Nearly 15,000 patients will be orphans in the next few months in the United Counties of Stormont, Dundas and Glengarry, a bilingual region in Eastern Ontario, due to the departure of several family doctors. A constellation of organizations and politicians are now coming together to try to solve this long-standing problem, which could become a provincial election issue.
The United Counties are made up of six rural townships located about an hour’s drive from Montreal. They have about 110,000 inhabitants in total, and nearly 40% of them are bilingual.
In Alexandria, a village in North Glengarry Township — where the bilingualism rate is 58% — two family doctors will soon be leaving the local clinic, and another will be retiring. “It’s stressful not having a family doctor, but I’m especially worried about my parents,” says Dave Lorimer, who moved to the village with his wife and parents last year. To avoid becoming orphans, they have chosen to keep their family doctor in Toronto, almost five hours away.
The departure of these general practitioners “compromises access to care [de santé] primary schools and leads to a higher rate of more burnout”, laments the DD Nadia Kucherepa, Chief Medical Officer of Glengarry Memorial Hospital. Most of the township’s family physicians rotate through this Alexandria hospital center; if there are fewer available, those who stay have to work more in the hospital and are thus forced to reduce their work outside of it.
The chief doctor is already investing in the recruitment of new colleagues, but she also hopes to obtain support – financial, in particular – from the regional government. The Cornwall Social Development Council, which recently made this issue a priority, intends to contribute to the effort, says its director, Carilyne Hébert.
Shortage
Determining the number of family physicians missing in Eastern Ontario, however, is an inexact science.
Some 14,492 patients are orphans in the area managed by the Ontario Health Team of Upper Canada, Cornwall and Region, which primarily (but not exclusively) covers the United Counties of Stormont, Dundas and Glengarry. Twelve general practitioners are missing in the region if we rely on the average ratio established by the Ontario College of Family Physicians.
But according to the DD Kucherepa, the region needs 15 more doctors, including several French-speaking ones. To the 12,000 patients in the United Counties without family doctors, according to her assessment, she adds 3,150 patients who will soon be in the same situation.
Especially since new general practitioners rarely follow as many patients as those who leave, underlines for his part Kirsten Gardner, deputy mayor of the township of South Dundas and adviser to the regional government of the united counties. Doctors who have been there for years sometimes have to be replaced by two people: a Morrisburg doctor revealed in 2019 that some of her now retired peers were following almost 2,000 patients each.
Added to this context is the challenge of recruiting general practitioners in rural areas. Spouses of candidates are less tempted to dive into the adventure when job opportunities seem limited, notes Mme Gardner. And this, even if the village of Alexandria is located halfway between Ottawa and Montreal, indicates for its part the DD Nadia Kucherepa.
However, there seem to be alternatives.
Since 2011, the village of Lancaster, in the township of South Glengarry, has had a clinic run by nurse practitioners. According to its director general, Penelope Smith, this is an avenue to explore: some 175 new patients registered there during the pandemic, and the demand continues to grow.
The role of the province
This clinic is currently the only one of its kind in Eastern Ontario, and Mme Gardner says he faces silence from the provincial government about his expansion plans.
On the side of the Ontario Ministry of Health, however, it is said to examine all requests of this type. “If funding becomes available for such programs, the ministry may consider projects like this,” a spokesperson said.
On the political side, we are also mobilizing. On April 19, the Chief Administrative Officer of the United Counties of Stormont, Dundas and Glengarry publicly noted that “the problem [du manque de médecins] can only be regulated by the province”. Eastern Ontario, however, was one of the big omissions from the budget presented by the Ford government on the eve of the election.
“These pitfalls are one of the reasons I’m running” in provincial politics, says Kirsten Gardner. The Deputy Mayor of South Dundas was officially nominated as the Ontario Liberal Party candidate for the riding of Stormont–Dundas–South Glengarry on April 26th. She hopes to succeed the outgoing MP, the Progressive Conservative Jim McDonell, who is not standing. “There must be someone who solves the problem or, at the very least, who improves the situation,” says Ms.me Gardner.
This story is supported by the Local Journalism Initiative, funded by the Government of Canada.