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Improving Physician Retention Key to Addressing Doctor Shortage

Doctors Manitoba released a new report yesterday on the physician shortage, focusing on the need to improve physician retention as a foundational step to solving this problem. 

We know from your feedback that the physician shortage is a top concern for physicians in Manitoba, which is why we are dedicating our resources to understanding what’s driving this crisis and recommending a way out of it. Today’s report is one part of this multi-pronged advocacy, focusing on the causes of early retirements and physicians relocating to other provinces.

Our report finds that:

  • 46% of existing doctors are considering relocating to another province, retiring, or reducing their hours in the next three years.

  • Manitoba is at risk of losing 21%, or 688 physicians, in the next three years to relocation or retirement. 

  • In three quarters (74%) of cases, plans to retire, relocate, or reduce hours are related to systemic or institutional issues that could be addressed.

The main risks to retaining physicians include issues like burnout, not feeling valued, administrative burden, and not being engaged by the health care system. Of note:

  • 46% of physicians are experiencing burnout, and 54% are experiencing distress.

  • 18% to 26% of physicians feel valued by the provincial government, Shared Health, and/​or their Regional Health Authority.

  • 31% of physicians describe their workplace culture as generally positive.

  • Only 19% of physicians describe the health system as responsive to physician concerns. 

“The best way to prevent losing physicians in Manitoba is by improving how the system engages and supports us,” explained Dr. Guzman. ​“It is very concerning to see two thirds or more of physicians saying the health system isn’t keeping them up to date, isn’t seeking their input, and isn’t responsive to their concerns. We have recommendations to address these issues that very much support the government’s promise to change the culture in health care and prioritize front line feedback.”

Dr. Guzman noted the report shows improvements in key areas, including:

  • Modest decreases in the number of physicians experiencing burnout and distress, and in those planning to leave or reduce their practice.

  • Modest improvements in the number of physicians feeling valued by the government and health system, as well as the number satisfied with their professional life.

“While the numbers are still very concerning when it comes to our physician shortage, our findings suggest Manitoba may be turning the corner as we see early signs of improvement that could help with recruitment and retention,” added Dr. Guzman.

Manitoba has 215 physicians per capita, and it would take 445 more doctors to reach the Canadian average, according to the Canadian Institute for Health Information.

Click here to access Physician Resources in Manitoba: Focus on Retaining Doctors.

Cortext Secure Messaging Changing July 23

As we previously shared, the vendor behind Cortext secure physician messaging is discontinuing the app, with very little notice. Digital Shared Services has been working on a replacement that could be activated before Cortext is lost, and they recently announced they will be using Microsoft Teams as a new solution for secure physician messaging. Doctors Manitoba has negotiated free access to secure physician messaging, which we understand will continue with Teams.

The change from Cortext to Teams is planned for July 23, at 9:00am, according to Shared Health. Physicians are encouraged to get set up on Teams as soon as possible, to ensure you are ready for the switch on July 23.

You are not alone if your first thought is ​“really, Teams for secure clinic messaging?” However, we’ve learned that several health facilities use Teams for this purpose. We have heard some concerns from physicians about the change, and we are inviting your feedback to ensure concerns and issues are on Shared Health’s radar as they prepare for this change. Issues we’ve heard so far:

  • How will I differentiate Teams messages that are clinical and urgent from other non-clinical Teams messages I already receive?

  • How will this work for paging and on-call? How will we know which physician in a group is on-call?

  • How can I set this up so notifications break through when my phone is on silent?

  • I use Cortext right now to navigate the physician community and find a list of physicians practicing in a specific area. Will Teams do this?

  • Summer is a busy time to make a change. What support is available for individual physicians to help?

We are engaging physicians to collect these concerns with the goal of helping Shared Health configure and optimize Teams for secure clinical messaging in Manitoba.

We have also heard about some potential advantages. Some have asked about getting non physician staff onto Teams for secure messaging. Others have asked if you can easily switch from a text message exchange to a live voice or video conversation, which means moving from non-billable text-based collaboration to billable live collaboration with physicians and certain other designated providers where appropriate.

Here’s some key information from Shared Health to prepare:

We want to hear from you. What do you think about the change to Teams? Are there ways you use Cortext that could be list? Let us know by emailing practiceadvice@​doctorsmanitoba.​ca.

What do you think about New Clinic Plans?

The government appears to be moving ahead on two election commitments it made to create new minor injury and illness clinics, and primary care clinics. Details on these clinics are starting to emerge, and we are interested in what physicians think about them. Right now, the early plans focus on opening these clinics in Winnipeg, but the government’s broader agenda also includes Brandon. 

Here’s what we know, and please see our invitation for feedback.

