Tillsonburg council looks at physician recruitment options

Jeff Helsdon, Editor

Tillsonburg council voted for some changes to how it attracts physicians, but will not move to a municipally-employed physicians’ model, such as the one in Colwood, B.C.

Colwood, which made national news last year with its physician model, directly employs physicians. After the model garnered attention, Tillsonburg council passed a motion last fall to examine the possibility of such a model operating in town with the current shortage and looming retirement of a number of physicians.

Peter Raji, the town’s Manager of Innovation and Strategic Initiatives, presented council with a comprehensive report looking at the Colwood model and other possibilities in Tillsonburg at the March 23 meeting. Raji said replication of what is done in British Columbia isn’t possible in Ontario due to differing regulations. He also noted even if it was possible, the strategy would not be cost-neutral.

“Physician recruitment advantages of municipal employment remain unproven,” he wrote. “While physicians value reduced administrative burden and predictable income, there is no evidence that municipal employment is attractive enough to physicians as a trade-off to independence and autonomy of business ownership.

Instead, Raji recommended the town form a regional recruitment alliance with Oxford County and other neighbouring municipalities to pool incentives, coordinate marketing, and reduce competition between local municipalities. He also recommended building on the partnerships with the Tillsonburg District Memorial Hospital and the Oxford Ontario Health Team.

The report in detail

Raji’s report looked at other models used in Ontario, noting that Norwich’s municipally-operated, physician-owned clinic historically operates at a deficit, and the County of Brant has a municipally-owned corporation that acts as a landlord for physicians.

Raji presented several options in his report, which included a clinic such as the one in Colwood. His examination estimated a Tillsonburg clinic using this model would need at least eight physicians and would cost between $4.2 and $8.1 million, in addition to operating costs in the $1-million range and a likely operating deficit the first five years. (Option A) Noting the regulatory challenge and cost, he didn’t recommend this model.

“If we went that route, we would end up with a massive expense. At the end of the day, costs don’t deliver on the value we would receive,” he said during the meeting.

Responding to a point raised by Mayor Deb Gilvesy, Raji also agreed that the clinic would end up serving patients from outside Tillsonburg, although the town’s ratepayers would bear all the costs.

“If you are opening a medical clinic in Tillsonburg, the doors are open to anyone from anywhere. You can’t restrict it,” he said.

A municipally-owned facility would require the same captial outlay for the building as Option A.

The Tillsonburg Community Health Care Advisory Committee viewed the report at its March meeting and advised going with Options C and D. Option C, which is moving to the regional recruitment alliance, and Option D, which is continuing with the present initiatives. These still come with costs, though. Option C includes already-budged staff time and to-be-determined costs for a future dedicated physician recruiter. Option D’s costs are also already budgeted and include staff time, $70,000 of available physician incentives and $30,000 for marketing.

“There is a little more we can do to support residents,” Raji said. “We can pool our resources together to be able to make a little more of a significant change, rather than just us leading this.”

Coun. Kelly Spencer said the report helped people on the health care committee see the options.

“It’s important to look outside the box, and I’m really grateful for the suggestions brought forward,” she said. “It’s a great point that medical clinics can receive patients from all over. We know a lot of people in our communities are heading to cities, St. Thomas etc. to get their doctor. When it comes to working collaboratively in Oxford County, we need to keep that in mind. We should support each other, not just Tillsonburg.”

Council’s passed resolution was to support Options C and D.