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Home My WebLink AboutCL 09-03 Ûú¡o~ REPORT TO COMMITTEE OF THE WHOLE Report Number: CL 9-03 Date: March 13, 2003 From: Bruce Taylor, AMCT, CMM City Clerk Subject: Rouge Valley Health System - Enhancement of Medical Services in the City of Pickering Recommendation: 1. That Clerk's Report CL 9-03 regarding the letter from the President and CEO of the Rouge Valley Health System respecting the enhancement of medical services in the City of Pickering be received. 2. That the Council of the Corporation of the City of Pickering hereby makes application to the Ministry of Health and Long Term Care to be declared as underserviced in regards to the number of family physicians operating within the City of Pickering. 3. That copies of Report CL 9-03 be forwarded to the Ministry of Health and Long Term Care, the Honourable Janet Ecker, MP, Pickering-Ajax-Uxbridge, the Durham District Health Council and the President and CEO of the Rouge Valley Health System. Executive Summary: In a letter from the President and CEO of the Rouge Valley Health System, it is recommended that Council apply to the Ministry of Health and Long Term Care for the designation of being underserviced with respect to the number of physicians in the community. Financial Implications: Not applicable Report CL 9-02 Date: March 13, 2003 Subject: Rouge Valley Health System Underserviced Designation Page 2 Background: Please find attached to this Report a letter from the President and CEO of the Rouge Valley Health System recommending that Council make an application to the Ministry of Health and Long Term Care to be declared "underserviced" with respect to the number of family physicians in the municipality. Also attached is a "Briefing Note on the Need for the Communities of Ajax and Pickering to be Declared 'Underserviced' for Family Physician Services". The minimum standard set by the Ministry of Health and Long Term Care for family physicians in a community is one doctor for every 1, 380 residents. The latest statistics show that there is a ratio of one family doctor for every 2, 293 residents in the City of Pickering. The benefits of Council making an application to be declared "underserviced" are: . Access to the Ministry's recruitment incentives for physicians, which includes listing on the List of Areas Designated as Underserviced . Listing of vacant positions on the Ontario Medical Association's Physician Job Registry on the Internet . Participation in the Ministry's Annual Health Professionals Recruitment Tour . Access to the services of the Community Visit Program. If the number of physicians needed in Pickering have not been recruited after one year, an incentive grant may become available to a physician moving to the community. Other incentives include grants to medical students who conclude their training in the designated community and provide service in that community for four years after graduation. Attachments: 1. 2. Letter from President and CEO of Rouge Valley Health System Briefing Note on the Need for the Communities of Ajax and Pickering to be Declared "Underserviced" for Family Physician Services Prepared By: ,,/7 ,."/ ;~" ~ /7 y' Bruce Taylor City Clerk Report CL 9-02 Date: March 13, 2003 Subject: Rouge Valley Health System Underserviœd Designation Page 3 Attachments Recommended for the consideration of Pickering City Council 02/24/2003 15:22 Rouge Valley ~ Health System Ajax ami Plckerwg trea.i.tb Centre Centenary HI::J.lth Centre: Office of the President Tcl:(41biì,j.¡I.7227 FiIX:l41(,i2Hl..7l23 4152817323 RVHS CENTENARY SITE PAGE 02 A IT ACHMENT # L TO REPORT #.:.:=-.. h"'" it' i I July 25. 