Despite a long list of efforts to recruit GPs, Newfoundland and Labrador has lost more GPs than it has gained in the past two years.
According to the College of Physicians and Surgeons of Newfoundland and Labrador, the body that licenses physicians in the province, 122 general practitioners did not renew their license to practice medicine in 2021 and 2022.
During the same period, the college says, 115 new family medicine licenses were issued, a new loss of seven doctors — a small one, but one that comes after the government ramped up its recruitment efforts over a shortage identified years ago.
“It’s worrying. There is a crisis in family medicine, and we’re definitely seeing a lot of young doctors choosing not to enter community-based, family medicine practice,” said Dr. Kris Luscombe, President of the Newfoundland and Labrador Medical Association.
“There has been a lot of emphasis on recruitment and that energy is important, but it’s fair to say we still have a long way to go to achieve adequate recruitment to meet demand.”
The medical board says it’s likely some of the new license holders won’t be working full-time.
“We hear a lot of young doctors, recent graduates, saying, ‘I’ll do stand-in work,’ ‘I’ll go out and take over someone else’s practice,’ or I’ll work in a walk-in clinic, ‘” Luscombe said. “So we see that people change their practice style so that they don’t have the constant responsibility of having patients attached to them.”
More orphan patients
In 2019, a public survey by the Medical Association found that about 99,000 people in the province did not have a family doctor. The association’s latest polls show that the situation is getting worse as more members of the province’s aging medical profession are retiring.
“We have 136,000 people who now self-report that they do not have a GP and we recognize that many people who do have a GP are at risk if their doctors do not continue in those positions,” Luscombe said.
Luscombe says it is difficult for doctors who continue to practice in the province.
“They always feel pressure to take more patients because they’re very sensitive to the fact that there are a lot of people in need out there who aren’t attached to family medicine… people who are orphans and a lot of doctors are struggling along a moral distress over the people who aren’t connected, and it’s very overwhelming,” he said.
The Medical Association has been calling for a staffing plan for doctors in Newfoundland and Labrador for years.
“We really need to maintain metrics and get a sense of whether these people are full-time or part-time? What do you do? Do they do what the system needs? Then we align the support and incentives so people do what’s valued,” Luscombe said.
General practitioner prognosis
In 2019, the Medical Association commissioned Dr. David Peachey of Nova Scotia’s Health Intelligence Inc. developing a GP prognosis.
Peachey examined the number of physicians, the number of older adults, the burden of disease, the province’s recruitment efforts, physician turnover, and expected retirements.
His prognosis identified the shortage of general practitioners in the province at the time and a projected need for physicians over the next decade.
Peachey’s prognosis called for an additional 60 full-time family doctors in 2020 to fill the immediate shortage.
It also concluded that by 2030 an average of about 20 more GPs per year would be needed for a total of 243 additional GPs.
However, the college’s 2020 and 2021 recruitment and retention numbers show the province is losing ground instead of making progress toward meeting forecast targets.
Recruitment and Retention Efforts
In the past two years, the province has done a lot to attract and retain family doctors.
The provincial government established an Office for Health Worker Recruitment and Retention and created a new position of Deputy Minister for Health Worker Recruitment and Retention.
It has launched two pilot projects to attract more new medical graduates to primary care practice, financial support for new primary care physicians who open a new clinic or join an established clinic in their first two years of practice, and up to $150,000 for New GPs Open a new family medicine clinic or join an existing one and stay there for five years.
The province has also expanded the number of places available to residents of Newfoundland and Labrador in Memorial University’s undergraduate medical education program, and additional places have been added to the Family Medicine residency program for international medical graduates.
In July, the provincial government launched an advertising campaign called “Extraordinary Every Day” aimed at recruiting and retaining health workers
In August, the state government, in cooperation with the medical association, announced a year-long pilot project to bring retired family doctors back to work. It offers to pay admission fees and bonuses to returning GPs.
The province also says it is working with the college of doctors to make it easier for internationally trained health professionals to settle in that province.
In October, the provincial government announced new financial incentives to attract provincial doctors working elsewhere to return to Newfoundland and Labrador.
The government says it is also working on ways to make it easier for doctors licensed in other Canadian provinces to work in Newfoundland and Labrador, and in January the provincial government announced a mission to Ireland to recruit doctors and nurses.
CBC News has repeatedly asked Health Secretary Tom Osborne for comment, but it has not been provided.
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