Extended Hours Primary Care Clinics

Earlier this year, the provincial government’s budget announced funding for new clinics, with more details to follow. Shared Health has started sharing some details about the proposed new ​“regional extended hours primary care clinics.” The clinics would be open weeknights (5pm — 11pm) and weekends (1pm — 11pm), located in or adjacent to hospitals, with the goal of enhancing the accessibility, continuity, and comprehensiveness of primary care by ensuring services are available during times when community demand is high, yet options are limited. The clinics would offer online booking and walk-in appointments, with a physician or nurse practitioner, nurse, and primary care assistant. Hospital lab and imaging would be available as needed, and the purported goal is to ensure patient visits are connected back to home clinics.

Our preliminary analysis shows there are already dozens of walk-in clinics in Winnipeg already offering some level of evening and/​or weekend hours. These new clinics are being planned at or near hospitals to help with some of the low acuity ER or urgent care presentations. We have heard some early inquiries curious about the new model and how the public will differentiate it from existing walk-in clinics and urgent care clinics, and how the proposed new clinics will complement and integrate with existing primary care. We’ve also heard concerns about moving forward with these new clinics now, at a time when Manitoba has a significant physician shortage, rather than focusing on supporting existing community-based primary care and walk-in clinic services.

There is some information circulating about physician remuneration for these clinics. This has not yet been negotiated with Doctors Manitoba and should be considered a preliminary thought-starter. We have not received this information formally as a remuneration proposal, nor have we had a chance to assess the implications for, or changes needed in, other similar services such as Family Medicine Plus, walk-in clinics, urgent care, or inpatient coverage. Therefore, we recommend physicians take a cautious wait-and-see approach for now until more details are finalized. Doctors Manitoba will be meeting soon with the Shared Health team the government has tasked with designing these clinics, to offer our economic expertise and to share feedback from physicians about the proposed model.

What do you think of these extended hours clinics? How could they be shaped in a way that can support and complement existing physician practices and patient care? What concerns do you have? Email us in confidence at practiceadvice@​doctorsmanitoba.​ca.

Minor Injury and Illness Clinics

A Request for Proposals, or RFP, was posted this week seeking proposals to operate minor injury and illness clinics. The range of services appear similar to existing injury and illness clinics such as Pan Am, Corydon, and KALO clinics in Winnipeg. The proposal is seeking operators for two sites: Misericordia Health Centre and at Grace Hospital Access Centre. The clinic space, equipment and supplies are provided.

Doctors Manitoba is encouraged to see this posted as a competitive process to offer physician leaders with experience operating similar services the opportunity to apply. However, we are interested in your feedback about the proposed model, including looking for a community-based physician operator in a public clinic facility.

The RFP is available on MERX, a site used to post government tenders, and we have downloaded a copy you can access here. While the deadline is not until July 24, these requests are quite detailed so if this work interests you, we suggest exploring opportunities and working on a proposal sooner than later.

What do you think of these minor injury and illness clinics? How could they be shaped in a way that can support and complement existing care options? What concerns do you have about what is proposed? Email us in confidence at practiceadvice@​doctorsmanitoba.​ca.

Take Part in Bug Day

Nationally and internationally recognized experts will present timely topics in infectious diseases and public health at Manitoba’s largest healthcare education event coming up October 17 during National Infection Prevention & Control Week.

Bug Day is accredited for physicians. There is no charge, but you must register to attend the live sessions. Registrations are not accepted post-event.

Register here.

NCIME Resources Advance Indigenous Medical Education

The National Consortium for Indigenous Medical Education catalog of resources is now available.

The resources are to ensure medical education environments welcome and support Indigenous learners and faculty and that these institutions provide effective education in Indigenous health including safe, trauma-informed care. A wide variety of Indigenous and non-Indigenous academics, experts, Elders, and medical professionals developed the work of the NCIME.

NCIME is the result of a collaborative partnership between the Association of Faculties of Medicine of Canada (AFMC), the College of Family Physicians of Canada (CFPC), the Indigenous Physicians Association of Canada (IPAC), the Medical Council of Canada (MCC), and the Royal College of Physicians and Surgeons of Canada (RCPSC).

The NCIME mandate has six focus areas, including Anti-Racism Policies, Processes and Implementation Support, Assessment of Indigenous Studies, Cultural Safety and Anti-Racism. Improving Cultural Safety in Curriculum. Indigenous Student Admissions and Transition, Indigenous Faculty Recruitment and Retention, and Indigenous Physician Wellness and Joy in Work

Each of these correlates to a respective working group that directed the creation of reports and other products with recommendations to address their respective focus. Though each working group represents an individual component, they collectively work together to advance Indigenous medical education.

Park’N Fly Discount for DRMB Members

Flying away on a summer getaway? Drive to the airport in your own vehicle and have the convenience of it waiting for you upon your return, all at a reduced rate with your Doctors Manitoba membership.

Park’N Fly offers several options to park your vehicle at Winnipeg James Armstrong Richardson International Airport. Choose from indoor valet or a self-park option. Park in a secure lot and hop on a free shuttle for a short ride to the terminal, 24/7.

