Having children is a part of life for many people. It's trite to say that it's never easy for any parent, but our perspective is that it's particularly difficult to manage for family physicians in the community for a number of reasons (discussed below in greater detail).
With this in mind, our clinic has adopted a policy to strictly prohibit patients from switching family doctors within Magenta Health due to their physician's parental leave, whether permanently or temporarily. While we entirely understand why patients oftentimes make this request, as a clinic, we've decided to adopt policies that support the practical need for family physicians, just like any other individual, to balance their working and personal lives. We can't fix everything, but we can do our part by adopting family-friendly policies.
To patients whom this policy affects, we do understand why this can be frustrating as parental leaves can be seen to affect the continuity of care that you receive, or the scheduling or care options that you have come to expect. There are also, of course, situations where a patient does not like the personality or care of the covering physician.
Nevertheless, we trust the considerations discussed below illustrates that we have reflected on this issue at length, and why, on balance, we feel that it is important for us to adopt this policy.
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1) Parental Leave is Nearly Inevitable
Family doctors go through an average of 10 - 12 years of post secondary education before being considered fully qualified family doctors. Tack on a few years of working at different clinics to gain clinical experience and exposure, or doing specialized training, and the average family doctor is in their early 30s when starting a long-term practice. This is already well past the average age of parenthood in Canada making parental leave during their career a difficult to avoid reality.
2) Your Primary Physician is Paying for their Replacement
Finances are a consideration as most primary physicians are, for all intents and purposes, independent contractors. While there's some limited financial support from the government and the physician-funded Ontario Medical Association, for the most part, family doctors are unpaid while on parental leave. Moreover, since family doctors are professionally obligated to supply adequate coverage while on extended leave, family doctors frequently pay out of pocket during their parental leave to ensure patients have continued timely access to a family physician.
This means, for example, if a patient switches from their original physician to another physician, the original physician ends up in a net negative financial position, even if this switch is only temporary.
3) Your Primary Physician has Responsibility for their Replacement
The nature of this coverage is also important. Notably, there is no government agency or organization that takes responsibility for this process, nor does Magenta Health handle this task generally.
Instead, family physicians work hard to individually recruit, interview, select, hire, train, supervise, and support their replacement. This is done to ensure continuity of care for patients and to make sure appropriate & high quality care is available during the whole of their leave. For example, your primary physician is likely having regular meetings with their covering physician throughout the whole of their parental leave to discuss specific patients and how best to meet their continuing needs.
This is one of the reasons why, even in situations where a patient does not like the personality or care of the covering physician, Magenta Health is not able to facilitate a permanent or temporary switch. Instead, our recommendation is that if there are any concerns, patients should schedule an appointment with the covering physician to have an open conversation; if needed, your primary physician will assist / advise as well.
4) A Canadian Value that Supports Strong Families and Communities
Recognizing that family physicians are service providers is a further consideration. Even though nearly all care provided is covered by OHIP and direct patient payment is rare, physicians are still professionals delivering a service. To thus draw an analogy to Canadian employment and labour laws, we believe physicians can reasonably expect that their means of earning a living is secure and not at risk due to parental leave. We think this is an important Canadian value that supports strong families and communities.
5) Impact on Patient Care
Lastly, we find it important to recognize that our policy does not prevent any individual from having reasonable access to a health care provider of their choice. Our clinics are in areas with a high density of health care providers. While our sincere hope is that this policy does not motivate patients to seek care elsewhere, there are practical options should that not be the case.