Kingston needs to pin down concrete numbers on doctor shortage, says medical consultant
A local medical consultant says that evidence shows a family doctor shortage is once again a growing issue in Kingston. Despite recent action from the city council, she says that Kingston needs more data to convince the province to classify the city as in high need for family physicians.
Debra Lefebvre is a registered nurse and works as a medical consultant in Kingston. She was hired by the former Kingston Economic Development Corporation (or better known as KEDCO), in 2015 to evaluate whether Kingston was dealing with another family doctor shortage.
Global News obtained a briefing note presented to the city of Kingston in 2015 by KEDCO. It noted that Statistics Canada estimated 20,000 Kingstonians did not have a family physician in 2007.
Kingston was then designated a high-needs community for family doctors, and the city of Kingston put KEDCO in charge of attracting new general practitioners to the city. With the high-needs community designation, KEDCO was able to offer financial incentives to physicians, like a $25,000 relocation stipend and $75,000 delivered over five years for new, full-time, unestablished family physicians.
The 2015 KEDCO briefing note says the incentives worked, initially bringing 28 doctors to the region and connecting between 15,000 and 17,000 unattached patients with a family doctor.
At one point, Lefebvre said the Ministry of Health revoked Kingston’s designation as a high-needs community, closing off potential funding to bring more doctors to the city.
In 2015, KEDCO said seven doctors terminated their funding with the city and 14 doctors were up for the end of their five-year payment agreements between 2013 and 2017.
The KEDCO report also noted that only 42 per cent of the doctors listed as family physicians in Kingston practice family medicine.
“The community competes with Corrections Canada, CFB Kingston, Queen’s University, the Ministry of Health and Long-Term Care, Community Health Organizations, and the local hospitals for family physicians.”
Lefebvre said that by 2015, the city’s economic development branch was receiving complaints about the city’s lack of family physicians.
“They were receiving many many calls, from not only physicians, who were overwhelmed with their waitlists, and the number of calls from individuals seeking care, but also from citizens here in Kingston.”
KEDCO then hired Lefebvre’s consulting firm to look into the potential shortage, and she and her team presented a preliminary report to the economic development organization in 2016, summarizing data that was available at the time.
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Lefebvre said her team discovered people in Kingston were often resorting to emergency medical services.
“We are one of the highest utilization rates within the [area] for emergency rooms. Emergency rooms are one indicator of how well our community is doing with respect to family physician care.”
Despite telling numbers, Lefebvre’s report was presented to KEDCO at an unfortunate time.
After the city review into the corporation’s financials, KEDCO went through an organizational restructuring in 2016, and was renamed the Kingston Economic Development Corporation.
“It was the beginning of a very intense review of KEDCO by our city. So the report was shelved,” said Lefebvre.
The doctor shortage file lay dormant until recently, when local politicians became reinvested in the issue.
Back in early September, Coun. Jeff McLaren, who did not respond to a request for comment on this story, proposed a motion to have the province re-designate Kingston as a community in high need of family doctors.
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A month later, in early November, Ontario NDP Leader Andrea Horwath came to Kingston on the request of local MPP Ian Arthur, who introduced the opposition leader to Kingstonians struggling to find a family doctor. Horwath’s team claimed that upwards of 33,000 people could be without a family doctor in the city.
Former MPP for the region, Sophie Kiwala, quickly took issue with Horwath’s 33,000 estimate — a number first quoted in a story written for Kingston Life Magazine in 2015 — claiming that when she served as MPP for the region from 2014 until June of this year, the statistics were closer to 1,500.
The figure is most likely somewhere in the middle, Lefebvre says.
“In terms of numbers, I’ve heard as many as 15,000, and that came from a credible source. I have not, and nor has my team, confirmed that.”
She added it’s hard to pinpoint exactly what the need is for doctors in Kingston, because there really isn’t enough data to go on.
Lefebvre said that according to Health Care Connect, a provincial government agency that allows residents to put their names on a waiting list for family doctors, in 2016, the city of Kingston had somewhere between 3,000 to 5,000 people waiting for a family physician.
“We recognized in our data analysis, that the numbers would climb.”
The motion presented this September asking council to have the province designate Kingston as a high-needs community noted the number of family physicians was declining “due to deaths, retirements, relocations, reduced patient roster size due to the increased complexity of care for patients, and changing work-life balances.”
The motion also noted that the city’s population growth, including the increased number of students coming to the city, has become a burden on family physicians, whose income has declined 29 per cent in the last five years.
Lefebvre said through her work, she sees family doctors getting overwhelmed by the demand.
“I see the burnout in physicians on a daily basis,” said Lefebvre. “CDK Medical walk-in clinic had to reduce their hours because there wasn’t enough physicians to serve the community of unattached patients — that can speak volumes.”
But she believes the motion put forward by McLaren in September was a turning point in Kingston’s potential doctor shortage crisis.
“The city of Kingston is taking this very seriously, as is KEDCO, although KEDCO does not have a formal role at this time. With this motion being carried put forward by Coun. McLaren and seconded by Rob Hutchison, the file is visible again.”
As for what to do next, Lefebvre says city officials and interested parties are currently deciding who will take charge of the file, and that her consulting firm is still involved in the issue.
Whether the new Ontario government will be receptive to the request will be another issue, Lefebvre said. This is why the city will need concrete numbers to present to the province.
The city of Kingston did not comment when asked about this story, and redirected Global News to KFL&A Public Health. In turn, KFL&A Public Health said they were not in a position to comment on the doctor shortage issue.
The South East Local Health Integration Network, which is responsible for planning, managing and funding health care in the Kingston area, did not respond to a request for comment.
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