Is there a doctor in the house?

Natalie Smith is frustrated with a revolving door of walk-in clinics. The Kitchener resident has been on a physician waiting list since her doctor slowed down his practice four years ago.

“With acute problems, for example if you have injured yourself, the quality of care is great,” Smith says. “But if you have a history of issues, like my chronic sinus infection, every time I went [to a clinic], they would treat it like it was the first one because I was seeing a different doctor each visit.”

Kirstie Paterson of Kitchener moved to Waterloo Region last year from British Columbia. Her health concerns are made only more difficult because of physician shortages. The health-care gaps have her second-guessing her decision to move even though she paid more in the west.

“In British Columbia, we paid health premiums based on our level of income … In Ontario, we said goodbye to those payments and were happy to have the extra $50 a month we paid as a couple [in B.C.],” Paterson says. “Those payments are looking good right now.”

Smith’s and Paterson’s experiences are not unusual. According to Waterloo Region’s Vital Signs, the number of people without a family physician has increased from 6.1 per cent in 2007 to 9.2 per cent in 2009. This number is expected to increase considering that 25.4 per cent of family doctors in the area are nearing retirement age.

Published by the Kitchener and Waterloo Community Foundation and the Cambridge & North Dumfries Community Foundation, the annual report measures the vitality of the Region by assigning grades to 11 areas critical to quality of life. Waterloo Region received a C+ grade.

Some 20,000 residents in Waterloo Region are searching for a family doctor, according to the Greater Kitchener-Waterloo Chamber of Commerce. Mary Sue Fitzpatrick, a vice-president at the chamber of commerce, says she and her team have brought 38 family physicians to the area since 2006. They hope to recruit 16 more, but demand seems to be outstripping supply, and Waterloo Region’s rapid growth has put an increased burden on the system, she says.

“The younger physicians want work-life balance and take on fewer patients than the retiring doctors. This means for every doctor that leaves we have to find two more to replace them.”

The Region could see a few more doctors establishing medical practices here, however, thanks to a satellite of McMaster University's Michael G. DeGroote School of Medicine. Located at the University of Waterloo Health Sciences Campus in downtown Kitchener, the school graduated its first class of students last year. Four of the 2010 graduates are now completing their residency in Waterloo Region, and it is estimated that the school will graduate 450 students by 2012.

More physicians could also be recruited to Waterloo Region by looking internationally for candidates. Twelve years ago, the Kitchener-Waterloo Multicultural Centre started a group that helps internationally trained doctors get the information and support they need to recertify in order to practise medicine in Canada—and make their way to Kitchener and Waterloo.

Rukmini Pyatt, the group’s chair, is recommending that the province look at ways to accelerate the recertification process. She said she recognizes the importance of foreign-trained doctors updating their skills to meet Canadian standards but added that the five or even 10 years it can sometimes take individuals to obtain certification and licensing is too long.

Fitzpatrick is also concerned about the current practice of putting foreign-trained Canadian doctors — young local students who could not get into medical school in Ontario and subsequently studied abroad — into the same pool as doctors who have practised in other countries.

“They try to come back for residency, but are included in the international medical graduate category so they chase residencies in other countries and end up practising there.”

Getting physicians into the Region is one thing; being able to pay them is another. Finding a residency is a challenge for both Canadian- and foreign-trained medical professionals, Pyatt says. “Many of our doctor group members have qualified at all the levels of examinations but there are not enough residency spots.”

That comes down to money, Fitzpatrick says. “The province has to afford medical schools, then afford to fund residency positions and once those doctors graduate they have to afford to pay them.”