Provincial locum pool, expanded scopes of practice for NPs and midwives among wish list for Northern Ontario

In Northern Ontario, where about 800,000 people live in an area more vast than the state of Texas, improving access to primary and emergency healthcare requires a strategy with a single point of accountability, a process for measuring outcomes and a commitment to follow through on all actions within that strategy. A provincial pool of locums—similar to what’s available for schools in need of substitute teachers—should be part of this strategy, according to a panel of doctors who spoke at a virtual media brief hosted on November 1 by the Ontario Medical Association (OMA). “Our population has a lower life expectancy than the rest of the province of Ontario by two-and-a half to three years,” said Dr. Sarah Newbery, a family physician in Marathon, Ont., and associate dean of the Northern Ontario School of Medicine (NOSM), which has campuses in Thunder Bay and Sudbury. “We know that we have a significant burden of chronic illness and a significant burden of mental health and addictions. In fact, five of the seven public health units with the highest opioid death rate in the province of Ontario are in northern Ontario.” Of the 40 hospitals in Northern Ontario, 35 rely heavily on locums to fill emergency department shifts and to provide primary care services in communities where physicians are really stretched thin, said Dr. Newbery. Read: Locuming: avoiding the pitfalls A robust pool of locums is critical to retaining physicians in the North, she added. “We really need to move to thinking about locums as a retention tool for physicians in practice,” she said. “We want that robust pool of locums not because we want to increase the itinerant workforce, but because we want our physicians and communities to be able to have a break when they need it.” In addition to more locums, doctors in the North need supportive resources such as virtual technologies that would allow them to, for example, consult remotely with a specialist at another site. “That's a huge support,” said Dr. Newbery. “We now have an emergency department peer-to-peer program, which lets me pick up the phone and call someone in another place who can help give me guidance.” Having the support of a team would also encourage more doctors to practise—and stay—in Northern Ontario, said OMA president Dr. Andrew Park. “There has to be some support in your job and right now that's not what the typical physician in the North has and they're being stretched to their fullest extent,” he said. “Team-based care would be a great start.” Read: Doctors present suggestions to address Northern Ontario physician shortage NOSM president and dean Dr. Sarita Verma said expanding the scopes of practice for doctors, nurse practitioners, midwives and other healthcare professionals is “not a bad option” for Northern Ontario. The province also needs to invest in communication infrastructure, such as Internet broadband and Wifi, to enable broader delivery of virtual healthcare and support remote collaboration between Northern Ontario doctors and physicians, including specialists, in other locations. A solution to the lack of housing is also needed urgently, said Dr. Verma. “We have a shortage of housing, and physicians or locums or even learners need to have housing,” she said. “They need to have schools their kids can go to, they need to have great environments in which they have turnkey office operations, and they need to have jobs for their partners.” While locums are vital to Northern Ontario, one challenge with physicians who work short-term gigs is they often don’t make deep connections with patients. The ultimate goal, said Dr. Verma, should be to recruit doctors who will stay in Northern Ontario because they recognize the unique opportunities of practising in this part of the province. “We would urge for people to think about a better way of recruitment and retention that brings people to the North and it's not just based on remuneration,” she said. “It would based on the passion, the joy and the wonderfulness of being in the North which is, by the way, absolutely beautiful here today in Sudbury—absolutely gorgeous.” Read: Physician burnout: Solutions from someone who's been there, done that

Provincial locum pool, expanded scopes of practice for NPs and midwives among wish list for Northern Ontario

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