2002 Thomas J. Quinn Chief Administrative Officer The Corporation of the City of Pickering One The Esplanade Pickering ON L 1 V 6K7 i " I (Ii. p&tJ'-) «2f- CfIr'8 ! ! Dear Mr. Quinn: ! i This letter is to advise you of an opportunity for U¡¡¡ to work together to ¡ enhance medical services (physicians) to your municipality. As you w$1I know, the population of the City of Pickering is growing at a rapid rate.! Unfortunately, the growth in the number of family doctors has not keptlpace with population growth. The Mini¡¡¡try of Health and Long Term Care h~s been using the ratio of one doctor to every 1,380 persons as a mjnim~ standard. The latest statistics show there is a ratio of one family doctC¡r to every 2,293 persons living in Pickering. We believe this ratio Is too high to meet the ongoing health needs of this community. Communities are el~gible to apply for the desÎgnation of "Underserviced" once the Ministry minÎt11um standard is exceeded. Using ¡¡¡tatistics from the College of PhySicians/and Surgeons, at least 18 more family physicians are required to meet thei minimum number to provide adequate famIJy physician care to your! oommoo~ I I I Services from family doctors are of primary importance In maintaining ~he ongoing health of local residents. Family doctors also become Involv~d In emergency and pther hospital services provided to the community in '4'hich they set up practices. Rouge Valley Health System provides services!to about 57% of the community 01 Pickering. Currently our organization Is concerned about the availability of family physician services to these ¡ residents. There is an Issue we belíeve needs to be addressed by th~ City of Pickering as well as by the Rouge Valley Health System to ensure th* a reasonable level of medical service remains available in the local community. I ; The benefits to being declared underserviced by the Ministry of Healtij and Long Term care are; i . access to MOHL TC recruitment incentives for Ph. ysicíans, which ì~'CUde:!$ listing on the LADAU. (LIst of Areas Designated as Underserviced~: . listing of vacant positions on the Ontario Medical Association'¡¡¡ Physician Job Registry on the Internet; I . partìcipation in the Ministry's Annual Health Professionals Recruitment Tour, and ! . access to the services of the Community Visit Program. ! I j I ¡ i Centcn;¡ry Health Centre Site .?U67 EJIesmere Road. Toronto. OntilliO ¡\HE 4B9 Tel: (416)284'8~31 , I ! 02/24/2003 15:22 4162817323 RVHS CENTEN~RY SITE PAGE 03 ATTACHMENT#-L TOREPORT#.££. 1- (;"3 ¡ If the number of physicians needed has not been recruited after one ~ar, an incentive grant may become available to a physician moving to the community. Other incentives include grants to medical students who ¡ conclude their training in the designated community and provide servicle in that community for 4 years after graduation. : Several communities within the Durham Region, such as Uxbridge,' ! Beaverton, Bowmanville, Sunderland, and Port Perry have already be," declared underserviced or are in the process of applying for this desiglflation. The application process to the MOHL TC must be initiated by the munifipality seeking underserviced designation. Communities can join together in ~heir effort, but one municipality must take the lead role. ì We are asking tf the City of Pickering is prepared to support the appli~tion process to the Ministry of Health and Long Term Care for consideration of the designation of Underservicad. ; I i If you are, Rouge Valley Health System i$ prepared to work with you tÓ complete the necessary documentation for submission to the MOHL Tit, and obtain support from local health care professionals and the District He4tlth Council. We beHeve this would assist In recruitIng the necessary physIcians to this community. ' ¡ ì We have attached some further information for your consideration. a~ ask to meet with you to discuss this very important issue. ¡ Yours truly, ,,-Jr¡¡' Hume Martin President & CEO cc: Dr. Norma Baker, Chief of Family Practice, RVHS Linda Hessey, Executive Director. DHKPR, DHC Dr. Fathi Abuzgaya, Chief of Staff, RVHS PAGE 04 RVHS CENTENARY SITE 4162817323 62/24/2003 15:22 hrTACHI"IEN~ ft~.TOREPORT#Lâ) I j I Briefing Note on the Need for the Communities of Ajax Jnd Pickering to be Declared "Underserviced" for Family Phy~ician , , Services i i I í I I I I i I I i I i I I I I I I I I I I I i I Prepared by Elinor Lamey University of Toronto Resident