County Docs Backgrounder

Q: What is the PEFHT?

A:Established in 2006, the Prince Edward Family Health Team (PEFHT or the Family Health Team) is a corporation that has a mandate to provide primary healthcare services to the residents of Prince Edward County. The Family Health Team has close to 40 staff and is comprised of allied healthcare providers like Nurse Practitioners, Nurses, Social Workers, Registered Dieticians, a pharmacist and administrative personnel. These team members work in concert with family physicians to support comprehensive, team-based Primary Care. The Family Health Team offers a number of different programs and services and have sites in both Picton and Wellington.

Q: What is the PEFHO?

A:The Prince Edward Family Health Organization (PEFHO/FHO or County physicians or physician group) is an association of all the family physicians practicing in Prince Edward County and was formed in 2006 along with the PEFHT. The collective has an agreement to provide Primary Care services in Prince Edward County and that includes staffing the Emergency Department in Picton on a 24×7 basis. The Family Health Team model that is operating in Prince Edward County is hallmarked by family physicians working with the different professions in the Family Health Team to share care for residents. The Ministry of Health allocates the number of family physicians in the physician group and that number is 23 family doctors. In this model of Primary Care, only family physicians can roster patients. Currently there are five vacancies for family physicians.

Q: Why Isn’t there Nurse Practitioners operating independent healthcare clinics like we see in Belleville?

A:The Primary Care model operating in Prince Edward County, established by the Ministry of Health, only provides for family physicians to have the ability to carry a dedicated case load of patients. Sometimes that is referred to as rostering patients. Our model is called a “Family Health Team/Family Health Organization (FHT/FHO) Primary Care” model. Nurse Practitioners cannot roster patients in this model

The Belleville Nurse Practitioner-Led Clinic is a different kind of Primary Care model. They were established to have patients register to their organization and consult with physicians as needed. The Family Health Team and the County physicians are reviewing what is possible to shift the parameters of the current FHT/FHO model in efforts to provide more Primary Care services to more residents. Collectively we recognize the incredible strengths and capabilities Nurse Practitioners bring to our community and healthcare delivery and want to foster everyone working to their full scope of practice. We believe we are in a crisis and recognize an all-hands-on-deck approach is needed.

Q: I have heard there is a shortage of all healthcare professions. Is that true for Prince Edward County?

A:The hard truth is simply stated: yes. Not only are we short five physicians, we are short Nurse Practitioners and Nurses. This is true province-wide. When services are delivered being short-staffed, burnout takes place and everyone is strained.

Q: Why is having a family physician so important?

A:Your family doctor is typically your first point of contact with the health care system in Prince Edward County. They are trained to diagnose the whole person and play an important role in you and your family’s health.

Q: How many patients do physicians carry in their practice

A: Every physician carries a different number of patients, but usually has a practice size around 1000, sometimes slightly higher or lower. This is really dependent on the other commitments and responsibilities the physician has. For example, particularly in rural areas like the County, our family physicians work in a variety of settings. These include caring for hospitalized patients, covering the Emergency Department, care at hospice or long-term care homes, as well as in support of clinical programs at the Family Health Team. These other responsibilities will also impact the number of days they are in their office and the number of patients they can carry.

Q: Are doctors business owners?

A: Yes. Most people don’t realize that the physicians in Prince Edward County run independent business practices. They hire their own employees, such as admin and nursing support, carry leases, and pay for clinic supplies. They do not get paid vacation or sick time, nor do they have paid medical benefits.

Q: Why do we need to recruit Drs?

A:Prince Edward County currently has five physician vacancies with more to come in 2023. Patients are falling through the cracks and being ‘orphaned.’ Orphaned means a person does not have a family physician.

Q: Why is physician retention so important?

A:While it is important to bring new physicians to Prince Edward County, it is equally important to keep the ones we have. This means we need to think about such things as workload, mentorship, and professional development. We also have to think about a physician’s personal values and fit with the community, including opportunities for spouses and children. Support from community partners is central to this goal.

Q: What is involved in recruiting a doctor?

A:There is no science to recruiting a physician. Our approach is to expand our reach to new physicians through job postings, advertising and presence at job fairs and conferences. We are also increasing our engagement activities with prospective physicians, in an effort to showcase the benefits of living and working in Prince Edward County. It’s important that both parties feel that it’s a good fit.

