As Ontario faces a growing shortage of family doctors, a new study says one reason is that doctors are increasingly moving into specialized areas within hospitals, such as emergency medicine, rather than full-service family medicine roles.
The study, which analysed Ontario health data from 1993-94 to 2021-2022 and was published May 28 in the Annals of Family Medicine, found that while the number of family doctors per 100,000 people increased from 104 to 118, the number of family doctors providing comprehensive care decreased from 71 to 64.
Of the 6,310 new family doctors added during that period, about 40 per cent are working in “focused practice” areas — a trend the researchers call “concerning.” “It’s not about simply training more family physicians,” says Dr. Tara Kiran, a family physician and research director at St. Michael’s Hospital and the University of Toronto. “We have to get them to actually choose to be family physicians in their communities.”
In other words, the structural support and incentive design of the health-care system is key. She says better compensation for transitioning to a professional role is driving the reluctance to provide comprehensive care. The government is aiming for a “family doctor for all residents” by 2029, and an estimated 2.5 million Ontario residents currently live without a family physician. In response, the Doug Ford government has announced a $1.8 billion plan to strengthen primary care, with a goal of creating 80 new or expanded community-based team-based clinics and removing more than 300,000 people from waiting lists.
According to a spokesperson for the Ministry of Health, 621 students were matched in 2024 under the CaRMS (Residency Matching Program) for family medicine, up 113 from the previous year. There are also plans to recruit 1,500 new family doctors through new medical student scholarships for rural and northern areas and the ‘Practice Ready Ontario’ program. But the researchers warn that the supply shortage will persist unless the structural reasons for family doctors moving to specialties are addressed.
In particular, the proportion of families moving to specific specialties such as emergency medicine and addictions care has increased ‘significantly’ over the past 30 years. There are growing alarms that comprehensive, community-based primary care is disappearing.