Martha Marchand is a physician settlement and retention coordinator with the Health Services Foundation of the South Shore. She says she's gone as far as babysitting the kids of visiting doctors to woo physicians.Darren Calabrese/The Globe and Mail
When new doctors are thinking of moving to Nova Scotia, Martha Marchand does everything she can to persuade them to settle in one of the communities she represents on the province’s south shore.
Ms. Marchand, a physician settlement and retention co-ordinator for a hospital foundation in Lunenburg and Bridgewater, has gone as far as babysitting the children of visiting physicians at a local hotel pool so they can have adult dinner conversations with their potential colleagues.
“It’s crazy,” Ms. Marchand says, laughing. “I’m down there babysitting the kids in the pool and they’re going down the slide. I’ve done cartwheels with the kids. It’s just whatever is going to show the doctor that this is a community that’s going to embrace them and their entire family.”
Ms. Marchand works in the growing field of non-profit physician recruitment and retention. Her efforts and those of her colleagues are sponsored by provincial and municipal governments, hospital foundations, chambers of commerce and local volunteers desperate to attract family doctors at a time when as many as 6.5 million Canadians don’t have a regular primary care provider.
Some recruiters have the advantage of wooing doctors with six-figure signing bonuses funded by local governments, a trend that some experts say puts poor towns at a disadvantage. Other recruiters take small but crucial steps to set their communities apart. One found a chess club for a doctor’s children. Another regularly calls daycares seeking spots for the children of physician prospects. Still another starts the recruitment process years in advance by building relationships with local high-school students gunning for careers in medicine.
“Recruitment is a long process,” said Paula Mason, the manager of physician recruitment and retention at Docs by the Bay, which finds family physicians for the Eastern Ontario communities of Quinte West and Brighton. “It doesn’t happen overnight.”
Physician recruiters have special insight into what doctors from Canada and abroad are looking for. Their on-the-ground knowledge could be particularly valuable as health policy makers grapple with the fact that, according to a recent federal report, Canada is short nearly 23,000 family doctors.
David Mitchell, the mayor of Bridgewater, has drawn one key takeaway from the community tours he leads for doctors on provincially sponsored site visits to his town of 9,000 an hour’s drive from Halifax: “It absolutely is about work-life balance,” he said.
Doctors often ask him about Bridgewater’s trails and nearby beaches. They want to know about sports leagues for their children and the resources available for their own hobbies. One physician and baking enthusiast was sold on Bridgewater when she spotted a Bulk Barn on the town tour. Her husband is a doctor as well.
“I think a lot of decision-makers think, ‘Oh, it’s money. We’ve got to throw money at them.’ But not everyone is doing it just for the money,” Mr. Mitchell said.
Bridgewater, N.S. mayor David Mitchell says doctors are looking for 'work-life balance' not just financial incentives.Darren Calabrese/The Globe and Mail
That doesn’t mean that money is irrelevant, however. Nova Scotia’s Department of Health and Wellness offers a financial incentive of up to $125,000 paid out over five years to qualifying family doctors and specialists. The province has recruited more than 212 doctors so far this fiscal year, 70 of whom are family doctors, according to Katrina Philopoulos, the director of physician recruitment for Nova Scotia Health. They’re still actively searching for another 116 family doctors and 108 specialists.
Nova Scotia’s approach levels the playing field between poor and wealthy towns, whereas in some other parts of Canada, local governments with the means have stepped in to fill a signing-bonus void.
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Data on the prevalence of municipalities offering financial incentives to attract family doctors are scarce because of the ad-hoc nature of the practice, said Western University professor Maria Mathews, who holds a Canada Research Chair in primary health care and health equity.
But anecdotally it seems to be increasingly common, she said – and that’s a problem. “That’s money that the municipality is not spending on roads, not spending on water and sewage, not spending on playgrounds,” Dr. Mathews said. “There is an opportunity cost to this.”
Dajana Turkovic, a work-force development analyst for the City of Kingston, said it was difficult to persuade family doctors to seriously consider relocating before the city launched a recruitment program in 2022 that included $100,000 signing bonuses. Kingston later added primary care clinic grants that family physicians could use to lessen the administrative burdens they often cite as a disincentive to practise.
But other factors tend to matter more, Ms. Turkovic said, such as jobs for their spouses and daycare for their children. Ms. Turkovic guides prospective physicians through the process of registering for child-care waiting lists in Kingston and then calls daycares on their behalf to see whether spots have opened up. The city has recruited 24 doctors in two years, many of them recent graduates of the local medical school at Queen’s University.
Jill Croteau, physician recruiter for the Niagara Region, knows how tricky it can be when neighbouring communities compete for coveted doctors. She represents 12 municipalities. Some offer signing bonuses, others don’t.
Ms. Croteau is also the head of the Ontario Physicians Recruitment Alliance, an umbrella group for non-profit recruiters formed last spring. They’ve found success in co-operating rather than competing, pooling resources to send representatives to overseas recruiting fairs where they connect foreign doctors with Ontario communities that meet the doctors’ desires.
The Niagara Region brought in 26 new doctors last year, Ms. Croteau said, about 60 per cent of whom came from Britain, although many weren’t born in that country.
“The Canadian work-life balance and the lifestyle here is appealing to them,” she said. “They can buy bigger houses with bigger backyards.” Some are following medical colleagues who’ve successfully settled in the Niagara area, she said.
The town of Bridgewater, N.S. in January, 2025. The province has recruited more than 212 doctors so far this fiscal year, 70 of whom are family doctors. They’re still actively searching for another 116 family doctors and 108 specialists.Darren Calabrese/The Globe and Mail
Still, local recruiters can only do so much, especially in rural and remote communities. They don’t control how provinces pay doctors or whether their regions have a team-based primary care clinic, a model popular with recent graduates. And they can’t force city-loving doctors to embrace rural family practice.
Some trainees worry that “they’re going to be on their own out in the country, the only doctor in the hospital,” said Nichelle Desilets, a family doctor in Neepawa, about two hours west of Winnipeg. “And while the medicine is really exciting, there might be something else that they’re looking for,” she added, such as a specific faith community.
That’s why Ms. Mason, who is also a past chair of the Canadian Society of Physician Recruitment, says her best targets are local medical students who already have connections to the community from childhood.
Jaclyn Robinson fits that bill. She is starting her career this month as a hospital anesthetist in her hometown of Walkerton, Ont. The town northwest of Toronto made headlines last month when hundreds of people lined up in the snow to register with a different new family doctor.
Coming home after medical school was an easy decision for Dr. Robinson, a mother to a toddler who plans to open a family practice in the future. But it didn’t hurt that local volunteers pulled out all the stops to win over her family. One even gave her husband, who is not from Walkerton, advice on the best places to hunt.
“When the community comes forward and makes something like that so possible for my husband,” Dr. Robinson said, “it makes me even happier to be in this area.”