The number of Islanders on the waitlist for a family doctor continues to rise, and it’s been exacerbated in recent years by population growth, recruitment struggles and departing doctors.
Three years ago, P.E.I.’s then-health minister James Aylward called the number of Islanders on the provincial patient registry “troubling”.
Back when Aylward expressed concerns, there were nearly 15,000 people on the registry. By May 2020, that number dropped to 12,324. However, it has since ballooned back up to 24,296.
In addition to the province’s existing difficulty recruiting family doctors, at least a half dozen family doctors on the Island have left their practices so far this year.
As of March 31, 2019, there were 83.5 full-time equivalent (FTE) family doctor positions filled.
As of March 31, 2022, there were 87.6 — but by the end of June that number had plummeted to 81.6 FTEs. At least one other doctor is known to have left his practice this month.
In the meantime, the province’s population has grown at a record pace.
Between 2019 and 2022, the population increased by 7.5 per cent. So the province may be down only two FTEs over that time period, but the number of Islanders per practising family doctor has grown to more than 2,000 from about 1,800.
Complement falling short
The province’s target for the number of doctors it needs may be too low, says P.E.I. College of Family Physicians president Dr. Heather Austin.
“It has been a concern to family physicians for many years that the means by which government determines how many physicians are needed to support the delivery of health services is outdated,” Austin wrote in an email to CBC News.
Calculating the need for family doctors is more complicated than just comparing numbers, Austin said.
And while the number of patients on the Island continues to grow, the needs of the province’s existing patients are also increasing, she said, which means more resources are needed to care for the same number of patients.
“Even without an increase in the population, the number of physicians and other health-care providers required within the system is greater,” she said.
The province continues to actively recruit family doctors.
The full complement for the Island (that is, the number of FTEs that are open) is 100, up from 95 in 2020.
Since 2018, the complement of family doctors has increased by five per cent — while over that same time period the Island’s population has increased by 10 per cent.
Impact of vacancies on FTE number
While the current complement may not reflect the growing population, the province is unlikely to increase it while so many positions are vacant, said Austin.
“Even though the numbers would show additional physicians are needed to provide adequate services to an area, as long as there are vacancies it is unusual that additional positions would be approved,” she said.
In an email to CBC News, the provincial government said the complement is determined by the health minister.
“[The minister] approves increases to the complement based on recommendations from the Physician Resource Planning Committee,” the email said.
“PRPC accepts applications/requests for changes to the complement, an analysis is conducted to see if a change is warranted, and then PRPC makes a recommendation to the Minister.”
The committee includes members from the Medical Society of P.E.I., Health P.E.I. and the provincial government.
A push for a responsive system
The Medical Society of P.E.I. believes it’s time for the province to move beyond the idea of a complement.
“We have long advocated to have it removed and rather make evidence-informed decisions based on the population health needs,” Dr. Pádraig Casey, president of the Medical Society of P.E.I., said in an email statement.
“We need to be responsive to our province’s changing needs.”
The society is working with the province to develop a new system for physician requirements, Casey said.
CBC News asked the Department of Health if the current complement of 100 was high enough given the growing population, but the government email did not offer a response to that question.