At first, Peter Hamer thought the empty lot in Carleton Place, Ont., was destined to become a standard medical clinic.
With an estimated 4,000 residents in the area without a family doctor, the project would help address a need.
But as work progressed, Hamer began to see the outline of “something much more interesting.”
“Instead of just bringing doctors in one building, we also want to bring other health service providers,” said Hamer, the executive director of the Ottawa Valley Family Health Team.
“All the ancillary health service providers that are in the geographic area under one roof.”
The idea to bring a team of health-care workers — including doctors, nurses, dietitians, mental health workers and others — together in a single health centre located about 50 kilometres southwest of downtown Ottawa may be “paving a new approach” for rural health care, he said.
The Ontario College of Family Physicians estimates more than 2 million Ontarians are without a family doctor, and those shortages are felt more acutely in rural and remote parts of the province.
That competitive market is pitting municipalities in Ontario against each other in creative attempts to lure family doctors.
Many small towns are sweetening the pot for prospective physicians by offering direct cash incentives in exchange for a commitment to practise in the community.
But cash alone doesn’t guarantee a desirable work environment, and Hamer said the goal in Carleton Place is to create a different competitive model.
“It’s about the environment,” he said. “If you can offset the costs associated with that, then it’s a really easy sell.”
Carleton Place Mayor Toby Randell said the town’s relatively limited budget pushed it to “think outside the box.”
The health centre is the product of a partnership between Carleton Place, the nearby Township of Beckwith, the developer MNH Group and the Ottawa Valley Family Health Team, a group of family physicians who practise in the area.
Set to open in fall 2024, the health centre is currently under construction at the end of Costello Drive on a plot of land that had been set aside for a new hospital until provincial funding dried up.
The physician group — which includes every practising family doctor in Carleton Place — formed a legal corporation, helping the town pay a portion of their rent. The town will be offsetting the physicians’ rental costs at the new health centre by $150,000 annually for a 10-year period.
Randell said it is doing so because some physicians left practices they owned to pay rent in the new building. The developer is also renting the property at a reduced rate, he added.
According to Randell, the building will have room for up to seven family doctors beyond the 14 who are already slated to move in.
If the centre can fill that space and each new physician takes on a normal roster of patients, Randell believes anyone in the area who is currently without a family doctor could be covered.
Team-based care ‘remains elusive’
New medical school graduates will generally choose to work in a practice that “looks and feels” like the practices they were educated in, said Lawrence Grierson, a professor in the department of family medicine at McMaster University.
Grierson said most medical training in Canada follows a model called the “patient’s medical home,” a form of team-based health care led by a family physician.
But that model, he said, “remains elusive” in Canada, as provinces have largely halted its funding.
One difficulty for rural communities, according to Grierson, is that young medical graduates have a strong perception that working in rural areas means setting up a comprehensive practice. For those who would prefer to narrow their scope, rural clinics may not be as appealing as urban ones.
Although team-based care is not impossible in rural settings, it’s less common.
But Hamer said the nearby municipalities of Arnprior and Russell have expressed interest in attempting something similar to Carleton Place’s approach. Randell said he hopes to share the model with municipal councillors from across the province.
“Hopefully people can kind of look at what we’re doing here and see if it works for them,” he said.