150 doctors across the province hand-delivered a presentation on Ontario’s worsening “healthcare crisis” on October 21, 2024, to underscore the severity after the provincial legislature resumed this past Autumn. But, since then, Dr. Dominik Nowak, a family doctor in the Greater Toronto Area and President of the Ontario Medical Association, says that he thinks it is not just a crisis, but a “catastrophe” that sometimes leads to residents of Northern Ontario losing an average of two and a half years from their lifespan.
While Dr. Nowak did discuss the creative approach some Ontario municipalities, like Fort Frances, have adopted to make ends meet, Dr. Nowak suggested the improvement of healthcare access is “by far the most important thing” an incoming provincial government could do. Moreover, Dr. Nowak thinks a strong economy cannot be separated from a strong healthcare system, and considers healthcare to be a provincial responsibility.
The Ontario Medical Association’s campaign, titled Stop the Crisis, describes the situation as a “historic challenge.”
“It’s time to stop the crisis. As we face historic challenges, let’s build a strong healthcare system for a stronger Ontario,” reads the release.
“The future of our province depends on it.”
Another release dated February 17, 2025, from the Ontario Medical Association claims “the majority of Ontarians believe the health care crisis is worse now than it was a year ago.”
It is bad enough that Dr. Nowak thinks Ontario healthcare is “not just in crisis, but in catastrophe.”
“What we’re advocating for is for the government to address the serious challenges that our healthcare system faces,” said Dr. Nowak.
“Stop the crisis priorities are really those places where our healthcare system in many communities, is not just in crisis, but in catastrophe.”
One of the areas Dr. Nowak thinks healthcare has been stagnating is rural and Northern communities.
“The idea that everybody should have a family doctor, the idea that emergency departments should stay open, the idea that rural and northern communities deserve this foundational level of healthcare, [like] bringing in [new] technology. These are really things where we’re stagnating,” said Dr. Nowak.
“For citizens in Ontario, [the provincial] government is failing to deliver on the foundational promises that our healthcare system should have for them. We’re talking about rebuilding the foundations.”
For Dr. Nowak, the rebuilding of foundations is integral to successfully addressing the “catastrophe” healthcare finds itself in Northern Ontario.
“We’re talking about keeping that foundation there, especially for rural and Northern Ontario, where people already live two and a half years shorter,” said Dr Nowak.
“I believe that’s an important part due to the lack of access to a foundational level of health care. Ontario should be providing [foundational healthcare] for everybody across the province.”
Dr. Nowak emphasized how the average number of people in Northern, rural Ontario are beyond crisis levels.
“We have nearly one in four people across the province who can’t find a family doctor, and many of these communities are Northern and rural communities. The mayors and local community groups [in the North] are telling me that it could be one in two people in their community who can’t find a family doctor,” said Dr. Nowak.
“That’s more than crisis levels. That means that the people who can’t find a family doctor are missing cancer screenings, getting delayed diagnoses, using the emergency departments more often, using hospitals more often, overwhelming hospitals and catching things later on and when they’re more serious. And because of that, it’s costing our healthcare system significantly more money and making it less sustainable. So, we’re at a point where we called things a crisis a few years ago. Things have only gotten more challenging.”
One of those challenges is the closing of emergency rooms, many of which Dr. Nowak said are in the North.
“Last year, emergency rooms closed over 200 times across the province,” said Dr. Nowak. “Many of those emergency rooms are actually Northern and rural emergency rooms, where our communities in the North and rural places need those safety nets.”
Moreover, Dr. Nowak said many doctors in the North are feeling “stretched” by the demands being put upon them.
“I’m meeting with many of the doctors and many northern and rural communities and small communities, and they’re feeling stretched,” said Dr. Nowak.
“They went into medicine for a reason, and they’re seeing a system that’s failing to deliver on its promises. What I’m noticing is that many smaller communities rely on a handful of doctors, oftentimes family doctors, to fill in the gaps in that community. There are oftentimes four or five doctors in a community. They’re oftentimes family doctors.
“They’re the Swiss Army knives of the healthcare system locally because they’re working in the family practice clinic, but also staffing in the emergency room, also delivering babies, also helping out with surgeries and end-of-life care,” Dr. Nowak continued.
“They’re filling all the needs of that community, but they’re feeling stretched, and that’s where they need our support from the healthcare system to deal with their severe shortages, and those shortages are intense.”
Not only are doctors working harder to make ends meet, but, Dr. Nowak said it is becoming “less sustainable” for Northern, rural communities.
“Northern communities are short one-quarter of the staffing that they need. That means that every doctor is working that much harder to keep that healthcare system flowing, and it’s making it less sustainable for those communities,” said Dr. Nowak. “[But] there is a way forward.”
However, Dr. Nowak said this path forward will need “political will” to succeed.
“There is a way forward here,” said Dr. Nowak. “It’s going to take political will. We put forward the solution that would make a difference in the Stop the Crisis campaign. A big one is connecting everyone to a family doctor, building out teams, making family practice financially viable again in this province, including in the north, and at the same time, there are also northern-specific solutions that would make a difference.”
One solution Dr. Nowak described is a centralized hub for training an recruiting doctors in Northern Ontario.
“Creating something like a center north … built off of the idea of a coordinating center for rural communities,” said Dr. Nowak.
“In British Columbia, there has been a success story there, and we can do a similar kind of thing. [Such as] a coordinating center for Northern Ontario that would support bringing in doctors, training, doctors, support recruitment, education, and keep our healthcare system around and strong for years.”
Dr. Nowak gave special recognition to NOSM University for their pioneering work.
“I do want to acknowledge that Northern Ontario School of Medicine University is a big success story in ensuring that we can do this. We can do the ‘grow your own’ approach to getting doctors into northern communities. We can have a concerted effort around the north, but it’s going to take those solutions, like the Northern Ontario School of Medicine University, to make that happen.”
While Dr. Nowak commended the ingenuity of approaches like that of NOSM University, he suggested that the shortcomings of Ontario healthcare are a “provincial issue.”
“Healthcare is a provincial responsibility. The fact that our healthcare system is stagnant and not delivering on its foundations is a provincial issue,” said Dr. Nowak.
“We’re seeing some creative ideas coming up from municipalities But, it’s not the role of the municipality to rebuild. What happens in many small communities, especially in rural communities, is that when municipalities start to get involved, in a more wholesome way. Sure, there are some benefits, but then you get the haves and the have-nots, the municipalities that can afford to get involved and support recruitment and do initiatives, and then others who just don’t have the resources to do it … That’s why we need provincial leadership.”
Provincial leadership that Dr. Nowak suggests many are “yearning” for.
“When I speak with mayors, with local leaders, with physician recruiters, they’re also yearning for leadership from the province,” said Dr. Nowak. “They’re doing what they can and what they’re forced to do in the absence of provincial leadership.”
But, Dr. Nowak is optimistic about healthcare taking centre stage this election.
“I’m an optimist, and optimism means realism, acknowledging the challenges that our system faces, but also hope, which means bringing forward solutions and getting things to a better place,” said Dr. Nowak. “That’s what is optimistic is that actually, healthcare is the number one issue now in this election. Voters have to be making their decisions based on who they trust to rebuild our healthcare system. At the same time, we’ve seen historic announcements from all major parties and things that would help get our healthcare system back on track.”