July 22, 2002 Introduction I i I Tbe;re is a shortage of family physicians in the Ajax and Pickering area ,t~ meet the ongoing needs of the local population. Official designation as "Undene~ced" by I me Ministry of He:ùtllllnd LDOg Term Care is one opportunity to addresi ¡this issue. ì i i The communities of Ajax and Pickering have experienced and are experiencin~ tremendous population growth. Durham Region as a whole has seen a rapid growth me that is swpassing the growth for much of the rest of the province. The growth in the number þf family physicians serving the municipalities of Ajax and Pickering has not kept pace with thi~ , population growth. ¡ The Ministry of Health and Long Term Care has been using the ratio of one dJtor to every 1,380 persons as a minimum standard required by any community to meet its h Ith needs. The latest statistics show that there is a ratio of one family doctor to every 2.293 perso Uving in Pickering. We believe this ratio is too high to meet the health needs of this conun, 'ty. Communities are eligible to apply for the designation of"Underserviced" once this exceeded. Using statistics wm the College of Physicians and Surgeons, at least 18 ' : re family physicians are required to meet the minimum number to provide adequate care to this: I community. Ajax requires six more family physicians to meet the minimum ratio. . ì ' The demand for specialists is also great for Ajax ~d Pickering; however, acco1ding to guidelines oftha Ministry of Health and Long Tenn Care, Community Development Program, I southern comm.unities do not receive financial support in recruiting specialists. i .02/24/2003 15:22 4162817323 RVHS CENTENARY SITE Introduction ;:',TTAO.{f"iEt-.r- ;'f -~- TO REPORT # c t- 1- 0 ') -- Issue: Background PAGE 05 , -¡ According to Ministxy of Health ànd Long TeM Care sources, the benchmark t designating an area underserviced in Ontario is 1 physician to every 1,380 people. ¡ ~en combining the most current population infonnation regarding the and the number of 'vely practicing physicians, both Ajax, and Pickering exceed the ministry benchmark. Whit y. the next closest town in Durhatn Region, also exceeds this benclunark. (please refer to T Ie 2.) I. 1 ,02/24/2003 15:22 4162817323 RVHS CENTENARY SITE PAGE 06 ,'-. itf_E!'_. ., - ,. ') The population of Ajax and Pickering has seen a tremendous growth in the past five ~ears. The growth in the number of physicians has been steady, but unfortunately has not kept pace ¡ with the population growth, with the excq1tion of Pickering. The need for physiGians1Ïn PiCkering is higher than that in Ajax or "Whitby; therefore this city has a large "catch..~" need. (See Table 1) The City of Pickering has projected its population growth to be àppro~matelY 3- 4% per year.2 Population growth for the rest of Ontario was 6.1 % between the years <>If 1996 and 2001. Table 1: Population Data (Statistics Canada) City Population 1996 Population 2001 % Change in Net Average ~early five yean Change in P~sidan Numbers ¡ A.iax 64.430 73,753 +14.5% +1 i I Pickering 78,989 87,139 +10.3% +1.5 I ! Whitby 73,794 87,413 +18.5% +1 ! The municipality of Orillia has received a lot of support from the Community Development I Officer Program for family physicians with a current ratio of 1 physician to 448 peoplp, Uxbridge, with a much higher ratio 1 : 1241 also receives some support. , I Sunderland. Beaverton, BowmanviUe and Port Perry all are Durham municipalities listed i as nonUAP (Underserviced Area Program)or in the process of obtaining underservice4i status. : Orillia, Port Perry, Bowm.anvi11e are also listed as underserviced for 5Pecialti~, although the program states that southern communities are not eligible for financial support in rþcnriring specialists. 3 2 02/24/2083 15:22 4162817323 RVHS CENTENARV SITE À l K-î.:¡':>UKI #...:::...~. 1- o'~ PAGE 07 Table 2: Ratio of Number of Physicians to Population (JO01 census, 1999 Physici II info)4 ..