Thousands of aging Ontario physicians planning to retire

Doug Williamson, Windsor Star
http://www.canada.com

When Dr. Ciaran Sheehan came to Essex in 1979, he got involved with with a kids’ Saturday morning soccer league.

“I had about eight, ten other guys that helped me with it,” Sheehan, 60, recalled Tuesday. “I’m the only one of those guys that’s still working, and they were all my age or younger and yet I’m the only one that’s still working.”

Sheehan is one of several thousand Ontario doctors who are getting close to retirement age. As the age of physicians increases, there is growing concern about the supply of this profession before enough new replacements can come into the fold.

According to a new survey, six per cent of Ontario family doctors and seven per cent of specialists are planning to retire in the next two years. The National Physician Survey also shows that doctors are already working very long hours, and 26 per cent of family doctors in Ontario are planning to reduce their workloads in the next two years as well.

There are 20,000 doctors in this province.

The survey of 19,239 doctors across Canada showed that doctors are worried about their patients’ access to specialists and other forms of treatment. For example, 71 per cent of family doctors in Ontario ranked access to psychiatrists in this province as fair to poor.

Dr. Janice Willett, president of the Ontario Medical Association, said 20 per cent of provincial physicians are aged 60 and older, and 2,500 are planning to retire in two years.

She said they are already working an average of 53.9 hours a week, and can be on call for up to 130 hours per month.

“That’s over 80 hours a week to provide physician services. That’s a pretty big amount of work,” Willett said.

“When you see how many of our physicians in Ontario are over 60, and we’re trying to find a way to retain them in the workforce, if we’re presenting them with a workload that’s that high we probably aren’t going to get to keep them in the workforce.”

The looming shortage of family doctors and specialists is echoed locally. Windsor-Essex has a total of 435 doctors. We are short 257.

This area should have 289 family doctors but has only 163.

Other critical shortages are in: psychiatry – we have 24 and are short 22;   general surgery – we have 15 and need 14 more; and medical oncology – we have seven and need 14 more.

Willett agreed that while the provincial government has created more medical school spots, more are needed. And because of working conditions, it can be difficult to retain doctors in this province. In fact, three per cent are planning to move to another jurisdiction.

“When you look at the trends of workload, we’re very concerned we’re not going to be able to retain the physicians,” said Willett.

Doctors can only spend an average of 33.6 hours a week on direct patient care as it is, Willett said. “There’s a big gap where physicians are doing something else related to the patient’s care.

“They’re spending their time chasing down lab results that aren’t available to them, they’re hunting and pecking for all this stuff. I’m surprised at how many hours a week that’s taking on average.”

Also, doctors have difficulty getting more access for their patients. “We do need to make our system more approachable for the patients.

“If I have to go and try to move up a patient’s test three times because it’s so long and they’re getting sicker, that’s taking a significant amount of time away from patient care.”

Willett said there is a need to create a more “moderate” work environment for new doctors – “fewer hours or less frustration.”

“We do know that doctors are getting burned out. Some physicians are retiring when they get burned out, others are just adjusting their workloads.”

Sheehan said he has an office patient load of 1,500, and he takes care of palliative care patients as well as consulting for the Hospice of Windsor. He also puts in dozens of hours per week being on call in case any of his patients go to the hospital. He said he has committed to his patients that he’ll work full-time until he’s 65.

“My practice has been closed (not taking new patients) for a good number of years,” Sheehan said. “The only new patients I accept are those who come from patients of mine already who plead to take their relatives, which I try and limit. But if somebody phones my office there won’t be an opening for a new patient, because I’m just not able to take on any extra work.”

Sheehan said he believes the new breed of doctors simply isn’t interested in putting in the hours he’s accustomed to. “I don’t think they do, and the number of the female physicians have young families, so they’re not capable of working those hours.”

He thinks the situation locally will get worse before it gets better.

“The time it takes to refill the pipeline – they just don’t have the time for the number of docs leaving. This is going to take an awful long time before it catches up.”

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