0 
0 If you’re having a hard time finding a pediatrician in Winnipeg, chances are you’re not alone.
“Unless the family is already connected with a pediatrician because of previous siblings, I think the likelihood of finding a pediatrician for well-newborn and child care is going to be slim to none,” said Dr. Ruth Grimes, a longtime pediatrician in Winnipeg.
Grimes, who has been practising in Manitoba for nearly 30 years, said traditionally in this province, pediatricians have provided primary care for babies and children, including newborn checkups, vaccines or common health concerns like a cold.
But that’s changing, said Grimes, a former president of the Canadian Paediatric Society.
“What families in Manitoba need to understand is that the whole concept of pediatricians practising primary pediatric care is quite an anomaly in the country,” she said.
In other parts of the country, pediatricians spend more time providing care and consulting for children with complex medical needs, she said. That’s something she’s also seeing happen more often now in Manitoba.
In the last two to three years, Grimes said she’s seen demands on her practice change as she responds to those complex needs, which means she doesn’t have the capacity to take on primary care for new patients the way she used to.
Over the years, medical advancements mean more premature babies are surviving and children with complex medical issues are living longer, requiring pediatricians to devote their time to more specialized care, said Grimes.
And when the COVID-19 pandemic hit, she also started seeing more consults for mental health care, she said.
But those aren’t the only factors affecting the availability of pediatricians in Manitoba.
In Manitoba, she points to the retirement of at least five pediatricians in the last year as another contributor.
“[Those were] pediatricians who’ve had practices for 30, 40 years,” she said, and it’s hard for other physicians to pick up their patient loads.
“[There is] a huge primary care base, but also complex care base [of patients].… The dwindling numbers of us cannot possibly absorb all of those patients into our collective practices.”
A shortage of family physicians also means many pediatricians struggle to find doctors for aging patients with complex health issues — so pediatricians are keeping some patients into their late teens or early 20s, said Grimes.
She thinks family physicians and nurse practitioners need to be part of a new pediatric primary care model in this province, while acknowledging family physicians in Manitoba are stretched thin too.
“This is, I think, a natural evolution over time, but it is now creating a crisis because we also know there are not family physicians to take on any patients, regardless of the age,” she said.
‘Overloaded, overworked’
The head of Doctors Manitoba said what the province is seeing when it comes to pediatric primary care is another symptom of the physician shortage here.
“Pediatricians that are still doing primary care are overloaded, overworked — their patient roster’s expanding. Family physicians that are doing it feel like they just can’t take more,” said Dr. Michael Boroditsky, president of the physicians’ advocacy organization.
He said Doctors Manitoba continues to push for recruitment and retention plans for doctors. And he wants people in the health-care system to think outside the box.
One example: physician-led team-based care that includes other medical professionals, nurse practitioners and physician assistants to help manage care.
Doctors Manitoba also said starting April 1, a new funding model will include incentives for family physicians taking on babies and children.
According to Doctors Manitoba, this new model takes into account the complexity of care a family doctor is providing to their patients.
That means additional funding for age groups with increased medical needs, including babies, children and older patients, explained spokesperson Keir Johnson.
It also applies to patients who need care for chronic diseases, mental health and substance use, he said.
Boroditsky wants to assure families that family physicians are trained to provide excellent care for kids and babies.
Grimes, meanwhile, said there’s a need in Manitoba for more pediatricians, family physicians and nurse practitioners.
She said she also wants families to know that pediatricians in Manitoba want to make sure every child has access to a pediatrician for specialized care if they need it.
