The Ontario election is now underway and despite the Premier’s belief that this election is about a mandate to deal with Donald Trump, the reality is that the dominant issue is likely to become health care. Given that Canada and by extension Ontario are both small open economies, aside from moral suasion,Trumpian tariff policy is beyond the direct power of Ontario’s Premier. Health care, on the other hand is a provincial responsibility and directly within the Premier’s mandate. Here, the picture is not pretty.
There are apparently 2.5 million people in the province without access to a family physician and the number has been growing because while total physician supply in Ontario since 2019 is up over one percent, population has grown by nearly 10 percent. The Ontario Medical Association already has a campaign underway highlighting the crisis in provincial health care and in particular the shortage of medical professionals and physicians. The province has indeed responded to this crisis with the unveiling of an additional $1.8 billion to ensure that everyone has access to a family doctor with four years. And yet, the nature of the crisis is such that the absolute number of physicians required is only part of the problem given demographic changes in the profession, changing workloads as well as the reality that the size of the shortage differs regionally.
Figure 1 takes data on total physician vacancies from HealthForceOntario for major Ontario cities (accessed January 29th) and plots them ranked from highest to lowest. The number of vacancies range from highs of 683 and 204 for Toronto and Ottawa to lows of 21 and 16 for Barrie and Brantford. This ranking is in terms of absolute numbers and says little about relative vacancies which need to consider population. So, Figure 2 presents these vacancies in terms of vacancies per 100,000 population (using CMA population data from Statistics Canada for 2024) and ranks them from highest to lowest and the results show the physician shortage in relative terms varies considerably. The largest vacancies once adjusted for population are in Thunder Bay, Peterborough and Belleville at 34, 28 and 26 physician vacancies per 100,000 population. Meanwhile, the lowest vacancies per 100,000 population are in Oshawa, Hamilton and Windsor at 7, 6.6 and 5.8.
Two things come to mind with these results. First, a blanket or provincial level response approach to this problem is likely to be unsuccessful. Solutions for Thunder Bay or Peterborough cannot be the same as those for Barrie or Toronto given the size of the gap in terms of vacancies per 100,000. Indeed, the size of the problem in Thunder Bay, Peterborough and Belleville seems to be in a league of its own given the drop off in Figure 2 after Belleville. Second, for the time being, if you are indeed looking for a physician in a major Ontario city, given these numbers, your odds of getting access to one is greatest in Windsor and worst in Thunder Bay.