~. P's +. s !Po .', IllatioD i I 156<J.21 229 .14 118 .16 1404 .89 1241.21 448.02 I *The total active physicians include all physicians practicing in specialties. The high t. umber likely indicates the specialists practicing at the hospital in Ajax. ..The number of family practitioners in Ajax and Pickenng varies ffom 85 ftom the{~ntario Physicians Human Resources Data Centre to 96 listed on the College: of Physicians an~ Surgeons website. % :ioU Although some infQnnation lists FamHy Practitioners and General Practitioners s arately. for the purposes of this docmnent. they are combined as their functions arc generally e same. I I I I :Reported Difficulty in Obtainht,g Physician Services I I According to a recent survey conducted by the Rapid Risk Factor Surveillance 6ystem. ¡ Durham Region Health Department, 17% of those surveyed reported difficulty in making an I appoi1J,tInent to see their fanilly doctor, mostly due to long waiting times. Half ofthos~ surveyed with difficulties ended up going to a walk - in clinic for services.5 I Another factor influencing the public's ability to acccss physician services is ~ lack of I public -';1 which would allow people to access services io Toronto. Some of the 1u1ation close to Toronto, may travel to T oto!lto for their services, Public Transit cum:ntly doe!¡ not cro.. the Pickering, Toronto boundary with the exception of Go Transit. Likewise. transit dÓes not cross the Aja:JC- wmtby border to allow access to physicians there. This would not be algood solution in any case, as the shortage of family practicioners is jU$t as evîdent in that .unity. According to a recently published study conducted by the Canadian Institute fo~ Health Information., the aging òfphysicians and the increase of women in the ranks OfPhYSiCi~ has ! I I I I i I r .vealCity *Total Adive I Physicl.au 86 48 134 106 Total Active Physicians! Population 857.59 1815.40 1131.11 824.65 Ai ax Plckerine AiaxlPl~kerinfl Whitby Uxbrid2f Orillia POPUbtiOD, 1**Family 2001 I Practitioners / (GP's.;. FP'i5) 73,753 47 87.139 38 160,892 85 87,413 62 3 02/24/2003 15:22 4162817323 RVHS CENTENARY SITE PAGE 08 'i ~ CL 1-c '3 had an impact on the availabilityofphysícians. Female physicians tend to work less ~han male3 especially in their 30's and early 40' s (child bearing years). Tnerefore the actual num~er of physicians needs to be tempered with the infonnation about gender and age to get a sepse oillie workload that the physicians will be able to handle. ,figure 1; Number of Family Physicians in Ajax and Pickering, by age and gender. N um ber of PhysicIans in Ajax and Pickering, by Age Group and Gender ~ . "~ 0 c: 20 j ~ .. . e in 10 ~.È' 8 Z Q" 0 ~j 30-38 <0...9 &0-$0 10-&1 70-" Age Group ¡.".m."'. CIIM.". I Of the ninety-six physicians that are listed on the College of Physicians and Surgeons '}Vebsite as actively practicing in Family Medicine. only 15 are currently accepting new patients. There were no physicians under the age of 30 listed. The majority of physicians are male, atili OV~ the age of 40- The largest group of female physicians is comprised of women in the 30 -3fJ age group. It is critical at this time to move ahead with a strategy to encourage family praoiiûoners to set up practices in the Aj ax Pickering area. Although it appears that there has been a. l,ge influx of younger physicians, many oilliese are females who are Wllikely to manage as largeia : workload as their male counterparts. The populations ofboth Ajax and Pickering have þwn at a faster rate than the rest of Ontario, and therefore the demand for physician services is greater than the supply. Efforts must be made to recruit physicians who will stay fo~ many ye~ as there: are many physicians in the oldèr age categories that will retire in the next decade.! 