Examining the doctor shortage in the Highlands
By Jenn Watt
Published Feb. 11, 2019
Six doctors at minimum – four in Haliburton and two in Kinmount – are needed in order to meet the needs of the population.
In January, county council discussed hiring a physician recruiter to address a longstanding need, which has left many people without a family doctor or with fewer choices in the health care.
At the Haliburton Highlands Family Health Team, new doctors coming in have replaced those retiring, which hasn’t done much for the wait list, which is 1,000 names long.
Five years ago, the family health team increased its roster by 1,200 patients, executive director Kimberley Robinson told the Echo in an email.
“We have maintained that roster, but lost eight providers in the interim. Our four newest physicians, Dr. Thomas, Dr. Suke, Dr. Gilmour, and Dr. Tilbrook, took over the practices of retiring physicians Dr. Wu, Dr. Heyes, and Dr. Varty so we have not been able to roster a significant number of new patients,” she said. “Dr. Ferracuti, Dr. Beattie, Dr. Dawson, Dr. Cossons, and NP Sue Robinson were not replaced. We do roster a few patients per month, but are still taking names from the wait list from 2016.”
Ten physicians are part of the family health team. One works exclusively in Minden with another four and other health professionals visiting Minden twice a month to see patients there.
Robinson said four more physicians in Haliburton would come closer to meeting the needs of the population and would also satisfy the need for emergency department doctors at the Haliburton ER.
The situation at the emergency department has been serious for a while.
At the last Haliburton Highlands Health Services board meeting, chief of staff Dr. Kristy Gammon said by the end of May, there would be only two full-time equivalent physicians in an ER that would usually need five or six.
“Reliance on Health Force Ontario emergency department locum program is not an ideal long-term, but necessary ongoing short-term solution to our staffing here in Haliburton. Recruitment efforts haven’t been successful to date, but we continue to work with our regional partners, the county and Health Force Ontario on this crucial issue,” she said.
Health Force Ontario provides locums to the Haliburton ER, but isn’t considered ideal because it’s more expensive and doesn’t offer staffing stability.
For many county residents, their family doctor is based at the Kinmount and District Health Centre, where Dr. Elena Mihu and Dr. Susan Gleeson see patients.
Recently, Dr. Gleeson announced that she would be retiring on April 11, 2019.
While Dr. Mihu has committed to take on Dr. Gleeson’s patients until a new doctor is found, Alan Howard of the Kinmount District Health Services Foundation said it puts pressure on a single doctor.
“Dr. Mihu has said that she’ll step into the breach for the time being, which of course is great for the people, but is a massive undertaking for Dr. Mihu,” he said in an interview.
Dr. Mihu has been with the Kinmount health centre for 20 years and will be taking on an additional 700 patients from Dr. Gleeson.
The facility can accommodate three doctors, and that’s what Howard would ideally like to see. In the short-term, he’s most concerned with finding a permanent doctor to take the patients Dr. Gleeson used to care for.
He said the foundation was currently considering whether to hire a recruitment agency.
“It’s a significant financial undertaking to take on these individual services to do this recruitment, but we think that might be the appropriate step,” he said.
The group has not yet made a decision, but is “actively investigating” it.
According to Howard, it could cost in the neighbourhood of $20,000 just to find a physician between an engagement fee with the agency and a finder’s fee, once a doctor agrees to come to Kinmount.
While there are incentive programs available through various municipalities, Howard said Kinmount’s location – at the nexus of Peterborough County, City of Kawartha Lakes, and Haliburton County – has made it harder to decipher who should take the lead on recruitment.
“We’re in an awkward position because we’re not technically located in the City of Kawartha Lakes … We’re Trent Lakes, which is Peterborough County. If we were 30 yards to the west, we’d be in Kawartha Lakes … We’re in a bit of a no-man’s land … that we almost don’t belong anywhere,” he said.
He hopes that if Haliburton County does hire a recruiter, that he or she will work with the Kinmount District Health Services Foundation, since the health centre serves many Haliburton County residents and many who live in Kinmount use the Minden and Haliburton hospitals.
“We have a lot of Haliburton County patients and we use the Haliburton health services, the hospital in particular. We certainly are very much part of Haliburton. I would suggest we feel more connected with the Haliburton region than we do with the Peterborough [region] or City of Kawartha Lakes,” he said.
It’s not enough to have family doctors based in larger towns or cities; local doctors keep the population physically healthy and the community socially healthy, he said. Transportation to clinics outside the area is an issue for many, plus, having a health team supporting people in the village keeps people healthier.
“Little towns are in tough spots, so fighting to make sure that we have the services to continue to make them viable places is very important,” he said.
Tory Hill resident Richard Ayotte knows first-hand how difficult it can be to find a family doctor close to home.
He moved to the Highlands from Milton in 1990 and kept his doctor, who works in Mississauga. Eventually, that doctor told Ayotte he was cutting down the size of his practice, and Ayotte would need to find someone new.
He searched on his own for a doctor, inquiring with the Dorset clinic, but was told he lived too far away to be considered.
Then he signed up with Health Care Connect and was placed with a doctor in Fenelon Falls. The drive takes him about an hour and 15 minutes.
Ayotte has had several medical issues in the last year, including surgery, and he said he needs to go to his doctor in Fenelon Falls for medication.
To cut down on driving time, he goes to Bancroft’s walk-in clinic when he can, but they cannot prescribe everything he needs.
“It’s closer and it’s fast,” he said. “I drive into Bancroft and it takes me 40 minutes. If you get it timed right in the afternoon, you might wait 15 or 20 minutes and you’re in.”
But he can’t always go to Bancroft.
He said he’s inquired with Health Care Connect about finding a doctor closer to his home, but the process would put him in a precarious position.
“The Health Care Connect, I called them and told them about the doctor we have now. She said the only thing you can do is sign off with her completely and then we’ll put you back on the list to look for a new doctor,” he said. “And I said, ‘what do I do in between for my medication and stuff? [She said,] ‘Well, you’ll have to work it out.’ Which makes no sense.”
Ayotte said his preference would be to have a doctor in Haliburton and wishes the government would put more of their resources in building up smaller health centres, rather than focusing on the large ones.
Both Kimberley Robinson in Haliburton and Alan Howard in Kinmount say their facilities and the surroundings have much to offer a doctor who decides to move to the Highlands.
A full complement of patients is available in facilities that are ready to go.
Robinson highlighted the benefits of living in the area and the incentives available for someone coming to work with the Haliburton Highlands Family Health Team.
“The Highlands are an amazing place to raise a family with a plethora of activities to keep everyone happily busy,” Robinson said. “There are countless trails for use year round, beautiful waterfront, great food, proximity to larger centres and a strong medical community. There are a number of financial incentives for new physicians moving to the area including a return of service grant (local initiative through the county of Haliburton), northern and rural recruitment and retention initiative (MOHLTC), and income stabilization (MOHLTC), to name a few.”
She said the clinic is turnkey with a staff of nurses and administrative support and no equipment to purchase.
Haliburton County is in the midst of budget talks, during which they will consider whether to hire a recruiter.