A Prescription for Northern Ontario: More Health Care Staff, More Flexibility

Ontario Medical Association makes 87 recommendations

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As Ontarians prepare to head to the polls, area doctors are calling on Queen’s Park to address a doctor shortage, a mental health crisis and long wait times for surgeries and tests.

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In the Sudbury area, 48 per cent of cataract surgery patients waited longer than provincial targets, according to the Ontario Medical Association, while 11 per cent waited longer for bypass surgery and 76 per cent waited longer. long for an MRI.

“One of the vulnerabilities in the health care system is that we’re really hospital-centric,” said Stephen Cooper, a Manitoulin physician and local OMA district chair. “They are the backbone of the healthcare system, so it is absolutely essential that they are well funded, but a hospital is a big center that has to do everything for everyone, and that has become a challenge during COVID.”

Many hospitals, including Horizon Santé-Nord, have been forced to postpone surgeries during the pandemic to maintain space and bed resources, resulting in a massive backlog.

One way to solve this problem, Cooper said, would be to use ambulatory care centers — state-funded stand-alone clinics that could perform less complex surgeries and procedures on an outpatient basis.

“Ambulatory care centers focus on one thing in particular and do it at high volume,” Cooper said. “So we could just do hips or knees, or cataracts. They can continue to operate during COVID because these resources are dedicated to this particular area, and across the world they have proven to be very effective in producing high quality care at a reasonable cost, with good patient satisfaction.

Toronto’s Shouldice Hospital, which specializes in hernia operations, would be an example of this approach, Cooper said, but there aren’t many such services in northern Ontario.

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“Dr. Reddy runs a small colonoscopy clinic in Sudbury, or if you go for an x-ray at 65 Larch Street, it’s the same idea,” he said. outpatient care, but it’s the same principle, where the radiologists charge the government to do the diagnostic procedures.”

Given the current pressure on hospitals and long waits for tests and surgeries, “we think we should promote the opening of these centers and allow doctors and organizations to start running them,” Cooper said. .

In many cases, surgery will allow someone to return to work, so there is also an economic argument for faster access to procedures.

“It could be a 60-year-old man who works in construction and can no longer walk up and down scaffolding,” Cooper said. “Now they’re waiting a year and a half to have their hip replaced, and it’s tough for a company when you have this kind of program.”

Others are waiting “to get their cataracts fixed so they can drive again and not rely on their families,” he said. “Those are pretty important to people.”

Ontario also needs more doctors to help address issues that concern residents and address health system gaps that have been exacerbated during the pandemic, according to the OMA.

Northern Ontario is particularly short in this regard. Health Force Ontario, which posts job openings for physicians, calculates Sudbury and surrounding northern communities, including North Bay, Sault Ste. Marie, Timmins and Cochrane – need about 150 more doctors, and Cooper said that was likely a conservative estimate.

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“They use the word doctor shortage, but it’s really about patient access to care,” he said. “The Canadian healthcare system has many advantages, but patient access in Canada is terrible compared to other OECD countries. We find especially in rural communities, and even in places like North Bay and Sudbury, that people don’t have a family doctor and can’t staff their emergency department.

Some small town hospitals have even been forced to close their emergency departments, he said, due to a shortage of doctors.

“Part of that is not having the right doctors in the right place, but there’s a shortage of health care providers — nurses and personal support workers, as well as doctors — across the province,” he said. “And you notice it in the North more than anywhere else, I think, because sometimes it’s difficult to get people moving in the Highway 11 corridor, despite the fishing and the snow removal.

Cooper himself is very happy to have established his career as a doctor on Manitoulin Island, where he enjoys boating and paddling, as well as riding a tractor, but many doctors are hesitant to head north.

“I think the biggest problem we have in the North and in rural communities is the lack of respect for urban centers,” he said. “If you want to do good family medicine or become a top orthopedic surgeon, you don’t go to North Bay — it’s like a backwater. It’s unfortunate, and we encourage universities in major centers like Toronto or Hamilton to send their residents up north, with preceptors, so they know you can have a very successful career and be clinically excellent in a northern community.

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Area residents are also concerned about mental health and substance abuse, according to the OMA.

ASI, a market research firm that analyzes social media activity, found that these issues were top of mind in five of eight northern ridings: Sudbury, Nickel Belt, Nipissing, Sault Ste. Marie and Mushkegowuk-James Bay.

Cooper said he certainly noticed more people with mental health issues during his practice in the North.

“I’ve been doing this for 30 years, and back then it was hooks and gun trauma,” he said. “I would say 40% of the people we see in the ER right now have some sort of mental health issue, some of which are very serious, and they take up a lot of our time.”

Meeting this challenge cannot be done by the healthcare sector alone. “It has to be a community effort,” Cooper said. “Certainly from the health system, you need emergency resources, you need counsellors, access to psychiatry to make sure they’re on the right drugs, someone to follow up. But then you need good housing, job opportunities, educational opportunities, secure income.

Ontario doctors have made dozens of recommendations to eliminate the surgical backlog, address wait times, ease doctor shortages and tackle mental health and addiction in a document called Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care.

The OMA called on all political parties to adopt the 87 recommendations of the prescription to strengthen the health system as part of their platforms for the June 2 elections.



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