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Science Table: Pandemic exposed the crisis in health care

In its final report, the Ontario Science Table says health care in Ontario is facing a crisis because of the shortage of physicians and nurses was made worse during the pandemic
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The COVID-19 pandemic has made it apparent there is a serious problem for getting access to family doctors in Ontario.

That was one of the many findings published this week in the final report of Ontario's COVID-19 Science Advisory Table, which was recently disbanded by the Ontario government. 

The Science Table has published the report outlining some significant concerns with the state of health care in Ontario. One of those is access to health care and access to Primary Care Clinicians (PCCs).

The report said one in five Ontario residents could be without a family doctor by 2025. The Science Table quoted a report from the Ontario College of Family Physicians published on Sept. 13.

The report also stated that during the pandemic most Ontario residents who were diagnosed with COVID-19 had their cases treated and managed locally and it put an additional workload on local doctors.

"Family physicians have taken on multiple roles, including managing infections in the office and through remote care; supporting public health (e.g., by staffing assessment and vaccination centres); providing surge capacity in acute care settings; and supporting outreach to equity-deserving populations," said the report.

"In the later and ongoing stages of the pandemic, there has been extraordinary pressure to keep emergency departments (EDs) open. To this end, in many rural communities, family physicians practicing in the local primary care practice also provide ED services. Many rural family physicians have been asked to prioritize the ED and forego their offices to keep EDs open, further impacting workload and primary care delivery in many rural settings," the report continued.

Ontario is also being impacted by the shortage of nurses, said the Science Table. It reported more than 21 per cent of Ontario nurses in primary care report an intention to retire within four years. 

"Based on the unfilled positions in Family Health Teams (FHTs) for nursing and other interprofessional health care providers, the declining interest in comprehensive primary care likely extends beyond the physician workforce, signaling a need for a comprehensive approach to address shortages in all areas of HHR in the primary care sector," said the report. 

It said primary medical care in Ontario is facing a crisis because of the growing shortage of health care professionals. 

"The practice and capacity of primary care in Ontario have changed since the start of the COVID-19 pandemic. Primary care is facing an accelerating capacity crisis driven by trends in HHR (health human resources), varying models of care, and gaps in integration and coordination. These complex factors, when coupled with longstanding health system challenges, pose an ongoing threat not only to coordinated pandemic response and future pandemic preparedness, but also to routine health system functioning," said the report.

The pandemic has also changed the way many Ontario residents "visit" their physician. 

"In the first four months of the pandemic, virtual primary care increased dramatically, comprising 71.1 per cent of primary care physician visits," said the report.

It went on to say the level of virtual care went back and forth depending on the rate of COVID case counts. The suggestion was that patients and doctors both wanted to do telephone or video visits when case counts were rising.

The report said that research indicated overall positive experiences with virtual care among patients. For example, in one Ontario survey of 500 primary care patients, respondents overwhelmingly reported that telephone and video visits reduced time (97 per cent / 97 per cent), it reduced costs (81 [er cent / 85 per cent) and were more convenient than in-person care (91 per cent / 91 per cent).

"The majority wanted telephone (69 per cent) and video (71 per cent) visits at least as often as in-person visits post the COVID-19 pandemic, while only 5 per cent did not want any future virtual care.

Len Gillis covers health care and mining for

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Len Gillis

About the Author: Len Gillis

Graduating from the Journalism program at Canadore College in the 1970s, Gillis has spent most of his career reporting on news events across Northern Ontario with several radio, television and newspaper companies. He also spent time as a hardrock miner.
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