200804 Physician AGDThe Corporation of the Town of Tillsonburg
Physician Recruitment & Retention Committee
August 4, 2020
12:00 p.m.
Electronic Meeting
AGENDA
1.Call to Order
2.Introduction of New Member
3.Adoption of Agenda
Proposed Resolution #1
Moved by:
Seconded by:
THAT the Agenda as prepared for the Physician Recruitment and Retention
Committee meeting of August 4, 2020, be adopted.
4.Minutes of the Previous Meeting
Proposed Resolution #2
Moved by:
Seconded by:
THAT the Minutes of the Physician Recruitment and Retention Committee Meeting
of February 4, 2020, be approved.
5.Disclosures of Pecuniary Interest and the General Nature Thereof
6.General Business & Reports
6.1 New Models of Primary Health Care- Cephas Panschow
6.2 Funding- SW Public Health Daily Update July 2, 2020- Sandy Jansen
6.3 Updated Recruitment Matrix and Contract- Kyle Pratt
7.New Business
8.Roundtable
9.Next Meeting
10. Adjournment
Proposed Resolution #3
Moved by:
Seconded by:
THAT the August 4, 2020 Physician Recruitment and Retention Committee meeting
be adjourned at _____ p.m.
The Corporation of the Town of Tillsonburg
Physician Recruitment & Retention Committee
February 4, 2020
12:00 p.m.
200 Broadway, 2nd Floor, Council Chambers
MINUTES
Present:
Dave Beres, Chair
Mayor Stephen Molnar
Councillor Penny Esseltine
Kyle Pratt, CAO, Town of Tillsonburg
Sandy Jansen, CEO, TDMH
Lesley Ross, Recruitment Coordinator, TDMH
Dr. Jamie Cluett, Chief of Staff, TDMH
Mike Bastow, Director of Operations, TDMH
Laura Pickersgill, Legislative Services Coordinator
Absent with Regrets:
Dr. Brian Holowachuk
Dr. Howard Lamb
Also Present:
Dave Rushton, Director of Finance
Dr. Courtney Fan, Optometrist
1.Call to Order
The meeting was called to order at 12:12 p.m.
2.Adoption of Agenda
Resolution #1
Moved by: Sandy Jansen
Seconded by: Dr. Jamie Cluett
THAT the Agenda as prepared for the Physician Recruitment and Retention
Committee meeting of February 4, 2020, be adopted, as amended.
Carried
3.Minutes of the Previous Meeting
Resolution #2
Moved by: Penny Esseltine
Seconded by: Sandy Jansen
THAT the Minutes of the Physician Recruitment and Retention Committee Meeting
of May 21, 2019 be approved.
Carried
Sandy Jansen provided a brief update on the Ontario Health Teams (OHTs). Oxford
OHT has been renamed ‘Oxford and Area OHT’ to reflect the population that is
serviced that resides well beyond the jurisdiction of Oxford County. A progress
report has been submitted to the Ministry of Health which demonstrates Oxford and
Area OHT’s readiness to move to the full application stage in March 2020. The
submission now also includes a plan for supporting mental health and addictions
treatment. Once feedback is received from the Ministry, then a full application could
be submitted.
4.Disclosures of Pecuniary Interest and the General Nature Thereof
There were no disclosures of pecuniary interest declared.
5.General Business & Reports
5.1 Update on physicians/recruits
5.1.1 Dr. Naser, Internal Medicine
Dr. Naser has resigned his position from TDMH due to family
reasons. A request has been submitted to Dr. Naser from TDMH to
return the incentive as he did not complete the minimum five years of
service agreement as defined in the incentive agreement.
Clearer verbiage should be used in future agreements with regards to
the incentive provisions.
5.1.2 Dr. Yao, Internal Medicine
Dr. Yao started working with TDMH as of January 1, 2020. An incentive
of $30,000 is to be granted.
5.1.3 Dr. Haj-Bakri, Family Medicine
Expenses are expected in the near future for Dr. Haj-Bakri.
5.1.4 Department of Surgery
Currently, TDMH has two surgeons that have two OR days per week
and one endoscopy day per week in the hospital. This was a result
of budget shrinking initiatives done in previous years.
