by Tom Sasvari and Alicia McCutcheon
MANITOULIN—While the Gore Bay Medical Centre received good news recently from the province that it has been approved to add three doctors to its complement, the funding increase to provide the physicians does not include funding for overhead costs such as equipment and staffing.
“It’s exciting news that the province is increasing the complement of doctors in areas like ours, but it is not a solution in total. It’s a step,” stated Dr. Robert Hamilton of the Gore Bay Medical Centre who, along with Craig Matheson, recruitment coordinator for the North Shore Health Network met with Gore Bay Council last week.
“To recap, we received a letter last month from the Ministry of Health (MOH), advising the process that was undertaken, and the committee approved supporting services of smaller towns in Ontario, like ours. Thirty-eight communities with no hospitals or physicians (currently) have received news of additional contracts.” He noted the contracts had been in place for 20 years.
“None of us here were involved in the process, but we know for our medical centre there has been an increase in the contracts,” said Dr. Hamilton. “In Gore Bay we have received approval for three additional doctor contracts (from two or three to 5.9). It is good news the ministry has recognized the need for more doctors.”
“It is all a work in progress,” said Dr. Hamilton. “They have allocated additional contracts but they are providing zero funding for overhead funding for doctors we recruit. This means they will not be able to hire staff or have funding to purchase equipment, so there is a big gap there. There are to be ongoing discussions, but we are not clear on the timeframes.”
“It is important to get the contracts right,” said Dr. Hamilton. “So while it’s exciting news, the doctor complement is increasing but it is not a solution in total. It is a step.”
Dr. Hamilton pointed out when the contracts were first finalized the overhead costs were in the order of 30 percent, and this has no doubt since increased.
“As a municipality should we be approaching the MOH minister indicating we are pleased with the increase in the doctor complement, but lobby for financial support of the new doctors’ overhead costs?” asked Gore Bay Mayor Ron Lane, who said the issue could be taken to the Federation of Northern Ontario Municipalities as well.
“Absolutely,” stated Dr. Hamilton.
Mr. Matheson had told council that he is a recruiter for the North Shore area, Espanola and Manitoulin. “One of the things we do is attend many conferences and events where we set up a booth and provide information to potential doctors and locums that we can try to recruit for the area, to put our clinics, for example, on the map in terms of areas where they could consider working. I also liaise with the ministry and the health advisory committee.”
“It is a slow process, but we have made some progress,” said Mr. Matheson. He said the competition for doctors, locums and nurses is not only a nation-wide issue, it is universal.
Mr. Matheson said that in a Northern Ontario School of Medicine (NOSM) survey carried out last year, “I would say five of 100 locums are looking to work in a clinic only. Locums are shopping around more for areas where there are emergency departments.”
“And we need continuity with our locums,” said Mr. Matheson. “When we get them here, we promote how fortunate they are that they have chosen this area to work.”
“So can we now actively recruit everywhere?” asked Councillor Dan Osborne.
Mr. Matheson explained, “this is still all in the works.”
“Is there a good level of interest internationally (for doctors/locums) to come to Ontario?” asked Mayor Lane.
“Yes, and they want to get to work asap,” stated Mr. Matheson. He said the next step in the recruitment process is to open up the advertising for locums/doctors nationally and internationally.
Mayor Lane raised the issue as to whether there is an issue with accommodations when locums come to Gore Bay.
“We have been very well supported by Manitoulin Transport on this,” said Dr. Hamilton. “They have new housing units on the water, and if have need for somewhere to stay for a locum we have been able to use the units. We have better access to accommodations than a lot of other places. And the units here are within walking distance of downtown.”
“I think it’s great and we appreciate everything you have done for us,” Mayor Lane said to Mr. Matheson.
“Gore Bay is a special place to live and work,” said Dr. Hamilton, who pointed out there has been a doctor presence in the town for over 100 years. “I know for the past 41 years it has been a rewarding place for us to live and work.”
Mayor Lane said, “I’m optimistic Gore Bay will remain a viable community for many years to come. My concern is that you (Dr. Hamilton) and Dr. Shelagh McRae are getting closer to the age you will want to retire. If there is no one to fill your positions this will be an issue for us.”
Dr. Hamilton said he and Dr. McRae had postponed retirement plans because of the pandemic and with the recent development of an increase in doctor contracts for the medical centre, this may encourage them to stay even longer. “We are really excited about the redevelopment of the nursing home and a possible use for long-term care (of the current nursing home).”
Mr. Matheson also attended the August 15 meeting of Northeast Town council. He told council that there are two barriers to enticing doctors to the North: universal crediting (currently, doctors must fill out a great deal of paperwork before being allowed to practice in a hospital) and locum planning. “The geographical differences in Northern Ontario mean we really need to plan efficiently with these locums who are quite often taking time out of their busy practice to help us out in the North,” he said, giving the example of a physician attending two or three locations during their locum period.
He also pointed to remuneration and claims processes as other hindrances to encouraging locums to come to the region. “It comes up with the locums,” he said. “Six months to a year, sometimes, locums have to wait for travel and accommodation costs. When you’re paying for air fare to a remote community out of pocket, that can cost in the thousands of dollars.”
Mr. Matheson further explained that the scope of the locum (what they practice in), the length of stay and whether they’re practicing in an ER or clinic all factor into decision-making.
He said he was horrified to see those two of the three online ads seeking locums in the area posting reductions in salaries, calling it a step backwards.
“In chatting with physicians, they are concerned for October, when the funding is set to be reduced,” he continued. “They’re fearful of burnout and that we will not be as appealing with reduced funding. While locums want to help out their ‘Northern brethren,’ it still has to make economic sense. It’s going to be an interesting and challenging time.”
Mr. Matheson noted that 32 sites in Northern Ontario received notice of increases to their physician count, including on Manitoulin Island.
“First things first, our ads are getting updated,” he said about next steps. “The big thing is matching—making sure we’re finding good fits. Supporting the contract while having that work/life balance. New graduates ‘love to locum,’ but we have to close the gap on finding the balance between community, camaraderie with their peers and creating a home.”
Councillor Patty Aelick asked Mr. Matheson about the trend in new graduates toward specializing over family practice. He agreed that is one of the challenges, as are physicians wanting to do one thing, like ER work, instead of clinic time. “One of the first questions I get asked is, ‘what do I get for 24 hours at this site?’”
“At least the ministry has said, ‘you couldn’t do it with that many doctors.’ It’s a positive first step,” he added. “There has to be a continuity of care with these people coming into our communities. It would be nice if community members would interact with them. Take them for lunch, show them the sites.” He said that Mayor Sally Hagman in Blind River is known for dropping off home-baked cookies at the apartments of the visiting locums, by way of example.
Council talked of the benefit of having a recruitment familiarization tour such is used in the tourism industry by way of showing off all that Manitoulin has to offer. Mr. Matheson agreed that this would be a good idea.
