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Writer's pictureMerrilee Fullerton

What happened to Primary Care and where do we go from here?

Policy makers and politicians have grossly miscalculated the consequences of their decisions to date with respect to family medicine.

As millions of Ontarians find themselves without access to a primary care doctor, provincial Ministry of Health bureaucrats are reported to have dismissed concerns about the supply of physicians. They have reportedly stated that “Ontario has enjoyed a growth in physicians that far outstrips population growth”. This might be factual but creating and sustaining a sufficient medical workforce is not that simple. Much more meaningful measurement is required.


It is passed time that the Ontario Ministry of Health and our politicians at Queen’s Park take action on the critical issue of shortage of family physicians.


Some politicians will say they are not worried since they believe foreign-trained international medical graduates can fill the gap but there is global competition for medical skills. The United States could absorb every doctor that Ontario produces (actually, every doctor Canada produces).


The perspective that there is no concern of a diminished supply of physicians is short-sighted and fails to address the full measure of demographic and scientific realities which are at hand as well as failing to address potential solutions. Consider:


  1. The aging population, particularly the increasing number of Ontarians over the age of 80 which is expected to double by 2050, requires more visits for primary care and more medical services and advanced care

  2. Productivity levels are an obstacle to access now and into the future especially as the Old Age Dependency Ratio shifts and labour shortages amplify even with high levels of immigration

  3. Aging work force challenges the physician supply making retention a major challenge that could be offset with more flexible options for physicians of retirement age

  4. Impact of COVID-19 on both physician morale and physical health including Long Covid

  5. Role of AI in reducing administrative time for physicians

  6. Role of AI in administrative roles for nurses

  7. Point of Care Testing and AI directly integrated for Patient Self Care

  8. Robotics in rehabilitation and elder care



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