Family doctor shortage in eastern Ontario could get worse, Alexandria doctor warns


With many communities facing doctor shortages in the province, one eastern Ontario doctor says theirs could get worse in the coming years.

“We get streams of calls into the hospital asking every day if there’s family physicians available for rostering new patients and we just don’t have them available right now,” said Dr. Nadia Kucherepa, chief of staff at Hopital Glengarry Memorial Hospital (HGMH ).

“We have about three practices that will be closing and one that will be winding down in preparation for retirement,” she added.

That means more than 3,000 people could possibly be without a family doctor, adding to the other 12,000 in the region also without one.

Other areas in the province are also struggling to fill shortages, like Prince Edward County and northern Ontario regions.

Dr. Kucherepa says increasing cash incentives for new physicians to move to the area is her top priority, with HGMH already offering $40,000 up front for new graduates.

“But we’re also looking at seeing if the communities can offer an extra $15,000 to bring that total up to about $55,000,” she said. “Debt recovery we feel is the big issue for new grads. The average graduate is looking at an average debt load of $150,000, so we’re hoping to help offset that.”

“They need money up front to buy their house, establish their practice, buy their equipment, pay off their loans from medical school and undergrad, that’s what they need,” she added.

“We do have some competition with Cornwall (hospital), they have a really good recruitment package as well,” Dr. Kucherepa said. “We’re competing with Ottawa Hospital, there’s more practice models available in larger centers they can be lucrative over time.”

Dr. Nadia Kucherepa working on Friday at the Hopital Glengarry Memorial Hospital. (Nate Vandermeer/CTV News Ottawa)

On March 21, the doctor presented Stormont Dundas and Glengarry Council members with the issue, asking for $5,000 to help up the incentive.

“The doctor did come and made a terrific report and the next step after our delegation is to receive a staff report,” said SD&G Warden and North Glengarry Deputy Maj. Carma Williams.

“This has been a decades-long issue across rural Ontario, so yes I knew it was a problem and it’s something that various groups, a lot of different groups are grappling with,” Williams added.

“The Eastern Ontario Wardens Caucus, which I’m a member of, it’s one of their top three priorities for this year and it was just identified this spring in terms of going out there and working on this issue,” Williams said.

Dr. Kucherepa has also had meetings with North Glengarry and South Glengarry officials, also requesting $5,000 towards incentives.

“What we’re doing is, we need to work together,” added Williams. “I also know that there’s a group out of South Dundas and South Stormont, they’ve been working on physician recruitment for some time (as well).”

Another issue Dr. Kucherepa says is the stigma of rural doctors being isolated, which is not the case in Alexandria or eastern Ontario.

“I think that’s under recognized we are commutable,” she said. “It’s a nice commute, there is absolutely no traffic.”

“We have a great community of practice where we look at offering, at least in Alexandria, office space that is well below market value,” Kucherepa said. “We have a lot of add-ins, we have practice share models and we also have a lot of rules in the hospital that really protect that work-life balance for family physicians who are playing more than one role in the community.”

An issue presented in her report found that a doctor’s spouse might not be willing to move to a rural area, especially if they already live close to their current workplace.

“The beauty is you get the quality of life, the rural quality of life and you can work in one of those cities if you want and there’s really no need to pick up and move,” Williams said. “One spouse can work in one community and the other spouse can work in another community and they can live where they want, ideally rurally.”

“New grads, really the world is their oyster,” Dr. Kucherepa said. “They can go to a lot of different communities and we hope that they do choose rural or northern medicine. The need is definitely there.”

She says that with 15,000 people possibly looking for a doctor, they would need to hire around 15 family physicians to cover the need.

“I don’t think we know moving forward exactly where that number is going to land, it’s an ongoing issue,” she said. “We have retirements that are coming up that certainly will exasperate those issues so the numbers will probably be more as we’re moving forwards, we don’t have a finite deadline for that.”

The doctor says discussions with local councils have been proactive, and has been assured talks will continue to find a solution.

“Wheels are in motion and what’s been really nice feedback is that it’s like people have been waiting to have this discussion and just needed an opportunity to get there,” Dr. Kucherepa said.

She noted that since her presentation to the SD&G Council in March, one new physician has signed on to work in the region. The aim now is to hire three more by the end of the year.

“Everybody is on board. Everybody realizes that this is an issue,” she said. “A lot of people who are sitting at those tables are without family physicians, and I, myself, am without a family physician because of some of these practice changes in my community so we all have something to gain by this.”

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