Kingston clinic a ‘beacon of hope’ for Ontario’s health-care system

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The Ontario Medical Association president described Kingston’s latest team-based primary health-care clinic as a “beacon of hope” amidst the province’s growing family doctor shortage and ongoing health-care crisis.

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Dr. Dominik Nowak visited the Midtown Kingston Health Home last week for a tour of the innovative family doctor clinic that is providing primary health not only for those who need a doctor, but also for many who can’t get one.

The Midtown Kingston Health Home opened in August 2024 and when running at full capacity will employ five physicians, three nurse practitioners and a team of supporting health-care practitioners to make the clinic a one-stop location for all family health needs.

The clinic is aiming to roster 8,000 unattached patients based on their geographical location, in the surrounding neighbourhood around the clinic, located at 791 Princess St. The project was spearheaded by Kingston Community Health Centres, and many of its community health-care approaches are informing how the primary care clinic is helping individuals access not only a family doctor, but also health clinics for people who have no primary care.

Those low-barrier services, such as a sexual health clinic, cancer screening, prenatal support and well-baby care, will be available to anyone, whether they’re rostered or not.

Nowak toured the clinic last Monday with Meghan O’Leary, the clinic’s director of clinical services, clinic family physician Dr. Mary Rowland and Dr. Joy Hataley, the OMA’s District 7 chair. The clinic is temporarily housed in the former offices of Frontenac Medical Associates, a practice that saw six of its eight doctors retire in 2023, leaving around 8,000 Kingston residents without a family physician.

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Nowak asked how many unattached patients remained in Kingston.

“So many,” Dr. Mary Rowland said. “We’re funded for five physicians here, so we’re a drop in the bucket.”

The clinic has four physicians in place, and Rowland said that they won’t have any trouble attracting the fifth, as people are “loving the model” that the health home has developed.

The Midtown Kingston Health Home opened its doors following two years of planning and a $4.1-million investment from the Ontario government. The investment was part of $110 million in funding that the provincial government announced earlier in 2024 to help approximately 328,000 people connect with primary care teams across the province.

Its model is very intentional in the way it creates wraparound health care for its patients, with access not only to doctors and nurse practitioners, but a team of 30 staff including registered practical nurses and other regulated health professionals like social workers, mental health counsellors and a certified diabetes educator.

Medical residents from Queen’s University will also be getting involved in patient care in the future.

“All the issues that new grads are reluctant to commit to, this model solves so many of them,” Rowland said. “You don’t have to hire your own staff. You’re not financially responsible for the physical overhead and location. All the HR is looked after, you have benefits, you have a pension, all the things that are like a normal job that usually family medicine didn’t have we can offer people, and a team.”

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Rowland said that new graduates want to work in team-based care settings, and there are not enough spaces available to them yet.

“It’s the number one thing I see doctors saying that draws them into the community,” Nowak said. “Is there a team? Is there a foundation of the health-care system in that community?”

Connecting with patients

According to a recent survey conducted by Ipsos on behalf of the OMA, 68 per cent of Ontarians believe that the province’s health-care system is worse than it was a year ago.

The Ontario College of Family Physicians reported in July 2024 that there were 2.5 million Ontarians without a family doctor, up from 1.8 million in 2020. The number is expected to grow.

Kingston is no stranger to the shortage of family doctors. Hataley told the Whig-Standard in 2023 that as many as 35,000 people in the Kingston region were unattached to primary care, and in February 2024 hundreds of people lined up outside in the cold at the chance to be rostered at a clinic that had opened its doors to new patients.

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Midtown is rostering from the Health Care Connect list, choosing patients who fall within a geographical region to the clinic. And those patients who are rostered are expected to come to Midtown for all their health needs.

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“We’re talking about meaningful attachment,” Rowland said. “When we take you on, we’re going to look after you. If you’re sick and you call here we will see you. We don’t want you to go to emerg unless you have to call an ambulance.”

Rowland said that the patients being rostered are being caught up on long-neglected health issues — cancers that haven’t been diagnosed, new diabetes, in one case an individual who hadn’t seen a doctor since 1992.

Nowak said that this kind of care will rebuild trust in the health-care system.

“We just did some polling that showed that almost 40 per cent of people were avoiding or delaying care because they weren’t confident in their local health-care system,” he said. “So actually a lot of people are now seeing this and gaining some confidence and coming to you, but that comes with a lot of delayed things they may have (found) earlier if they had some kind of support.”

Team-based health care a solution for Ontario doctors

Rowland was quick to admit that the Midtown health home is “not the solution to the whole problem,” but that the way it is operating is an accessible model to others, and having more sites like it could be an effective way to provide consistent health care to Ontarians.

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“You’re a beacon of hope for the health-care system,” Nowak told staff at the clinic. “Even though you have this focus on a postal code, and the work that you have to do locally, you’re actually role modeling for other parts of the health-care system of what could be.”

“I think this is a great model that could easily be scaled into any kind of context,” Rowland said.

Nowak has visited several health teams, but he praised Midtown, saying that the province needs more like it. A physician himself, he spoke to the importance of helping doctors find a deeper fulfillment in their jobs as a strategy to address the family doctor shortage.

“It’s so important that we bring in joy in work for doctors, for health-care professionals as a big part of our strategy for how we connect everyone to a family doctor,” he said. “Joy in work has to be a key part of that. Right now 40 per cent of doctors in the next five years are thinking of retiring early or scaling back. It’s because of outdated funding models, the massive administrative burden, the lack of access to teams, the feeling of needing to be everything to everyone at all times.”

Rowland said that team-based health care is the way toward those feelings of fulfillment.

“I think the exciting thing…we had a team operational planning day last week and all the physicians and (nurse practitioners) are energized, and a lot of people have come from other models and worked in other settings and they’re like, ‘This is the first time I’ve enjoyed my work in years,’” she said. “I don’t feel burnt out. I feel hopeful. I feel excited…how often do you hear primary care providers saying that? And so I think that we really need to pay attention.”

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