Hi Everyone, 

I'd like to thank everyone for their support and patience.  A number of colleagues were wondering if they were eligible to sign The Family Doctor's Pledge.  From the information I have gathered thus far, I developed the following framework to help guide Family Doctors in their decision to sign the pledge.   I will be converting the whole pledge into a faxable document to try and reach more Family Doctors across the province.  In the meantime, please continue to share the pledge.  

Definition of a Vulnerable Clinic:

A vulnerable clinic is an individual or group family medicine practice at risk of closure within the next five years. The viability of these clinics hinges on several factors, notably the well-being of the family doctors and the financial stability they offer to a clinical practice through their OHIP Billings. Group clinics with vacancies for new Family Doctors are particularly vulnerable to closure in the next 5 years due to the shortage of Family Doctors.  Compound below inflation revenue increases, and an OHIP billing system designed not to pay out, there comes a point when a clinic or Family Doctor must close their practice.  One may not realize it, but your clinic may be vulnerable to closure in the next 5 years.  Join The Family Doctor’s Pledge if you select one or more of the indicators below.

Key Indicators of Vulnerability:

Human Resource Shortage:

• Doctor Attrition: The loss of family doctors, leading to increased patient loads and orphan patients.
• Recruitment Challenges: Difficulty in replacing retiring doctors or attracting new graduates to comprehensive family medicine.
• Burnout Rates: High burnout rates among family doctors affecting the ability to provide services.

Financial Pressures:

• Rising Operational Costs: Expenses exceeding revenue, inability to offset cost increases with medical service fees.
• Ownership and Overhead: The challenges of clinics that do not own their property, particularly with unpredictable rent increases by landlords, or renovictions.
• Clinic Size and Funding: Small group practices, especially those with less than six physicians, facing amplified financial strain due to funding changes and cost inflation.
• Revenue Streams: Reliance on increasing patient rosters to compensate for financial cutbacks, and declining net income due to inflation.

Infrastructure and Operational Risks:

• Facility Issues: The need to relocate due to inadequate or failing clinic infrastructure.
• Landlord Relations: Complications arising from difficult or unresponsive landlords.

Interpersonal Dynamics:

• Inter-Office Conflict: Disagreements among physicians that could necessitate the relocation or dissolution of practice.

Corporate Involvement:

• External Ownership: Clinics operated by publicly traded companies, non-physician private equity, or international investors, which may introduce additional complexities to clinic operations.

Impact of Vulnerability:

• Increased Patient Wait Times: As clinics struggle to maintain operations, patients face longer wait times for appointments.
• Continuity of Care: Vulnerability can disrupt the consistent and reliable delivery of care to patients.
• Community Health: The closure of clinics affects the health of the community, especially in areas with few medical resources.