Doc who led advocacy campaign for family medicine leaving his practice

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Dr. Ramsey Hijazi, who currently practices at a clinic in Carp, is leaving his roster of 1,500 patients for a hospital job. He’s not alone.

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An Ottawa physician who led a campaign to make family medicine more sustainable to attract and keep doctors says he’s had enough.

Dr. Ramsey Hijazi, who currently practices as part of a clinic in Carp, will leave family medicine and take a job in a hospital beginning this spring. He has worked as a family physician for a decade.

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Last year, Hijazi helped found the Ontario Union of Family Physicians in order to push for changes in the way family medicine is compensated and organized. The advocacy organization, which has more than 1,700 members, struck a chord with family doctors, many of whom said their work is unsustainable.

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Hijazi’s decision to leave is part of an exodus of doctors who trained to practice family medicine but say the system as it is currently funded and organized is no longer sustainable. It comes at a time when there is a severe shortage of family doctors across Ontario and the country, something putting strain on the entire health system. Around 2.3 million Ontario residents don’t have a family doctor – a number that is expected to nearly double over the next two years, according to the Ontario Medical Association.

Hijazi and others say the workload, compensation and the way family medicine is funded in Ontario just doesn’t make sense as a business model and the situation will only get worse if things don’t change. It is leaving many doctors looking for less stressful alternatives.

“I feel like I am burnt out from family medicine. Once you burn out, it is hard to come back,” Hijazi said.

It is a decision Hijazi says he made with both regret and relief.

He is leaving a roster of 1,500 patients, but says others in his practice will be able to absorb them into their practices.

“It wasn’t an easy decision. But it was made a little easier knowing my patients were not going to be left stranded.”

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But he says he is relieved that he’ll no longer have the burden of spending evenings and weekends catching up on paperwork. On average, family doctors spend 19 hours a week on administrative tasks – work that is usually done after hours and is unpaid.

“I just feel like my mind is never idle. Sometimes on weekends when I am playing with the kids, paperwork is on my mind. I try to do my best to not let it affect my life, but it is really impossible. It has affected my happiness. I have come home irritable and grumpy. That is not who I want to be.”

But increasing volumes of paperwork are just part of the problem, he said.

Hijazi calls family medicine a failing business. “Every year it loses money and OHIP billings have not kept up with inflation or costs,” he said. “I didn’t go into medical school for the money, but I certainly didn’t sacrifice all the time and money and years of studying to enter a career just to be running a failing business.”

To keep their businesses going – including paying staff enough to keep them – physicians are forced to pay out of pocket. Both staffing and operations costs have been steadily rising, he said, which is not matched by the amount physicians are paid to see patients.

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Among factors driving physicians away are the financial burden, inadequate compensation and uncompensated administrative workload, according to the Ontario Union of Family Physicians, which notes the average cost of running a single doctor’s practice is $100,000 a year and doctors do not have access to benefits such as maternity leave, pensions, sick leave, vacation pay or health and dental benefits.

Hijazi said he has been weighing his future as a family doctor for some time. He is not alone. Up to 47 per cent of physicians, according to a poll, said they are thinking about leaving their practices in the next five years. Meanwhile, fewer medical students are choosing family medicine and among those who are trained in family medicine, fewer are choosing to practice it.

As a sign of growing concern about the exodus of family doctors, the Ontario Medical Association is devoting an online media briefing to why family doctors are leaving.

Hijazi said he founded the Ontario Union of Family Physicians last summer because he felt that things were bad and getting worse and there was a need for more advocacy. He said uptake in the organization was so high because many family doctors felt the Ontario Medical Association “has failed to represent and advocate for us. I felt that someone needed to step up and advocate around the issues that are driving the crisis.”

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Hijazi said he is discouraged about the state of family medicine. “I don’t think I have any words of encouragement for students or residents to get into family medicine.” He said he would even “actively discourage” his children from going into family medicine.

Still, he said he plans to continue to advocate for change.

“I feel as a citizen of Ontario, as a patient and as a family member we need to fix the system and advocate for change. Even though I am leaving, this is important to me.”

He is taking a job at an Ottawa hospital focusing on long-term transitional care.

“At the end of the day, it gives me more flexibility and is a lot less stressful.”

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