Manitoba made important progress in 2025 in narrowing its physician shortage, driven in large part by successful recruitment of internationally trained physicians. But the challenge is far from over.

Manitoba’s population is growing steadily, and patient needs are becoming more complex. This is making it difficult for physicians to keep up.
At the same time, the Manitoba government is considering how to implement a new federal directive to ensure patients do not pay out-of-pocket for medically necessary services from nurse practitioners and pharmacists that would otherwise be covered under the Canada Health Act.
For Doctors Manitoba, the federal directive is a reminder of the progress needed to expand team-based care, rather than simply adding more fragmented silos for care with more gaps for patients to navigate. 

“Our health care system already has too many silos for patients to move between, and too many gaps for them to fall through,” explained Doctors Manitoba Past President Dr. Nichelle Desilets. ​“But Manitoba has a solution that both meets the federal direction and improves well-coordinated access to care for patients.” 

That solution is team-based care in family medicine and other specialty clinics. 

In a well-designed team, patients have timely access to the right provider for their needs, including a physician when care becomes more complex or uncertain. Care is well-coordinated, access and quality improve, and patients are not left to navigate a system on their own.
​“Team-based care is one of the most promising ways to strengthen our health system,” said Dr. Alon Altman, Doctors Manitoba President. ​“It’s better for access, better for continuity, and better for provider well-being. Plus, it helps to retain physicians in Manitoba.” 

How it Works 

Team-based care in physician practices can make a real difference to both patients and physicians. At its core, it brings physicians and other health professionals together in a coordinated team, with physicians providing clinical leadership and each team member working to their full scope to improve access, quality, and continuity of care. 

Team-based care models have been proven to work in both family medicine and specialty practices. Family physicians take on more patients when they have other providers with expertise to care for specific issues or to support ongoing chronic diseases. A range of specialists can also benefit from teams – from psychiatrists with other mental health professionals, to sports medicine or orthopedic specialists with occupational or physical therapists, to geriatric specialists with pharmacists. 

Currently, team-based care models are more common in hospitals or health system-run clinics, where positions are funded and managed by regional health authorities. For example, ACCESS Centres in Winnipeg and Brandon include physicians, nurse practitioners and social workers, offering primary health and social services in various communities. Specialized team-based care can be found at provincial clinics such as the Prostate Centre at CancerCare, the Heart Function Clinic, and Kidney Health, where multidisciplinary teams of specialists and other providers care for patients within a well-coordinated medical ecosystem. 

In independent community-based practices, however, it is a challenge to build team-based care without targeted funding. In some cases, physicians have pooled their own income to create positions. When the government funds these positions, however, these challenges decrease and it puts all practice types on a level playing field. 

In family medicine, the team-based care system has relied for years on two initiatives that currently fund approximately 160 team-based providers: My Health Teams and Interdisciplinary Team Demonstration Initiative (ITDI). That number, however, hasn’t changed for many years.
Kingsbury Medical Centre in Winnipeg has benefited from both its My Health Team and ITDI resources. Clinic leaders say the results of working within these models have been rewarding for both patients and providers. 

“It’s been so amazing,” said Dr. Erin Olivier, a family physician at the practice and Doctors Manitoba President-Elect in a recent interview on CJOB Radio. ​“We have our nurse, we have our physician assistant, and we have access to other providers including a physiotherapist, occupational therapist, dietitian, counselor and social worker.” 

Dr. Olivier noted the value of being able to see and serve patients through integrated care from different types of experts. 

“For example, I’m not the best to talk to a patient about how they can increase their income like our social worker can, or know exactly what specific physiotherapy exercises a patient needs to do, but we can do the referrals to providers who work down the same hall,” she said, adding the system makes way for well-rounded patient care. ​“Our patients can get the care they need, especially for those who cannot afford a private physiotherapist or a dietitian, and it makes all the difference to an individual’s health care and their wellness.” 

By the time Dr. Olivier sees a diabetic patient, for example, a nurse has already checked for signs of neuropathy, reviewed sugars and checked blood flow, among other typical checks. 

“So, we do full preventative care, and then the physician can come in, wrapping up the visit in about ten minutes because the nurse spent 20 – 30 minutes with them before,” Dr. Olivier added. 

It shifts the focus from acute, episodic care to long-term prevention and chronic disease management with the support from a team that can address a variety of health needs. Each provider concentrates on their areas of expertise, enhancing care effectiveness and improving patient outcomes. 

“When our patients do well, we do well, and the entire health system gets better as a result,” she said. 

Kali Braun is a Manitoba-based physician assistant (PA) who represents the province as a board director with the Canadian Association of Physician Assistants. She agrees, and says PAs are heavily utilized in surgical services, pediatrics, psychiatry, nephrology, ICU, internal medicine and in emergency departments across the province, with growing numbers in rheumatology and ophthalmology. 

“In Manitoba, team-based care gives physicians and other providers the ability to focus on what they do best,” Braun said. ​“As PAs, that collaboration allows us to contribute meaningfully to patient care every single day. It creates a more sustainable system for everyone.”
​“Our scope of practice allows us to conduct physical exams, order tests, prescribe medications, formulate treatment plans, and perform other functions, all under the collaborative leadership of a physician,” she added. ​“When teams function well, patients notice the difference. They’re seen sooner, they feel more supported, and physicians are less stretched thin.” 

Improving Health Outcomes, Reducing Physician Burnout and Increasing Retention 

Evidence shows these models increase provider satisfaction, and contribute to system efficiency, particularly when multiple team components and strong collaboration are in place. In turn, patients’ health outcomes can improve. 

Not only is team-based care beneficial to patients, but it has been proven to reduce physician burnout, which is currently a factor driving 43% to consider retiring early or relocating to another jurisdiction, according to the 2025 Doctors Manitoba Annual Survey.
A well-functioning team-based care system has been shown to improve job satisfaction, reduce burnout, and strengthen recruitment and retention, according to a review by the Institute of Health Economics. 

In well-functioning teams, doctors spend more time practicing at the highest levels of their scope and less on items in a patient’s care plan that could be safely handled by other well-trained professionals. This sense of practicing ​“high-value medicine” is a strong protective factor against burnout, and leads to stronger professional fulfillment. 

Team-based care also reduces isolation. Physicians working in solo or fragmented systems often experience professional isolation, which is associated with higher stress and burnout. Integrated teams create regular communication, shared decision-making, and peer support, which improves morale and reduces the emotional burden of difficult cases. 

From a system perspective, it also improves patient flow and access. When patients can be seen by the right provider at the right time, physicians face fewer backlogs and less pressure to overbook or extend hours. That reduction in constant overload is a key retention booster, especially in high-demand areas like primary care. 

Finally, there is a long-term stability effect. Clinics and health systems that invest in team-based models tend to have more predictable schedules, clearer roles, and better coverage for absences – all factors that reduce the risk of burnout-driven exits and make it easier for physicians to envision a sustainable career path. 

In short, team-based care retains doctors because it reduces administrative overload, restores professional autonomy, improves support and collegiality, and makes day-to-day practice more manageable. 

More Work to Do 

The provincial government promised to fund 250 more team-based care providers in physician practices during the 2023 election campaign. Doctors Manitoba continues to work with Manitoba Health, pressing for plans to implement this important government commitment.