Primary Care in Distress

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Dr. Nancy Whitmore

“This is a time for re-thinking.” That was the urging of Dr. Danielle Martin, one of the nine high-profile family physicians we spoke to for our eDialogue cover story about primary care in crisis. The current system is not working and our article explores the issues and potential solutions to the crisis.

We also interviewed Dr. Sabra Gibbens, a ‘cradle to grave’ small-town family physician. Dr. Gibbens expresses a genuine love for her role in her community, but discusses how difficult it is to provide the kind of care she would like to provide in a system where she is stretched too thinly.

Burnout and moral injury have been prevalent across all practices of medicine. However, many emergency room physicians have been especially hard hit. We interviewed Dr. James Maskalyk, an emergency physician at St. Michael’s Hospital in Toronto, who was recently appointed as Wellness Director for the Divisions of Emergency Medicine at the University of Toronto. Dr. Maskalyk describes how doctors are constantly dealing with their patients’ worst days. This article discusses why the culture of medicine needs to change to allow physicians the opportunity to express vulnerability and ask for help. Burnout continues to be a priority for CPSO and we are working closely with stakeholders across the health system to address this critical issue.

“The current system is not working, and our article explores the issues and potential solutions to the crisis.”

One of the seven solutions proposed to addressing the primary care crisis was boosting physician numbers. Over the past year, we have amended a number of our registration policies to remove barriers and allow more physicians to practise medicine in Ontario, and we are seeing a notable increase in the number of new physicians entering practice. The effect has been immediate, and has already resulted in 151 new US applicants and 54 new CCFP applications. With our recent approval of the Subspecialist Examination Affiliate Program pathway and the waiving of the moonlighting license fees for residents, we expect to continue to see improvement in physician supply here in Ontario.

We launched our 2022 Annual Report in early June. Over the past five years, CPSO has focused on improving our regulatory approach. We continue to work diligently to improve processes and apply the principles of right-touch regulation throughout the College. Resulting changes include improving complaint resolution timelines; supportive and informative communications — including a new podcast; and significant streamlining of annual renewal questions and process. These improvements have helped decrease the regulatory burden on physicians. We also continue to see the success of our QI (Quality Improvement) approach to quality oversight. By the end of 2022, more than half of Ontario’s practising physicians engaged in our QI program. This new QI approach has been well received with more than 80 percent of physicians reporting they found the process collaborative and worthwhile. I encourage you to read the full report to learn more about our recent accomplishments and challenges.

“This new QI approach has been well received with over 80 percent of physicians reporting that they found the process collaborative and worthwhile.”

June is Pride Month, and celebrating the contributions and acknowledging the experiences of 2SLGBTQIA+ individuals feels even more important this year. The recent anti-2SLGBTQIA+ rhetoric we have seen in North America is deeply troubling. Progress is not linear, so we need to continue supporting our colleagues, friends and family members who are a part of the 2SLGBTQIA+ community. The latest episode of our “In Dialogue” podcast features Dr. Jordan Goodridge, a Toronto-based family physician and medical educator who specializes in 2SLGBTQIA+ health and HIV (Human Immunodeficiency Virus) care, where we discuss inclusive, culturally safe and patient-centred care for 2SLGBTQIA+ patients.

Finally, I want to thank you for continuing to provide great care to your patients within this incredibly challenging system and hope you can find some time to enjoy summer.