Due to the pending retirement of surgeon, Dr. Colaco, Dr. Adam Fehr
has signed his agreement and will begin working with TDMH on July 1,
2020. Dr. Fehr will receive an incentive of $40,000. Dr. Fehr will have
two OR days per week and one endoscopy day per week. The plan is
for TDMH to have a full-time, on call surgical program in the near future.
Dr. Fehr has requested purchase of some new equipment to perform
non-invasive laparoscopic surgeries. TDMH Foundation has agreed to
support funding of this purchase.
5.2 Advertising Costs Incurred by Clinics
The Committee decided that advertising costs incurred by clinics do not fall
within the mandate of this Committee and should not be pursued as an item to
incur costs.
Advertisement of Community Health and its’ mandate could be added to the
Terms of Reference.
5.3 Reserve Funds and 2020 Budget for Recruitment
Dave Rushton provided a summary of reserve funds for 2016 until the present.
Currently there is $58,660 in reserves and the reserve cap is $100,000.
There is over $120,000 in reserves committed to at this point in time but this
amount will be less than $100,000 once the credit comes back for Dr. Naser.
TDMH pays for the incentive up front then historically has invoiced the Town
for our share of the incentive afterwards.
The Committee felt that fund distribution could be better ratified through
resolution of the Committee. The following resolution was passed:
Resolution #3
Moved by: Mike Bastow
Seconded by: Penny Esseltine
THAT the Physician Recruitment Committee approves the funding of the
following amounts totalling $80,000 to be shared equally between the Town of
Tillsonburg and TDMH including incentives for Dr. Fehr at $40,000 and for Dr.
Yao at $30,000 and expenses for Dr. Hayat at $10,000.
Carried
5.4 Family Health Organization- Application for Funding
No updates.
5.5 Update/Next Steps for Committee
Dr. Cluett will connect with Dr. Ruth Caperchione about having a
representative from her office participate on this Committee.
Lesley Ross will connect with AJ Wells to receive information from the Oxford
County Physician Recruitment Committee.
6.New Business
6.1 Frequency of Meetings
Meetings will be held quarterly.
7.Roundtable
Staff to have the Town’s Economic Development and Marketing Department reach
out to Sandy Jansen for an opportunity to showcase the Physician Recruitment
Program as a feature story in the Discover Tillsonburg publication.
Dr. Brian Evans will be providing plastic surgery in Tillsonburg one day a week.
Preoperative appointments are currently held in London but TDMH is hoping to have
them locally eventually.
8.Next Meeting
9.Adjournment
Resolution #4
Moved by: Sandy Jansen
THAT the February 4, 2020 Physician Recruitment and Retention Committee
meeting be adjourned at 1:04 p.m.
Carried
From:Dave Beres
To:Laura Pickersgill
Subject:Agenda item for physician recruitment
Date:July 2, 2020 4:05:18 PM
Laura:
Please circulate to Sandy Jansen's office to be prepared to discuss the third bullet
point at the up comong Physician recruitment committee meeting.
Thanks
Dave
SW PUBLIC HEALTH DAILY UPDATE JULY 2, 2020
Additional Investments
Other investments in 2020–21 to tackle COVID-19 and build a better health care system that
is there for patients when they need it include:
$75 million to supply personal protective equipment and critical medical supplies to
front-line staff;
$120 million to increase home and community care capacity to allow hospitals to direct
more resources to complex COVID-19 patients;
$62 million to provide more physicians, particularly in rural and remote communities,
nurses in hospitals and personal support workers in communities;
$23.8 million to enable more physicians to conduct video, email or phone visits for
patients to see their doctor from the comfort and convenience of their own homes;
$20 million in research and innovation funding to develop tools and resources to combat
COVID-19 and related diseases by leveraging the strengths of Ontario’s world-class
research institutions, industry and non-profit scientific partners;
Approximately $35 million to ensure patients have access to vital blood products,
particularly plasma, and support Canadian Blood Services with the establishment of a
new plasma site in Sudbury;
Approximately $70 million for infection control and personal protective equipment in
residential facilities for children and youth in care, children with complex needs and
people with developmental disabilities, retirement homes, youth justice facilities, and
emergency shelters for women and families fleeing domestic violence; and
A new website, Ontario Together, to help the government partner with Ontario’s
manufacturing sector to meet the challenges of the COVID-19 outbreak and redirect
resources towards the production of essential equipment such as ventilators, masks and
swabs.
