Ontario doctors urge province to reform specialist access and end fax referrals

Doctors in Ontario are calling for the province to overhaul how patients access specialists, including ending the use of fax machines and creating a central intake system. The Ontario Medical Association released a survey showing one third of patients with a chronic condition wait six months or longer for a specialist appointment. The poll of 1,156 adults, conducted in mid-October, has a margin of error of plus or minus 3.5 percentage points. The association said physicians are now resorting to social media and group chats to find specialists with shorter wait times for their patients.

OMA president Dr. Rebecca Hicks said these lengthy delays are pushing patients toward hospital emergency departments. "These delays have real consequences and people are growing frustrated," Hicks said on Monday. The OMA's proposed reforms include expanding team-based care within specialist practices, mirroring a model used in primary care. This approach combines physicians with nurses and other professionals like physiotherapists to increase capacity.

The association is also advocating for a provincewide central intake system for specialist care and diagnostics. "Patients should be connected to the right provider or service as quickly as possible, regardless of where they live," Hicks said. She noted that some regions already have centralized intake for procedures like hip and knee replacements. The OMA wants to apply lessons from those systems more broadly.

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Health Minister Sylvia Jones said the province will develop a centralized intake system for specialized care after completing a similar project for primary care. "I'm not going to give you a timeline because it is something that physicians have to make the decision that they want to participate in the central referral," Jones said. She added that primary care providers are very excited about the initiative. The minister also addressed the goal of eliminating fax machines from the medical system, a pledge made in 2023 with a five-year target.

On Monday, Jones said the government is "working on it" but declined to provide a new timeline. Hicks said the OMA is compiling a list of specialists to enable electronic referrals instead of faxes. The association also reported that wait times for non-urgent adult MRI scans have grown from about 70 days in 2022 to 100 days, far exceeding the 28-day provincial target. "Every day spent waiting for a diagnostic test can delay the start of treatment," Hicks said.

Dr. Zainab Abdurrahman, a pediatric allergist and former OMA president, described the current referral process as untenable. "Our physicians are using Facebook groups, WhatsApp groups, to actually find the community-based specialists to connect patients to care," Abdurrahman said. She argued a centralized system is needed so patients can find faster care options and know which specialists are practicing in their region. The OMA believes giving doctors better access to support staff can help more patients receive treatment sooner.

With files from CBC News