Read the full letter Group Health sent to Ross Romano before dropping 10K patients

As SooToday reported earlier this morning, a series of records released as part of a freedom of information request shed new light on what was happening behind the scenes in the days before the Group Health Centre announced it was dropping 10,000 patients from its roster.

Obtained by researcher Dax D’Orazio, the records include a Jan. 12 letter sent to Sault MPP Ross Romano by Lil Silvano, the president and CEO of Group Health, and Dr. Jodie Stewart, the president and CEO of the Algoma District Medical Group.

The letter was sent less than two weeks before the Group Health Centre went public with the news that thousands of patients would lose their primary care providers.

Below is the full letter.

January 12, 2024

Subject: Urgent Assistance Required to Address Primary Care Crisis in Sault Ste. Marie

Dear Mr. Romano

As discussed at our meeting on January 10, we are writing to request that you urgently address the escalating crisis in primary care that is significantly impacting Sault Ste. Marie and resonating across the province.

As you are aware, the healthcare landscape, particularly in primary care, has been under mounting strain, and the situation has become severe in many regions, including Sault Ste. Marie. We are grappling with an alarming shortage of physicians and nurse practitioners who practice family medicine. This shortage is exacerbated by health human resources burnout and a demographic crisis — the influx of new professionals is not keeping pace with the rate of retirements. Primary care at the Group Health Centre is currently being delivered by 48 providers: 43 Family Physicians and 5 Nurse Practitioners. Of those 43 Family Physicians, 33% are over the age of 60. These are issues that have been occurring across Ontario — it is not a problem specific to Sault Ste. Marie, but it stands to deeply impact our community in the very near future.

Despite our proactive measures, including recruiting new Primary Care Providers (PCPs) through all means available, including international physicians, securing locums, applying to the Ontario Practice Ready program, looking at alternative practice models and persuading retired physicians and nurse practitioners to return part-time, we find ourselves at a critical juncture. Our interim solutions are faltering, and we are now in the position that we will be notifying 10,000 patients that they will no longer have access to their family physician due to the departure and retirement of several PCPs.

As we discussed, there are currently multiple family physicians who have delayed their retirements, enabling their 6,000 patients to continue to have access to primary care. We acknowledge that this is a temporary solution, and these 6,000 patients remain at risk due to the lack of new incoming PCPs. There continues to be a risk that additional family doctors and nurse practitioners may also decide to no longer practice family medicine due to burnout, mostly from the extraordinary amount of administrative work they are doing — time that could be better spent seeing patients.

The shortage of primary care has a devastating impact on patients, their families and our community. Although we are putting forward our best efforts to recruit more PCPs, and are exploring innovative models to combat this crisis, we desperately need support in retaining our existing providers who continue to serve the remaining 50,000+ patients and our community.

Our Leadership Team and Board of Directors are dedicated to supporting our staff and community during this crisis. However, we are facing financial constraints that are impeding our efforts. Our primary funding agreement has remained stagnant since 2012. The current funding model, inflation, pandemic repercussions, and labour relations environment are straining our financial resources. Without adequate funding, our ability to provide the team-based support necessary for primary care will be compromised, which could lead to the further loss of primary care providers, impacting the health of our community and its economic growth.

We have several pending requests with the Ministry which will enable us to sustain our operations and provide the required support to achieve retention and help with recruitment. Below is a list of the outstanding Ministry requests:

Funding Envelope/Request: Model of Care Innovation Fund
Description: Modification to “Grow Your Own Nurse Practitioner” — enabling five (5) registered nurses to become Nurse Practitioners
Funds requested: $1.6M - one time over two years

Funding Envelope/Request: Expression of Interest - Expanding and Enhancing Interprofessional Primary Care Team
Description: Additional allied health professions for chronic disease management, health maintenance and mental health pathways. This funding will bring GHC closer to parity with how Family Health Team supports are funded.
Funds requested: $3.0M - ongoing

Funding Envelope/Request: 2012 Governance and Funding Agreement - Specialist support
Description: GHC Specialist Support funding has been static since 2012 (calculated as a percentage of Specialist notional rate) where Specialist notional rates have changed - does not reflect spirit of agreement.
Funds requested: $4.7M - one time (retro), $0.5M - ongoing

Funding Envelope/Request: Community Infrastructure Capital Fund
Description: Critically aging infrastructure
Funds requested: $0.5M  one time

Funding Envelope/Request: Bill 124
Description: Relief from Bill 124
Funds requested: $0.3M - one time (retro), $0.1M - ongoing

Total:
$7.1M - one time
$3.6M - ongoing

Unfortunately, because of the shortage of primary care providers, receiving these funds today will not prevent 10,000 patients from losing their family doctors. The funding will, however, stabilize the organization's ability to provide care to our remaining 50,000 patients.

Considering these challenges, we urgently seek your assistance. Support from your office can help us stabilize and retain our current team, and subsequently expand our services to meet the growing healthcare needs of our community.

We appreciate your attention to this critical matter and look forward to your prompt response and support.

Sincerely,

Lil Silvano
President and CEO
Group Health Centre

Dr. Jodie Stewart
President and CEO
Algoma District Medical Group

CC: Minister of Health Sylvia Jones
        Mayor Mathew Shoemaker