recruit family physicians is through the residency program offered locally, which has expanded from three residents to two, Dr. Johnson said. He noted of the residents in the past few years, 70 percent have remained in Renfrew County. There are currently three in Deep River, one in Barry’s Bay, one in Renfrew and six or seven in Pembroke.
Councillor Daryl McLaughlin questioned of those who were recruited through the previous recruiting committee, how many have remained in the area.
Ms. Robinson noted 10 of the 11 are here, with the one who left going to British Columbia with her husband.
However, Dr. Johnson noted, it’s not just about the physicians who were recruited to the area that is a concern, as other are leaving or retiring.
A major issue in this area is the capacity for more physicians and/or nurse practitioners, she said.
Ms. Robinson has met with Brenda Powers-Ross from the Whitewater Bromley Community Health Centre in Beachburg, regarding a physician being located there, but there is no funding to pay the doctor or nurse practitioner.
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Ms. Robinson is hopeful of meeting with Renfrew-Nipissing-Pembroke MPP John Yakabuski so he can be informed of what is happening, because she believes his help will be needed down the road.
And political clout is also where municipal governments come in, she said, because they can write letters of support regarding needing physicians in their areas.
Councillor Neil Nicholson questioned if this council had recently written a letter of support.
Chief Administrative Officer Robert Tremblay said that letter was sent to the Local Health Integrated Network regarding funding, but there has been no response.
Ms. Robinson also spoke about the number of patients many physicians are caring for, noting they have more patients than they hoped to have.
“The physicians here now are working very hard to ensure as many people as possible in our section of Renfrew County do receive primary care that we expect that Ontario residents should receive, that should be their right,” she said.
Councillor Dave Mackay questioned how many patients a physician has, and Dr. Johnson said it depends on their practice. Some may just be practising family medicine, some may have patients who require more care then others while others are also doing emergency department care.
“Probably the average new grad is somewhere between 1,200 and 1,500, depending on patient complexity for full-time,” he said.
There is also the community paramedic program, where paramedics attend to the frail, elderly and vulnerable in their homes, Ms. Robinson said. The community paramedic program reaches out to those people with basic care while in their homes, which is keeping them out of hospitals and emergency departments, she said.
“Many of those people do not have a family doctor,” Ms. Robinson said, adding, “And not everyone is signing up with Health Care Connect.
“It’s scary that there could be as many as 5,000 to 6,000 residents without a family physician.”
Dr. Johnson said the wait list for WBCHC is in the 650 range, which is more than it was six months ago.
“We want people to get care in the community that they want to get it in,” he said.
The WBCHC has been trying to get funding for the past year and has not been successful, he said.
Coun. Nicholson questioned if primary care can be provided by nurse practitioners.
Dr. Johnson replied, “Absolutely primary care can be provided by nurse practitioners and that is done currently at Petawawa Centennial, West Champlain and Whitewater Bromley clinics.”
The problem is getting the funding from the provincial government. He noted there are nurse practitioners in the area, but there’s no money to pay them.
Ms. Robinson said it’s not a case of finding the money, it’s the province who needs to find money to give to us.
“This is not just a community’s problem anymore,” she said. “If we find physicians, and we have nurse practitioners who could start work tomorrow, if there was funding available, that funding has to come from the province.
“That’s where we’re hoping Mr. Yakabuski will help us out.”
Coun. Nicholson also questioned if this should be a Renfrew County committee.
Ms. Robinson said 14 years ago there was an attempt by local municipalities to have physician recruitment done county-wide. Renfrew County is large and has different things to offers. A physician could come into the area and work in conditions they wanted, such as a life-style option, or location, that is available, she explained.
“Renfrew County council at the time chose not to go down that route,” she said. “We ended up with physicians being hired by various communities – and we were all recruiting the same people.”
The area recruiters know the importance of working as one unit, but also realize they are working for their own communities, Ms. Robinson said. However, while at a fair, or talking to physicians, if they know of one who would like to go to Renfrew, or Arnprior or Barry’s Bay, they direct them to that recruiter, she explained.
“We have to work together, that’s very, very important,” she said.
When questioned by Councillor Chris Olmstead if large cities are having the same problem, Dr. Johnson said yes, but there could just be pockets “here and there” in the cities without a physician.
“We struggle in the rural area because of the large distances,” he said.
Coun. Olmstead said he doesn’t hear of many physicians retiring, but noted his parents, who are 78 and 79, are being cared for by a physician who is also in that age group.
“What are older residents to do when their physician retires,” he questioned.
The first thing they should do is register with Health Care Connect, Dr. Johnson said. It’s difficult to keep track of people if they don’t register, he said. Physicians take patients from the Health Care Connect registry.
Coun. Olmstead said that registry should promote itself more, because before listening to Dr. Johnson and Ms. Robinson, he had no idea that registry existed.
Coun. McLaughlin noted his physician retired and he registered with Health Care Connect.
However, he questioned why the previous committee disbanded if it was successful in bringing physicians to the area.
Ms. Robinson said that previous recruitment committee had its own registry because there was no Health Care Connect.
“We kept our own wait list,” she said. “Health Care Connect started after us.”
She noted that there were about 10,000 patients on the waiting list from the six municipalities who were part of the previous recruitment committee. When that committee disbanded, there was no waiting list.
Dr. Johnson noted when a physician retires now, it usually takes about two new physicians to take over the practice, because they have between 3,000 to 4,000 patients.
Ms. Robinson said this area of the province is designated as an under-serviced area. This means new physicians can get anywhere between $80,000 to $110,000 over a four-year period for coming to an under serviced area, she said.
The current recruitment committee is only looking to recruit residents who have been accepted into the family physician residency program, because they know what they want, she said. Any earlier than that, they could change their minds, she said.
Ms. Robinson noted this area is not alone in seeking a physician, noting there are 15 to 17 municipalities that are doing what this recruiting committee is doing.
“It’s a challenge, it is not going to be easy,” she said. “I do hope at the end of this year I have been successful in bringing at least one new physician to our area, but there’s no guarantee.”
Mayor Mike Moore thanked Dr. Johnson and Ms. Robinson for their presentation, saying, “Keep us in line with what’s happening. Let us know if you need help.”
