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211102 Physicians recruitment and retention committee PUBLICPage 1 of 2 The Corporation of the Town of Tillsonburg Physician Recruitment & Retention Committee November 2, 2021 12:00 p.m. Electronic AGENDA 1.Call to Order 2.Adoption of Agenda Proposed Resolution #1 Moved by: Seconded by: THAT the Agenda as prepared for the [type of meeting] meeting of June 1, 2021, be adopted. 3.Minutes of the Previous Meeting 4.Disclosures of Pecuniary Interest and the General Nature Thereof 5.General Business and Reports 5.1. A report from Sandy Jansen and Dr. Cluett regarding investigating Community Health Center Clinics as a model for Tillsonburg. 5.2. Report form Chair: Tillsonburg Council approved the request presented in the closed session from September 7, 2021. 5.3. Physician Recruitment Metric Baseline 6.Next Meeting Tuesday February 1st/2022 7.Adjournment Proposed Resolution #2 (ATTACHED) (ATTACHED) Page 2 of 2 Moved by: Seconded by: THAT the November 2nd 2021 Tillsonburg Recruitment & Retention Committee meeting be adjourned at _____ p.m. Please contact the Staff Liaison listed below to gain access to this electronic meeting: Contact Kennedy Atkinson 519-688-3009 ex. 4042 The Corporation of the Town of Tillsonburg PHYSICIAN RECRUITMENT & RETENTION COMMITTEE September 7, 2021 12:00 p.m. Electronic Meeting MINUTES Present: Deputy Mayor Dave Beres, Mayor Stephen Molnar, Councillor Penny Esseltine, Dr. Jamie Cluett, Mike Bastow, Ashley Edwards, Dr. Brian Holowachuk, Sandy Jansen Absent with Regrets: Lesley Ross, Dr. Matt Johnson, Dr. Howard Lamb, Dr. Abdalla Staff: Kyle Pratt – CAO Ann Wright – Records & Legislative Coordinator / Acting Executive Assistant 1. Call to Order The meeting was called to order 12:19 p.m. 2. Introduction of Guests or New Members None 3. Adoption of Agenda Resolution #1 Moved by: Councillor Penny Esseltine Seconded by: Sandy Jansen THAT the Agenda as prepared for the Physician Recruitment and Retention Committee meeting of September 7, 2021, be adopted. Carried 4. Closed Session Resolution #3 Moved by: Councillor Penny Esseltine Seconded by: Deputy Mayor Dave Beres THAT the Committee move into Closed Session to consider a matter regarding personal matters about an identifiable individual, including municipal or local board employees. Carried 5. Minutes of the Previous Meeting Resolution #2 Moved by: Sandy Jansen Seconded by: Ashley Edwards THAT the Minutes of the Physician Recruitment and Retention Committee Meeting of April 29, 2021, be approved. Carried 6. Disclosures of Pecuniary Interest and the General Nature Thereof There were no disclosures of pecuniary interest declared. 7. General Business & Reports 7.1. Community Strategic Plan – Baseline Metrics The Committee had a discussion in regard to the needs of the community in regard to Physicians and medical care. Sandy will send stats of current physicians that the Town has so that the Committee can work on a needs study. 7.2. Student Recruitment It was noted that at this time the Tillsonburg Hospital has stopped student recruitment because it was not attracting doctors. The Committee agreed that it would be a great idea to give medical students a tour of the town and community as part of an incentive package. 7.3. Finding a Local Physician – Correspondence from Nancy Puhr Correspondence from the Seniors Centre was received as information. It was noted that at this time there are not enough physicians to support out number of residents. Dr. Cluett recommends that people keep their current doctors even if they are a distance away, especially now that many doctors are providing care remotely. Resolution #4 Moved by: Councillor Penny Esseltine Seconded by: Sandy Jansen THAT the Physician Recruitment and Retention Committee receive the correspondence from Nancy Puhr as information. Carried There was a general discussion about how the Committee can start moving forward attracting new physicians and getting new medical facilities. Resolution #4 Moved by: Mayor Stephan Molnar Seconded by: Ashley Edwards THAT the Physician Recruitment and Retention Committee investigate a central medical building to support local physicians. Carried 8. New Business None 9. Roundtable None 10. Next Meeting The next meeting will be held on November 2, 2021 at 12:00 p.m. 11. Adjournment Resolution #6 Moved by: Councillor Penny Esseltine Seconded by: Sandy Jansen THAT the September 7, 2021 Physician Recruitment and Retention Committee meeting be adjourned at 1:10 p.m. Carried HEALTH PROFESSIONS HUMAN RESOURCE PLAN Fall 2021 Physicians HEALTH PROFESSIONS RESOURCE PLAN - PHYSICIANS The Hospital Board, Medical Staff and Hospital Leadership recognize that a proactive physician recruitment strategy is critical to the future of the hospital. The Health Professions Resource Plan has been developed based on the following factors:  Economic projections;  Demographics;  Shared services with other partner hospitals;  Technological and professional trends;  Ministry of Health and Long Term Care;  Tillsonburg District Memorial Hospital Strategic Plan;  Thames Valley Hospitals’ Partnership and other health care providers; and  Wait Time Strategies (cataracts, general surgery, joint replacements). The future impact of Ontario Health Teams on physician resources is unknown at this time. Dr. Jamie Cluett continues in his capacity of Chief of Staff of the Hospital. Recruitment efforts have been successful and one full-time General Surgeon and one full-time Orthopaedic