I’ve had the same GP for 20+ years. Chatting with him yesterday I was sad to learn that he’s retiring later this year. He’s maybe 50 years old. In fact, he and his colleagues are shutting the whole clinic. That’s seven doctors. The average GP has 1,200 patients.
Some of the pressure comes from their landlord, who continues to increase the rent. That despite the clinic being located in a suburban mall whose vacancy rate never recovered from the pandemic.
A bigger issue is that the government cut doctors’ payments during the pandemic on account of doctors shifting to “telephone medicine”. Before 2020, if I wanted to renew a prescription I would have to visit the doctor’s office. Health insurance would be charged $37 if the visit lasted 10 minutes. My doc says the government cut what he’s allowed to bill by 40 percent.
My GP says that last year, after overhead, taxes etc., he netted $20,000. And yes, he works full time. So it’s hardly any wonder why he and his colleagues find that their practice no longer makes any economic sense. For years news stories have bemoaned the shortage of family docs. In Ontario some 1.8 million people don’t have one. This one clinic closing will add more than 8,000 people to that total.
We all understand that the trajectory of health care expense is unsustainable. In the 1980s health accounted for a quarter or less of provincial budgets. Now in some cases it’s over fifty percent. If that trend were to continue, eventually provinces would be providing little else than health spending. Ridiculous, of course, but it underlines the magnitude of the problem.
We can’t keep throwing money at health care. But if we don’t spend where we need to we’ll be in worse trouble. One thing’s for sure – we’re not going to attract people to family medicine if they can only expect to take home less than minimum wage.
https://www.cbc.ca/news/canada/toronto/ontario-family-doctors-physician-shortage-workers-wanted-1.6730091
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I got a question via email:
"I was gonna ask: What do you think is the answer to a problem of increasing demand and even shorter supply? "
My reply:
Good question. I general I don’t think you want to discourage demand at this level. Primary care can avoid a lot of expense down the road by catching things early. That suggests the answer is on the supply side. So, how much do you need the MD to be doing? Can a RN do most of a routine exam and only consult the doc at the end? Do we really need to see the doc to renew a prescription you’ve been on for years?
But really, if docs are leaving the profession, if clinics are going under, then the government isn’t paying enough. Now that it’s in the news that some clinics are proposing membership fees for patients those clinics will likely close, making the problem worse.
People talk about the Canada Health Act as something sacred. The act was introduced by Monique Begin, health minister in the dying days of Pierre Trudeau’s last government, to bludgeon Alberta for allowing physician user fees. That should hardly make it the last word in health care.