CBC Published an article March 02, 2023
More family doctors in Ontario could begin caring for their patients in teams — alongside nurses, social workers and other health professionals — as a result of the new federal-provincial funding deal.
The deal between the governments of Premier Doug Ford and Prime Minister Justin Trudeau is at this stage just an agreement-in-principle, so the two sides still need to sort out precisely how the promised $8.4 billion will actually be spent.
The first priority named in the funding agreement is providing Ontarians "access to high-quality family health services when they need them."
But Ontario is facing an acute shortage of family physicians that is only forecast to worsen. It's currently estimated that more than two million Ontarians are without a family doctor, and projections suggest looming retirements of physicians will push that number even higher.
With little prospect of rapidly and significantly boosting the number of family doctors in Ontario, how can the deal with the federal government increase access to primary care? Experts say the key is allowing more family doctors to work in teams of health professionals so they can take on more patients.
Team-based care has long been shown to be better not only for patients but also for the well-being of family doctors, says Dr. Allan Grill, lead physician of the Markham Family Health Team and chief of family medicine at Markham-Stouffville Hospital in York Region just north of Toronto.
"You can't expect family physicians to just add on layers and layers of work," said Grill in an interview. "From the perspective of attracting and recruiting more family physicians, we need this team-based model."
Grill says the aging population means that patients' health needs are becoming more complex.
"If we want family physicians to be able to spend the time with those patients and even take on new patients, something has to give," he said. "They need more support than they're getting now, and the team-based model is the way to do it."
Less than 30 per cent of people in Ontario are currently covered by any form of team-based primary care.
The biggest source of this is what the Ministry of Health calls "family health teams" (FHTs). About 3.4 million patients are enrolled in one of the 184 teams scattered around the province, according to figures from the Association of Family Health Teams of Ontario.
However, for the past decade, Ontario has made it all but impossible for physicians to form new family health teams. All but three of the existing FHTs were created between 2005 and 2012.
At the Village Family Health Team in Toronto, 11 family physicians work together with two psychiatrists, a group of registered nurses, as well as a nurse practitioner, social worker, physiotherapist, dietitian, chiropodist and a pharmacist. About 3.4 million Ontarians get their primary care through a family health team. (Craig Chivers/CBC)