Windsor needs more family doctors. Other municipalities are spending big to attract them

The need for family physicians in Windsor-Essex, Ont. is growing, but there's mixed opinion on whether incentive programs can help attract more doctors to this region.

According to the head of the Essex County Medical Society, the current need for family doctors in Windsor and Tecumseh areas is somewhere between 50 and 60 physicians. That's an increase from 37 in June, according to the society, which says this gap is significant.

London, in comparison, is estimated to only be short 25 family physicians. 

Lauren Schmidlin is one of many parents concerned with the state of affairs. Though she has a family doctor for herself, wait times are long and she's still searching for a doctor for her children.

"Since [we] chose our family doctor, we initially would wait maybe two or three days to get an appointment, max," she said. "Now, it's two or three months. Ever since, we've become regulars at the local walk-in clinic, who tell us that they see all of our doctor's patients."

One way to tackle the issue, from the perspective of Ward 1 candidate Darcie Renaud, is to increase the current municipal budget that supports physician recruitment.

Windsor does not offer incentives directly but provides $25,000 annually to the Schulich School of Medicine and Dentistry's Windsor Campus to support its family medicine and psychiatry residency programs, with the aim of keeping doctors in the region after graduation.

Renaud said other municipalities are spending up to 10 times more on physician recruitment.

One example is Kingston's recruitment and incentive program launched in January, which commits $250,000 annually to family physician recruitment. Kingston hired nine new family doctors in August, and has about half of Windsor's population.

Renaud said she believes we can be doing more to retain our health-care talent, and unless changes are made, we should anticipate an exodus of sorts on an already pinched health-care workforce in Essex County. 

"In looking at what other municipalities around the province are doing, we're falling short," she said. 

"I'm worried that if we don't get on top of it, because other municipalities are going so much further than we are when it comes to recruiting physicians, we'll be left behind…because we are competing with other regions. I'm nervous we'll lose [newly graduated] doctors to those other regions, and we're going to need them."

Several other Ontario municipalities are funding doctor recruitment, including Hastings County, which has budgeted a $100,000 payout to medical students who commit to five years practising family medicine in the area. 

Fred Francis, the incumbent councillor in Ward 1 who is seeking re-election, said city council hasn't considered raising the funding level for the residency program because the school hasn't expressed a need.

He noted that in the past, the council had spoken with Schulich about the need for new medical school, which was then established, after which council supported recruitment efforts, and now, he said, it's time to talk about the new hospital.

He's said he's hearing that there is more of a need for specialists rather than family doctors, which he thinks the new hospital project will support.

"Having a state-of-the-art acute care facility is a great reason to stay in Windsor as a new graduate," he said.

Having the facility is "part of creating a medical community," he said.

"So as a family doctor, you want to start your practise in a city that has a reputation for having the latest and greatest facility. It becomes a health-care system."

Dr. Vikesh Maraj, a family doctor and president of the Essex County Medical Society, isn't convinced that more funding is necessarily the answer and said this issue isn't limited to Windsor. 

"I think we need to ask ourselves what's forcing physicians to go into early retirement, what's discouraging people from getting into family medicine," he said. 

"It all comes down to burnout rates being accelerated. So what we as family doctors have been asking for and advocating for is an increase in what we call 'team based care.' In other words, we're looking for more support in how we practise. But absolutely, if we could do recruitment more robustly, that certainly would not do any harm. Every little bit helps."

Maraj also shared that there is a trend of less interest in new graduates pursuing family medicine. According to Maraj, the family physician demographic is aging and retiring, and it takes two new grads to replace the roster of one retiring physician.

Renaud said there may be other solutions as well.

"I'd like to see us also do something that probably won't cost much, which is to partner with the University of Windsor and the Essex County Medical Society to really study the shortage and what's going to be needed as far as family doctors in the future, before it hits a crisis point."

Most graduates sticking around

According to a spokesperson for the Schulich school, more than 80 per cent of graduates from the family medicine residency program have opted to remain in Windsor-Essex.

"Investments like this from the city are part of how the school builds a sense of community, morale and belonging among our residents in Windsor — and, combined with other strategies, help our community to retain physicians," the spokesperson said.

Right now, the school does not plan to ask the city to boost its contribution to the program. The figure was raised from $15,000 to $24,000 in 2019 to expand the program to include psychiatry residents.

Bill Marra, CEO at Hotel-Dieu Grace Healthcare, said that the $25,000 funding amount was decided on while he was a city councillor.

"It was a collaborative effort and a requested amount," he said. "I didn't see a need to update that budget, everyone was happy with it. Now [at Hotel-Dieu Grace Healthcare], we have no challenges recruiting. My credit goes to the residency program at the Schulich School of Medicine satellite campus. It's a fantastic program." 

Hotel-Dieu Grace Healthcare, however, does not hire family physicians through the program, but rather specialists such as geriatricians and psychiatrists. 

Waiting months for a doctor

Yuxin Bai, a student at the University Windsor who is originally from Saskatchewan, was attempting to help two friends of his find a family doctor after graduation. They had to wait four months.

"Eventually, I found one clinic that had a wait list sign-up form online, and called them to ask for an approximate wait time. They said two months. [I] got my friends to fill out the forms in April, and they finally both got a family doctor in August," Bai said in an email to CBC News. 

"I was surprised by how difficult it was to find a family doctor. Even as a long-time resident in Canada and a medical student, I found the process confusing."

Meanwhile, Schmidlin, a parent of two, is unsure what will come next in her situation.

"I'm in a bit of a pickle for care for my kids right now," she said. "My current family doctor doesn't want to practise family medicine anymore and is not taking on new patients. I haven't started looking for a new one yet, because it's just another thing that I would have to juggle."