4 02/24/2003 15:22 4162817323 RVHS CENTENARV SITE PAGE 09 ¡ I I I I I , lIeu.ills of U Dderserviced DesignatioD I There are several benefits to being designated as 'imderserviced". They are lifd as ÎoUows: . Ministry of Health and Long Term Care recnútment efforts such as postin on the websn.. in the job registry. I . tuiti~n grants to final medical school graduates in exchange for 3 - 4 years return of serv1CC. . opportunities for location incentive grants. In addition: . . . Community Development Officers are available to help communities develbp recruitment and retention strategies. . Physicians may be reimbursed for travel expenses in Ontario to visit a desi fed UAP community to assess practice opportunities Options I There arc two options when considering this issuc. The first is to support the city of Pickering and or the Town of Ajax by working together to complete necessary doc1ltn I tation as the first step in obtaining the underserviced designation. The: second option is to not p caed with the underserviced designation application and continue solely with recmittncnt e orts underway currently through the Rouge Valley Health System. <~ C¿'7-()~ Option 1 Move to obtain designation as under serviced area Pros II Gain conununity support for this issue II Obtain MOH assistance for recruitment II In.crease the number of family doctors in Ajax and Pickering, and improve the heal services to the commW1Íty . Cons ! II We might be seen as desperate and therefore Wldesirable by family doctors lOOking.jo relocate II It is a long process ¡ 5 02/24/2003 15:22 4152817323 RVHS CENTENARV SITE PAGE 10 i'\/'A. J. é L ~J- úS Option 2 Do not apply for the underserviced area designatíon Pros $ Avoid being seen as having problems recruiting physicians I Cons 1 . Other methods will have to be employed in order to increase the number of d~. Thcsc: may be more costly and Jess effective than the process of application for underse . ced designation. Process for Obtaining Underservieed Designation The request for designation as an underserviced area must be initiated by the I municipality. Municipaliti.s caD join furc..; however, on. municipality must be dosiJwod as the lead or champion. Municipalities must be made aware of the impact of high pop4tion to 1 phYSician ratios for their community and their impact on the services of the hospital * communities demand. With fewer fænily physicians there are less physicians availabl~ for on- eall duties and emergency coverage. Therefore, patients must wait longer hours for Jergen.cy medical ~ or 1Iœtment in the hospital. This directly affects service to people Jiving r the commumtles. I An application mug. t be obtained fi:om the Ministry of Health and Long Term Cþre, completed and forwarded to them. I . I The criteria that mnst be met are: I . Accurate data on health professionals in place in the community now ! . Infonnatìon on the population and physiciæ1 -to-population ratio II . Evidence of previous recruitment efforts . A local demand for services and the ability to provide additional, supportive health resources II The support oflocal health care professionals . .. The support of the district health counci1.6 . An accurate completed application fonn. 6 02i24/2003 15:22 4152817323 RVHS CENTENARV SITE PAGE 11 I 2 I ¡{E'O¡n '# <:: L '7 - c ~ Reconunendation - ,I It is recommended that RVHS approach the municipalities of Ajax and Pick~ to obtain their support and commitment to proceeding with the necessary steps to deClare:re communities of Ajax and Pickering "Underserviced", The nranicipality must complete and forward the application to the Minisiry Offcalth and Long Term Care Underse1:VÍced Area Program for this designation. Rouge Valley Health System is prepared to support the municipality in this initiative. I 1'"(" . I Deborah Limoge, MOB: rcprescntati,ve in Sudbury, conversation in June 2002, :z City of Pickering wcbsìœ, www.citY.pickeOnl!'.on.ca 3 Community DevelopJIU!J::\t Officer Program website - www.cdoprogramcon'JIsouthemJlrogram.htm 4 Stat:îstics Canada Websiœ, www.statclln CJ - community profil~. ' Ontario Pb.ysicians Human Resource Data Centre. Active Physician Registty, 2000. $ RRFSS, Rapid Risk ¡::actor Surveillance System, Durlwn Regí.on Health Deparl:lnent, January to Dee ' II Ph)'1licians for Ontario Website- "The DistributioJ). of Physician Services in Ontario" bttp:/www. pairo. erg/me kendry I cbaptcrO5 .html elf 2001. 7 , !