More than 53,000 people in the Hamilton area dont have a family doctor, with research showing the crisis is getting worse.

Data from Ontario research group INSPIRE Primary Health Care shows the number of residents without a family doctor has increased to 53,288 in 2022 from 49,338 in 2020 in the Greater Hamilton Health Network, which includes Hamilton, Haldimand and Niagara North West.

The message is a really clear one that all Hamiltonians deserve a family doctor its essential to their own health and the health of the system overall, said Dr. Cathy Risdon, a Hamilton family doctor and a professor of family medicine at McMaster University. The situation in Hamilton is worsening. Weve seen an increase in the number of patients without access to a family doctor ... and, of course, its the people who really need care that are disproportionately impacted by the family physician shortage. Im just worried about whats going to happen to those people if we cant get them a family doctor.

Premier Doug Ford was at McMaster on Thursday to highlight the $33 million over three years that has been earmarked to expand Ontario medical schools. He was joined by Health Minister Sylvia Jones and Finance Minister Peter Bethlenfalvy.

The provincial cash that was set out in the budget tabled on March 23 adds another 100 undergraduate medical school seats and 154 postgraduate medical training seats beginning in 2024. The spots are prioritized for Ontario residents.

When it comes to health care, we know the status quo is no longer acceptable, said Ford. Too many people are waiting too long for surgeries, having to travel too far to see a doctor or spending too much time navigating our health-care system.

But educating more doctors doesnt guarantee they will go into primary care. For the second year in a row, McMaster has an unusually high number of family doctor training spots left empty after the first round of matching.

As of March 22, McMaster had 11 unfilled spots for family medicine residencies compared to 18 after the first round last year.

In the past, the university has generally had five or fewer unmatched spots for its roughly 87 family-medicine residencies for medical school graduates and 14 more for foreign-trained physicians.

Its a national concern, said Risdon. The government has recognized the need to replenish the family-medicine workforce and its investing in new training spots. But without the changes to the practice environment, learners are voting with their feet and are not making a family medicine career choice. I really strongly believe we offer an absolutely fantastic training experience. What we need is for the practice environment to be equally enticing and attractive.

Last year, McMaster was able to ultimately fill all of the unfilled primary-care residencies during the second round of matching. However, 12 of them were in Hamilton compared to none left unfilled in the city this year.

The current open spots include six in Kitchener-Waterloo, two in Brampton, two in rural Mount Forest and one in Six Nations.

Risdon says there are straightforward solutions to making family medicine an attractive specialty again.

The first is to invest more in team-based care that consists of a number of health-care professionals working together instead of solo family doctor practices.

Training as a family doctor in a team-based environment definitely adds to the career satisfaction, said Risdon. The majority of Ontarians do not have access to team-based care, and family docs running a solo practice without that kind of support are getting extremely burned out.

Next is to relieve some of the administrative burden on family practices, which Risdon says has increased sharply particularly third-party forms.

The joyous part of being a physician is caring for patients, said Risdon. But the amount of time we get to spend doing that has shrunken considerably.

Last, Risdon says there needs to be better co-ordination in the health-care system so family doctors dont spend excessive amounts of time advocating on behalf of their patients.

Risdon gives the example of a patient who needs to see an orthopedic surgeon. Family doctors may have to contact seven different doctors before one agrees to take on the patient with little or no explanation of why the others turned them down.

The lack of co-ordination in the health-care system is really an enormous burden on family docs, said Risdon. I want my patient to get care, but in the absence of a centralized referral theres almost no way for me to know how to connect that person. So me and my staff deal with endless numbers of phone calls, frustrated patients and just a lack of clear access to other services.

The issue is significant because family physicians play a key role in knowing their patients full history and helping them navigate the system.

I can detect diseases early, I can co-ordinate care, I can understand when a person might need a specialist or if theyre coming in with something that weve dealt with before, said Risdon. The family doctor is just so core to the persons life and, in the absence of that, theres nothing else in the system that can replace it.

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More than 53000 Hamilton area residents have no family doctor - Hamilton Spectator