surgeon have been recruited in 2021. The Hospital has also recently recruited one Internist, Dr. Chester Yao. The recruitment of these physicians will provide service for the Inpatient Units, Intensive Coronary Care Unit, Emergency Department, Echocardiography and Stress Testing. Several Locum physicians in Anaesthesia, Emergency Medicine and Internal Medicine have been recruited to assist in on- call coverage in their respective Departments. Recruitment efforts continue for Emergency Medicine Physicians, Internal Medicine Physicians, Family Physicians, Hospitalists and GP/Anaesthetists. The Hospitalist Model at TDMH continues to work well and the Hospitalist Team consists of Dr. Christopher Foerster, Dr. Samuel Agaibi and Dr. Tom Kujawa. The Internal Medicine physicians continue to assist with Hospitalist coverage when necessary. With a goal to have four Hospitalists, recruitment of candidates continues. Medical Manpower Requirements September 2021 Specialty Current FTEs Projected Requirements Coverage Provided Number needed to recruit? Comments/ Actions Anaesthesia 1 3 On-call 24/7 M-F OR/Endo 2 There 1 Active Anaesthetist at TDMH and additional coverage provided by locums Emergency 7 2 Full Time 7 GPs cover ED shifts 2 FT Additional weekend coverage provided by Locums and Health Force Ontario Family Practice 16 22.6 6.6 Family Practice Physicians (including 7 who also cover ED) Ophthalmology 3 3 5 days/month 0 3 Ophthalmologists provide cataract surgery Hospitalists 3 4 M-T 8:00 to 5:00 pm 1 Recruitment continues Surgery (General) 2 2 2 FT Surgeons 0 Monitor Wait Times to determine need for a third surgeon Orthopaedic Surgery 1 1 1 FT Orthopaedic Surgeon 0 Monitor Wait Times to determine need for a second surgeon General Internal Medicine 3 4 24/7 call coverage 3 FT plus w/e locums 1 Recruitment efforts focused on attracting a fourth Internist. Plastic Surgery .4 .4 2 days/month 0 Dr. Evans provides plastic surgery 3 time per month FAMILY PRACTICE CLINICS The chart below reflects recent data (August 2021) on the number of attached patients. This data reflects people who live in Tillsonburg (for example) and have a PEM (Patient Enrollment Model – FHO, FHG, CCM) physician somewhere (could be anywhere in Ontario). The NPLC and CHC were also contacted to find out where their patients come and that is reflected in the chart below as well.  Current population with a Health Card address in Tillsonburg is 18,269 of which 15,854 are rostered to a Patient Enrollment Model physician who may be located anywhere in Ontario  There are 2,415 residents of Tillsonburg (person with a Health Card address in Tillsonburg) not attached to a primary care provider. CSD Avg PEM FP Roster Size (2018) Population 1 PEM Rostered2 Not Rostered Other Primary Care3 OHT Capacity Gap 4 Blandford- Blenheim 5,865 4,634 1,231 33 1198 Ingersoll 1178 14,115 10,967 3,148 1060 2088 Norwich 2269 11,871 10,216 1,655 77 1578 South-West Oxford 8,475 6,969 1,506 139 1367 Tillsonburg 1953 18,269 15,854 2,415 76 2339 Woodstock 1750 47,458 36,419 11,039 1997 9042 Zorra 1766 6,109 5,151 958 115 843 Oxford 1725 112,162 90,210 21,952 3497 18,455 1 Number of health card holders living in the CSD 2 Number of health card holders rostered to a PEM physician somewhere (not necessarily locally) 3 Number of residents enrolled to the Oxford NPLC or CHC 4 Number of residents not attached PHYSICIAN AGE REPORT The chart below illustrates Tillsonburg Family Physicians’ ages in Tillsonburg in 10 years. 0 10 20 30 40 50 60 70 80 90 TDMH Physician's Age in 10 years, December 2020 RECOMMENDATIONS 1. Continual monitoring of medical manpower to allow as many patients as possible to receive their care in Tillsonburg. In meeting this objective the Hospital Board, Administration and Medical staff will jointly consider all implications before additional appointments are recommended. 2. New Medical Staff appointments will require a cost/impact study to ensure this service is within the financial capability of the Hospital and what impact the appointment will have on other medical and Hospital services. 3. New specialty services should be reviewed to determine the feasibility of providing these services on a clinic or outpatient basis. A cost/impact study would also have to be considered. 4. Explore partnerships with other hospitals to strengthen on call schedule and/or to bring specialty services to TDMH even when population data does not warrant a full-time position. 5. Continue to work with Physicians and the universities to support Medical Student elective placements in Tillsonburg. 6. Support the work of the Tillsonburg Recruitment Committee incentives for Family Practice and Specialist recruitment and evaluate the resources committed to assisting new General Practitioners in building their practice. Continue to profile the Hospital and community with Family Practice Residents. 7. Track new models of Primary Care for Physicians and multi-disciplinary practices. 8. Continue to provide Physician Educational opportunities and consider providing an educational assistance program targeted to address needs of the Physicians and the Hospital. 9. Continue to monitor access to Internal Medicine and General Surgery. 10. Focus recruitment efforts on:  Emergency Medicine  Family Physicians,  Internists  GP Anaesthetists. 11. Pursue new opportunities for engaging Medical Students as they go through the training process (for example, forming a relationship with the Hippocratic Council at the Schulich School of Medicine).