1 in 10 people don't have a family doctor in the London region and it will only get worse

An estimated 55,000 to 60,000 people in Middlesex County are without a family doctor and the problem will only get worse, according to the London and District Academy of Medicine, which says too much "red tape" and too little support is keeping fresh medical graduates away from family practice in greater and greater numbers. 

It means approximately one in 10 people in the London Region are without a medical professional to diagnose common illnesses and injuries, do routine physical checkups and refer patients to specialists, which a 2015 study in the U.S. suggests saves the health-care system money and results in fewer overall hospitalizations. 

There were nearly 6,000 newly registered physicians last year, according an annual report from the College of Physicians and Surgeons of Ontario. They have yet to be certified, so the health-care regulator said it is impossible to know how many will become family doctors, of which, Ontario currently has about 14,500.

Except, fewer graduates seem to want to go into family medicine. Data from the Canadian Resident Matching Service, a non-profit that matches medical students with training, shows a steady decline in the number of students who rank family medicine as their top career choice, from 38 per cent in 2015 to 30.7 per cent in 2022. 

Doctor shortage part of deepening health-care crisis

The worsening shortage is part of a deepening crisis in Ontario health care, which has seen long wait times, emergency room chaos and a growing number of health-care professionals calling it quits because of burnout.

It means more people will find themselves in the same situation as Laura Lee Gilliberti, 62, of London, Ont., who's family doctor quit six months ago. 

"He was doing his own practice and apparently working in one of the hospitals. He has a young family and he was burnt out from doing both. He chose to do more of the hospital work and less of the family practice."

"[He] could not find a doctor to take over his practice." 

The reason, according to Dr. Sharadindu Rai, the president of the London and District Academy of Medicine, is because there is too much "red tape" and too little support, which makes becoming a family doctor unappealing for medical graduates. 

"Family medicine is not an attractive place for new graduates to be right now," he said, adding there are more graduates coming out of medical school than there are jobs to fill at existing doctor's offices.

"They're underemployed and it's difficult for them to, believe it or not, find the work and it's very difficult for them to set up practice and when they do get practising, they are very quickly overwhelmed by the huge unmet health-care need in the community." 

Pay rules don't provide incentive to play 'catch up'

Rai said when people do find a family doctor, the patients need "catch up" visits, ranging from physicals, to routine screenings and shots, which may not have been administered for some time. 

Roughly half of doctors in Ontario are paid under a system called "capitation," or rostering, which sees practices paid a lump sum for each patient, rather than a fee for each service provided.

With so much catch up to do, no extra reward and too many regulations on opening up a new practice, he said, there is little financial incentive for new graduates to get into family medicine. 

Add to that, a rapidly growing population in the London region that is also aging at the same time. Older patients have more complex needs and require more frequent doctor's visits, which means more work without extra financial reward. 

"This is a dire situation that is only getting worse over time," Rai said.  

Province says it is 'reversing years of under investment' in health care

Hannah Jensen, the press secretary for Ontario Health Minister Syliva Jones told CBC News Wednesday that the province is "reversing years of under investment" in health care by building new hospitals, adding new beds and recruiting nurses, doctors and personal support workers. 

Jensen said the province plans to add some 6,000 health-care workers, who will free up 2,500 hospital beds when the province enters "the next phase" of its health-care recovery plan. 

Until then, however, fewer family physicians means more expensive health care for the system overall. Fewer doctors means fewer opportunities to catch medical conditions early, such as high blood pressure, diabetes, cancer and even administer routine shots —  which stave off hospitalizations and worse outcomes in an already overtaxed health system. 

For people without a family doctor like Laura Lee Gilliberti, it only took a recent visit to a London emergency room with her mother to decide it's a place she'd rather not be. 

"Emergency would be the last place I would want to go based on that experience. I felt like I was walking into some kind of third world refugee situation because the state of the waiting room was just appalling.

"People were on the floor in emergency. Somebody was vomiting into a bucket. The despair that was indicated by people sitting in chairs, it was just appalling." 

"I used to think I'll go to emerge or I'll get help if I really am sick, but I'm not sure anymore."