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Shared Physician Recruitment Incentive Support Model – Family Physicians, Internal
Medicine, Hospitalists, Emergency Medicine and Surgery Trained Physicians
July 17, 2020
EXECUTIVE SUMMARY
The purpose of this report to the Physician Recruitment Committee is to propose an amendment
to the Physician Recruitment Incentive Support Model that is currently in place.
BACKGROUND
In January 2016, a Shared Physician Recruitment Incentive Support Model was implemented
collaboratively between the Town of Tillsonburg and Tillsonburg District Memorial Hospital
(TDMH). At that time, it was recognized that family physicians are critical to the town’s further
growth and prosperity. Since that time, three important factors have changed the landscape,
necessitating a re-evaluation of the incentive framework. First, it has become apparent that as
the demographics of the population of our community ages the health care needs of our patient
population have become increasingly complex necessitating the need to recruit physicians
specially trained in areas like cardiology, respirology and gerontology. Secondly, the acuity of
patients seen in our Emergency Department (ED) has increased. Lastly, our physicians are
aging. Family physicians, with increasing frequency, are expressing the desire to limit their
practice to their offices and are opting out of providing coverage to the ED and hospitalized
patients. We currently employ two General Surgeons and one has indicated he will be retire in
July 2021. All of these factors are driving the need for TDMH to recruit specialists in Internal
Medicine, Hospitalists, Surgeons and ED Trained Physicians.
The elements described above are creating an unprecedented pressure to recruit physicians into
our community; however, we are experiencing difficulty in attracting these skilled professionals.
As highlighted in 2016, financial incentives will increase the probability of physicians relocating
to the community.
OBJECTIVE
To ensure the ongoing sustainability/viability of the hospital is imperative that physicians with
appropriate training are available to service the community. As such we are recommending the
following financial incentive model for all physicians recruited into our community including family
physicians and specialty trained physicians.
Page 2 / 2 CAO
Transitional Support Package - Comparison:
SHARED PHYSICIAN RECRUITMENT
INCENTIVE SUPPORT MODEL
FAMILY PHYSICIAN
SHARED PHYSICIAN RECRUITMENT
INCENTIVE SUPPORT MODEL
SPECIALTY PHYSICIANS (i.e. INTERNAL
MEDICINE, SURGERY)
• Contribute up to $5,000.00 in moving
expenses for relocation to Tillsonburg
(with appropriate receipts).
• The physician recruit must reside within 15
kilometers of Tillsonburg.
NOTE: IF physician is relocating from
outside of Ontario, the incentive is increase
to $10,000
$5,000.00
$10,000.oo
• Contribute up to $5,000.00 in moving
expenses for relocation to Tillsonburg
(with appropriate receipts).
• The physician recruit must reside within 15
kilometers of Tillsonburg
NOTE: IF physician is relocating from outside
of Ontario, the incentive is increase to
$10,000
$5,000.00
$10.000.00
• Six months of housing support up to
$7,350.00.
$7,350.00 • Six months of housing support up to
$7,350.00.
$7,350.00
• Up to $10,000 for Clinic space and
equipment updates, to the Clinic that will
employ the physician recruit (with
appropriate receipts) (i.e. Electronic
Medical Record, new equipment)
$10,000.00 • Clinic space including payment for clerical
support to manage bookings, office visits
and patient records for up to six months.
This is not a permanent arrangement and
the Hospital will work with the recruit to
develop a clinic within the hospital that is
cost neutral to the Hospital.
$10,000.00
• Maximum $6,000 per month, for the first
six months, payable to the physician
recruit toward clinic overhead costs (with
appropriate receipts).
