When the only walk-in clinic in St. Thomas closed, patients experienced doctor shortage first-hand

When St. Thomas resident Paul Pearce felt unbearable pain and swelling in his lower legs on Wednesday, he had no choice but to go to the emergency department at St. Thomas Elgin General Hospital.

Pearce doesn't have a family doctor, and the only walk-in clinic for a city with a population of approximately 40,000 was closed "due to a shortage of doctors".

"I think that wait is extended by people that could probably use a clinic rather than an emergency ward," Pearce said, who often requires medical attention due to complications following a heart attack.

"You're sitting out in the hall and there could be 50 to 60 people out there. There have been times where I've had to just leave because they're not looking at any more people."

Patients were being directed that day to the emergency room (ER) where Pearce found the wait to be three hours.

St. Thomas is one of many Ontario communities struggling to find and retain family doctors. The Ontario College of Family Physicians says having a dedicated family doctor rather than relying on walk-in clinics is especially important for people, like Pearce, who have complex chronic issues. 

But even the situation with walk-in clinics in St. Thomas is dire. The only clinic that takes non-registered patients has limited hours. It's open weeknights from 5:30 p.m. to 8:30 p.m., and 8:30 a.m. to 11:30 a.m. on weekends. 

"These gaps often leave individuals turning to the emergency department for their health care needs, contributing to our high patient volumes," said St. Thomas Hospital Chief of Staff Erica Van Daalen.

Over the past several days, she said the hospital has seen close to 200 daily visits. She adds that approximately 10,000 St. Thomas residents do not have a primary care provider.

Pearce, who often works evenings, said the limited hours at the walk-in clinic makes it difficult for him to use the services. When he has taken time off work to visit the clinic, he hasn't always had success securing an appointment.

He's said he's always looking for a family doctor, but in the two years since moving to St. Thomas, he's had no luck.

Different communities across Ontario are trying a variety of options to get family doctors to move to town, including offering incentives. Woodstock offers a $5,000 moving allowance, and St. Thomas has been known to offer $33,000 over several years, alongside six months of free rent. 

But it's become increasingly competitive and municipal leaders say they can't afford the bonuses. 

"Not only are there not enough physicians or nurse practitioners in St. Thomas, there's not enough in the province of Ontario," said Mike McMahon, the executive director of the Thames Valley Family Health Team. "There's just not enough primary care providers currently to address the needs of people unattached."

As a way to bridge that gap, McMahon's team opened the health hub in September, offering by-appointment primary care services to anyone, regardless of if they have a family doctor or not.

He said the hub has served 1,400 people since it opened and people can often get an appointment within one to two days of calling. 

St. Thomas mayor Joe Preston said the city is also working to bring more doctors to the community through a physician recruitment committee. 

"We have a number of doctors that have retired or will retire over the next little while so there are practices available and we're trying to offer the opportunity for someone to practice medicine here in St. Thomas," Preston said.