Q: Can the physician recruiter find me a doctor?

A:No, the physician recruiter’s role is to help recruit physicians to work in Prince Edward County. If you are in need of a family doctor you should register with Health Care Connect(https://www.ontario.ca/page/find-family-doctor-or-nurse-practitioner)

Q. What is Health Care Connect and why should I add my name to the Health Care Connect Wait list?

A.Health Care Connect (can be seen as “HCC”) is a provincial service that tries to match people seeking a family physician with physicians who are accepting new patients into their family medicine practice. The HCC list for Prince Edward County, as of December 2022, is approximately 1,675 people waiting for a family physician. We believe that number is much higher and would recommend and request our community members without a family doctor register themselves for one. It helps indiscussion with the Ministry of Health to potentially allocate more spaces for family physicians.

The one requirement for signing on the HCC wait list is that a person does not have a family physician. We have heard people do not want to give up their family physician who practices outside of the County in order to add their name to HCC. What we want people to know is that the person can still continue to see their family physician for care even if they are ‘giving up’ their family doctor to go on the HCC wait list. That family physician will only be paid differently to provide the same care while you are waiting for a new physician. It is important to discuss this with your existing family physician to be sure all are aware of the intent to obtain a local physician in Prince Edward County.

For more information about Health Care Connect and how to sign up, please refer to:https://www.ontario.ca/page/find-family-doctor-or-nurse-practitioneror call

1-800-869-8829.

Q: Does the Health Care Connect Waitlist Really Work to find me a family doctor?

A:Yes it does. The family physicians working in Prince Edward County do take people off the HCC waitlist and roster them into their practice. What has changed over the years is the increasing complexity of people’s healthcare status. This results in lower numbers of people being accepted into practices at one time, off the HCC waitlist, as it takes more time to stabilize a person’s health.

Q: What is the buzz with physicians and housing?

A:Accommodations in Prince Edward County have increased in cost significantly over the years and this has also impacted our ability to provide reasonably priced accommodations to locums and other medical learners. The County Docs Retention and Recruitment initiative has launched the Doctor Accommodation Network (DAN) to support Housing for locums and new physicians.

Q:Why are so many incentives offered to new doctors?
A:Financial incentives can be appealing to new medical graduatesand support them in setting up a practice where they may not have otherwise considered doing so.This is especially true when it comes to rural medicine. While these incentives and the competitiveness of them is an important strategy in recruitment, the overall fit of a community also plays an important role in decision-making and requires a collaborative community approach. County Docs is working on creating a competitive and comprehensive package for new physicians.

Q: How does the planning for the new hospital fit into Physician Recruitment and Retention?
A:Physicians and all other allied healthcare and administrative team members are needed to operate our current and future hospital in Prince Edward County. We feel a new hospital is a wonderful attractor for a new physician to join other physicians in Prince Edward County to practice family medicine.

Q: What else can I do to help?

A:There are many things that our community members can do to assist us in our success. These include, joining our Doctor Accommodation Network, support from our business community (financial and in-kind) – including restaurant, hotels, unique County experiences, lobbying your locally elected government officials to support the County Docs recruitment and retention program, donate to County Docs (portal is live on the Prince Edward County Memorial Hospital Foundation Website).

It is also equally important to look after you. Get vaccinated, live a healthy lifestyle and put your safety and those you love first.

Q. Has it always been a challenge to recruit new physicians to the County?

A.The simple answer to that is no. Since 2016, there have been 11 new family physicians recruited to practice in Prince Edward County. The challenges to find new physicians started in the pandemic. Comparable communities with mature physician recruitment programs appear to be making some progress at this time.

Q. I am without a family physician. Who do I go to for my health care issues now, such as prescription renewals?

A.It all depends upon what issues you may be having. Prescription renewals can sometimes be completed with the help of a pharmacist. There are also walk-in clinics in neighboring communities and sometimes virtual physician offerings can be an option for non-urgent care. The Prince Edward Family Health Team has a listing of both walk-in clinics and virtual care options athttps://www.pefht.ca/walk-in-care-clinics.php

If in an emergency, there is our local Emergency Room in Prince Edward Memorial Hospital.

-Staff

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