In interview with SooToday, Dr. Dominik Nowak pushes for health care teams, sharing of paperwork burden and easing pressure on hospital emergency rooms
A high-ranking Ontario medical official visited the Sault’s Group Health Centre Thursday to hear from stressed-out family doctors in an effort to fix local and provincial health care challenges.
Dr. Dominik Nowak, Toronto-based president of the Ontario Medical Association sat down for aninterview with SooTodayafter his visit to Group Health, which made national headlines afteraJanuary announcement that 10,000 GHC patients wouldbe de-rostered by May 31.
“I’m not surprised,” he said, when asked for his reaction to the announcement. “It’s the one that’s making the news."
“At the same time we’re hearing stories like this all over the province. On a health care system level we’re seeing that one in five people right now can’t find a family doctor and that’s soon to be one in four and that’s happening all across the province.”
“Sixty per cent of my colleagues are saying that in the next few years they're thinking of scaling back or leaving practice altogether, and in particular family practice. People are leaving for other provinces. It’s become, for many reasons, unsustainable for them,” Nowak said.
He said some family doctors are leaving their practices and going to work in hospitals, long-term care homes and palliative care.
“It’s not just retirements,” Nowak said of the family doctor shortage.
“A big part of it is related to administrative burden. Doctors are telling us they’re doing 19 hours of unnecessary paperwork every single week. It’s burning people out. It’s creating a grind. It’s making us live in a world where doctors are needing to pay attention to their computers and taking us away from caring for our patients, so a big part of the solution for recruitment and retention is creating a world where doctors can focus on being doctors. That’s what we signed up for. That’s what we’re trained for. I didn’t go to medical school to do paperwork and administration and work on my computer, I went to medical school to care for patients. That’s what I heard today [from GHC doctors].”
Nowak is familiar with those concerns as he, too, is a family doctor in Toronto.
There are also financial reasons some doctors are leaving the profession, Nowak said.
“The cost of running a practice has grown astronomically over the last few years. Inflation has risen and billing has increased by only six per cent. There's clearly a mismatch there. My colleagues are feeling crushed and this applies to family doctors and also specialists in the north where they’re hiring administrative staff, nurses, paying for rent and technology and the financial burden on practice is just crushing. That’s what I’m hearing from my colleagues.”
Nowak said GHC administrators voiced their support for their health care facility’s family doctors when meeting with them Thursday.
Nowak said there is a three-pronged solution to fixing the family doctor shortage in the Sault and across Ontario.
One part of the solution is the introduction of family health care teams.
“I see health care teams as one of the most important things that we can do. We can’t necessarily recruit and retain our way out of this crisis. Those teams can be led by physicians but team members can include social workers, pharmacists, nurses, nurse practitioners and other health professionals working together in creative ways to tackle this big crisis that we have at hand.”
Paperwork for doctors must be a shared responsibility, Nowak said.
“Let’s make sure we get that administrative burden, that unnecessary paperwork off the plates of doctors and let doctors focus on being doctors to care for patients and focus on what we were trained to do. A big part of that 19 hours a week of paperwork could be supported by other health professionals but also people who are trained in technology, or a social worker filling out some of those administrative forms. The answer to this is looking at things more creatively and distributing some of that workload.”
“Number three, let’s work on hospital emergency room overcrowding,” Nowak said.
“One of the reasons why our family doctors are feeling stretched is because our emergency rooms are overflowing and suddenly the people that used to be cared for in hospitals are being cared for as out patients in our offices and that’s such a challenging place to be.”
Nowak was clear in his opinion that it’s up to the provincial government to help by implementing that three-pronged strategy.
“We’re asking decision makers to step up. We need them to do everything it takes to get Ontario’s health care system back on track. I’m ready to work with the government and with decision makers to get things back on track. We’re in a health care crisis where people can’t find a family doctor, where people are waiting far too long in emergency rooms in hospitals and that’s why our government and decision makers need to step up and get our health care system back on track.”
Fixing the province’s health care woes is critical and life saving, Nowak said.
“People without a family doctor end up using the emergency department. They end up missing cancer screenings and other important diagnoses or getting diagnosed late. People who don’t have a family doctor are living shorter lives. Studies have shown that if you have a family doctor you’re living longer.”
“It’s important that decision makers commit to making sure everyone has a family doctor,” Nowak emphasized.
Nowak said there is still enjoyment in family medicine for doctors but their concerns need to be addressed.
“They want to practice. They’re feeling like they're contributing to people’s care. We’ve been meeting with doctors working at the Group Health Centre and hearing their stories and hearing some of their ideas for better health care and one of the things I heard about was their commitment to family practice in the community. That came out loud and strong.”
“The decision makers need to step up and remove those barriers to care and create a health care system where we can focus on caring for patients,” Nowak said.
The OMA president said he is hopeful the family doctor shortage can be fixed if there is the political will to do so.
“I’m an optimist but optimism includes realism. A big part of that realism is embracing that we’re in troubling times and unless the province, the decision makers, act now it’s going to get worse. I believe we can get there. We can get there. It’s going to take work. We’re advocating for what needs to happen but we need the decision makers to step up.”