Doctors Manitoba | Park ​‘N Fly Corporate Discount


Golf Reminder

Get in some Getting Healthy fun with fellow doctors and friends at our 2nd Annual Golf Tournament at Southwood Golf! Compete across the course and at each hole with your team for exciting prizes and giveaways, including a free stay at the Inn at the Forks!

All proceeds will go to support our Getting Healthy public awareness initiative. Presented by MD Financial and Scotiabank with support from Bokhaut CPA.

Find out more and register at doc​tors​man​i​to​ba​.ca/​g​olf24

Health System Updates

Pneumococcal Vaccine Update

The Manitoba Immunization Program is completing the transition from the previous pneumococcal vaccines (Pneu-C-13 [Prevnar13] and Pneu-P-23 [Pneumovax 23]) to the newer conjugate vaccines. The routine pediatric schedule will use Pneu-C-15 [Vaxneuvance], as previously communicated. The high-risk pediatric schedule, routine adult schedule (for individuals 65 years and older), and high-risk adult schedule will all use Pneu-C-20 [Prevnar 20]. Read the full memo here.

New Guidelines for the Management of MASLD 

The provincially approved Provincial Clinical Guideline on the Management of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is being rolled out to primary care providers and their teams who provide care for patients with MASLD to allow them to adequately manage the majority of these patients in their practice, and to improve appropriate access to specialist care for the subset of MASLD patients that require it. You can see the memo here, and the new guideline here.

Comment on Breast Cancer Guidelines By July 11

The Canadian Task Force on Preventive Health Care sent a bulletin this week inviting clinicians to comment on the proposed breast cancer screening guidelines by July 11. By providing feedback, you will help ensure the final guideline is clear and feasible for clinicians to use in practice. The Task Force provides a summary of the evidence in this bulletin and summarizes the recommendation, particularly as it relates to those in their 40s for whom screening is currently not generally recommended. Read the bulletin here.

Career Opportunities

Recruiting Project Lead. We just posted a job for a Project Lead to guide our work on reducing administrative burden, including on the sick notes and third-party requests project. See the posting here, and share it with any capable leaders you know! 

Prairie Mountain Health Physician Navigator — Brandon

Prairie Mountain Health is hiring a Physician Navigator. We’re excited to see the creation of this role, a result of collaboration between the region, Doctors Manitoba, and a dedicated group of physicians working to enhance physician health at the system level to positively impact patient care. 

The Physician Navigator will interact with other medical providers and provincial allied health workers to improve physician navigation of available resources for their patients/​practice, and be available to provide support to new physicians. This role will help physicians save time searching for vital information and resources. 

If you know someone who would be the right fit, please encourage them to apply! The posting closes July 8. Read the full job posting here.

The University of Manitoba (UM) invites applications for a part-time (0.4 EFT, 16 hours/​week) International Medical Graduate Training Program Director for a 2‑year term, within the International Medical Graduate (IMG) Program in the Department of Family Medicine, Rady Faculty of Health Sciences. The expected salary for this position is $72,424.69. Read more.


ICYMI

Upcoming Events

You can always review upcoming events on our events calendar page.

Canadian surgery Forum is coming to Manitoba!

For the first time ever the largest surgical meeting in Canada will be held in Winnipeg, Manitoba from September 25 – 28. To help celebrate, the Canadian Surgery Forum will do a draw of all Manitoba surgeons who register and attend to receive a refund of their conference registration post event.*

Held at the RBC Convention Center at 375 York Ave., the Canadian Surgery Forum includes scientific and educational sessions offered through interactive symposia, panel discussions, postgraduate courses, debates, plenary sessions, video sessions, and ​‘Meet the Fellowship Director.’

The theme of CSF 2024 is ​“Surgery Through Inclusive Innovation”. Delegates can expect over 50 accredited sessions across all participating sub-specialties, with full and half-day post graduate courses, content geared towards community and rural surgeons, and free child care!

Early bird rates: Secure your spot by July 31 and save on registration fees.

You don’t want to miss this premier event featuring cutting-edge surgical advancements, networking opportunities with leading professionals, and invaluable workshops.

Visit cana​di​ansurgery​fo​rum​.com for speaker bios, the conference program, travel and accommodation information, and to register!

Members of CAGS and CSF partner sub-specialty societies qualify for special discounted member rates!

Don’t forget, Doctors Manitoba members are reimbursed for continuing medical education expenses. 

For all conference information, including registration information and pricing, and the scientific program, please visit the CSF 2024 website.

*Draw excludes the cost of post-graduate courses.

CANPAD CME Conference and Family Event

The annual CANPAD Annual Continuing Medical Education Conference and Family event August 1 – 5 at the Fort Garry Hotel Spa And Conference Centre goes beyond the education sessions, including activities and programs tailored to all ages. Youth activities include movie nights, speakers, and volunteer opportunities. Events also include a ladies night, financial talks, family day at the zoo, picnic and gala night. Established in 2001, CANPAD has been at the forefront of advocating for the interests of Nigerian physicians and dentists across Canada. Register now.

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