“Code Grey” is one in a series of stories in The Lake Report about health care in Niagara Region. In hospital parlance, “Code Grey” means loss of essential service.

The Niagara region needs to attract 91 more family doctors to meet the needs of its residents – and NOTL needs at least three more, town councillors heard last week.

Jill Croteau, a physician recruitment specialist with Niagara Region, gave council’s committee of the whole a grim overview of the doctor shortage in Niagara-on-the-Lake and the entire region.

The region has a population of about 477,000 and if every doctor has a practice of 1,380 patients, then the region should have 346 family physicians.

Currently, Niagara has just 255 family doctors – and the shortage could soon worsen.

Croteau said 17 per cent of Niagara’s doctors are over 65 and expected to retire within the next five years. 

Those doctors have more 58,000 patients, Croteau said.

“Over the next three to five years, those 58,000 patients will need to be realigned with a primary care provider as their physician retires,” she added.

The current roster of 255 family doctors serves 322,000 people, or 67 per cent of the population.

This means almost 155,000 people in Niagara are potentially without a family doctor. 

Croteau said many doctors also provide care to patients outside their practice and that some patients seek primary care through community health centres instead. 

When these patients are considered, that figure drops to about 117,000.

According to the data Croteau shared, about only about 10,500 of NOTL’s 19,000 residents are enrolled with a family doctor.

That means NOTL needs 14 doctors to serve every member of the community, she said.

With 11 doctors, it is three short of what is required.

Lord Mayor Gary Zalepa said that estimate is probably low.

“It’s probably four,” he said.

He pointed out that losses caused by retirement, burnout and other factors could exacerbate the problem.

“If you’re not recruiting, you’re shrinking,” Zalepa said.

In 2022, Niagara was a revolving door for family doctors.

Croteau said 19 new doctors entered family practice and 19 more left.

Over half of those who left had no successors at their family practice, she added.

While “it is getting a bit better,” pandemic-caused burnout is still affecting recruitment of family doctors, she said.

“We’re seeing a lot more family doctors choose to work in the hospital or a salaried model such as the community health centres,” she said.

There also aren’t enough graduating doctors to fill all the job openings

“Approximately 400 family medicine residents graduate each year,” said Croteau. “We have about 1,800 jobs to fill.”

Niagara has to recruit a lot of doctors from abroad, at schools in Ireland, the United Kingdom and the United States because of the gap between the number of Canadian medical school graduates and the number of open positions for them.

“For the Niagara physician recruitment program, a large component is marketing,” Croteau said. 

“A big part of our strategy moving forward is to expand our outreach into the U.S., U.K., Ireland and Canada,” she said.

She added that the region needs to get the message out on “all the opportunities we have here in Niagara.”

“A five to 10-year regional recruitment strategy, I think, would be beneficial,” Croteau said.

Coun. Sandra O’Connor was concerned whether the region was considering the town’s population of seniors in their estimate of how many doctors each town needed.

“Niagara-on-the-Lake has the highest number of seniors at 65 years of age and greater, at 35 per cent,” O’Connor said.

“When you have more seniors the cases are more complex and more time is needed, hence more physicians are needed,” she said.

Croteau also noted most family doctors were no longer accepting patients but O’Connor said it is “much worse then it seems.”

“The wait list is so long at the Niagara North Family Health Team that they’re no longer accepting names for their wait list,” she said.

Moving forward, council has decided to continue working with the region’s physician recruitment program to expand outreach and develop a long-term recruitment strategy. 

Council also agreed to make it a priority for this term’s strategic plan, though it has yet to complete that plan.

“It’s a tough hill ahead,” Zalepa said.