$36,000.00 • Stipend of $30,000 based on a five-year
return of service agreement for full service
to the hospital and community;
$30,000.00
TOTAL INCENTIVE $58,350.00 $52,350.00
TOTAL INCENTIVE IF PHYSICIAN MOVING
OUT OF PROVINCE
$68.350.00
$62.230.00
The total amount that could be reimbursed per recruit, based on the proposed support
model, is $52,235.00 which would be a 50/50 split between the Town of Tillsonburg and
TDMH.
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SPECIALIST [ Insert Specialty] RETURN OF SERVICE AGREEMENT
This Agreement is between:
Tillsonburg District Memorial Hospital (hereinafter called “TDMH”)
- and -
Dr. XXX
The parties agree with each other as follows:
1. Recruitment incentive of:
(a) a stipend of $30,000 based on a five-year return of service agreement for full service
to the hospital and community;
(b) clinic space including payment for clerical support to handle bookings, office visits and
patient records for up to six months.
(c) Moving expenses in the amount of $xxxx, to support relocation to within a location
within 15km of Tillsonburg.
(d) Housing support for 6 months up to $7,350.00
2. Payment of the above noted recruitment incentive is conditional upon Dr. XXX:
(a) obtaining and maintaining a license to practice medicine in Ontario from the College
of Physicians and Surgeons of Ontario;
(b) abiding by the conditions set forth in the TDMH Professional Staff By-Laws and the
Rules and Regulations;
(c) receiving an Ontario Hospital Insurance Plan (OHIP) billing number and coverage by
the Canadian Medical Protective Association;
(d) partnering with our Team to utilize the Cardiac and Diagnostic Services available at
the Hospital for at least five years (specific to Internal Med Recruit);
(e) providing on-call coverage to the Hospital (see below).
3. On-call coverage requires Dr. XXX (details vary by specialty):
(a) To provide on-call coverage for at least one weekend in three as well as the equivalent
weekday coverage. The call schedule will be coordinated with the
Page | 2
other TDMH [Insert Specialty] and locums to ensure that 24/7 coverage is
maintained. The development and coordination of the call schedule is the
responsibility of the TDMH [Insert Specialty]. If the group is interested in maintaining
the extra locums that the TDMH [Insert Specialty] have traditionally utilized so that a
one-in-four call arrangement for weekends can be accomplished, this is acceptable to
the hospital as well. As part of this arrangement, Dr.XXX will have access to the
Hospital On-Call Coverage Funding.
4. In consideration of the incentive payments outlined in Part 1, Dr.XXX agrees:
(a) to meet all requisite standards of practice and to continue in the practice of [Insert
Specialty] at TDMH and servicing the community of Tillsonburg on a full-time basis,
for a period of sixty (60) consecutive months. For the purposes of this clause, “full-
time basis” means practicing in a manner and style similar to same specialty
physicians within the community.
(b) that at the date of execution of this Agreement, Dr. XXX has not made any other
arrangements for the provision of his services which are in conflict with his obligations
under this Agreement; and
(c) not to enter into any such arrangement which will be effective before the period that
he has completed his service commitment under this Agreement without:
(i) having first sought and received the express written approval of TDMH; or
(ii) having re-paid in full the amounts required under Part 1 of this Agreement.
(d ) to provide to TDMH not less than six months notice of intent to terminate this
Agreement.
5. TDMH agrees that in the event that Dr.XXX is unable to complete his obligation as a result of
his death or if he becomes permanently disabled (such that he would qualify for Canada
Pension Plan disability benefits), Dr.XXX obligations under this Agreement will terminate.
6. It is understood and agreed that nothing in this Agreement is intended to nor shall it
operate to make Dr.XXX an employee of TDMH for any purpose whatsoever.
IN WITNESS WHEREOF :
Signed, Sealed, and Delivered )
In the presence of: )
)
Page | 3
)
)
Witness for TDMH Sandy Jansen
Integrated President/CEO
Date: Date:
Witness for Town of Tillsonburg Kyle Pratt
Chief Administrative Officer
Date: Date:
Witness for Internal Medicine Dr. YYY
Chief, Specialty Service
Date: Date:
Witness for Applicant Dr. XXX
Date: Date: