Open Letter to Every Canadian Citizen and Politician


What if you or your loved one desperately needed to see a doctor, but there were none left, or just as hopeless, the wait list was well over a year long? What if there are not enough doctors to work at all the emergency departments across the country?


I do not expect people to feel sorry for the financial matters of doctors. From the public’s perspective, all doctors are relatively rich. As one prominent health journalist once unsympathetically wrote, perhaps doctors “should put a little water in their fine wine.”


I do not expect that the public realize and appreciate that doctors have gone through ten to fifteen years of advanced education and training after high school; that most graduate in their 30’s and it is not until then that they can start to pay down their hundreds of thousands of dollars of accumulated debt; that they have no benefits, no paid vacations; no sick leave, no maternity leave; that they have no pensions and have to personally fund their retirements; that doctors operate as small businesses and contribute to the economy by hiring employees, paying taxes, paying rent, and paying overhead costs; and that, perhaps most importantly, doctors make immeasurable self-sacrifices for the sake of their patients.


For over three years Ontario’s doctors have been hit with multiple unilaterally imposed cuts to funding, not to mention being repeatedly villainized by the Provincial government. More recently, the Federal government has proposed tax changes to corporations that will dramatically impact Canada’s doctors. Some estimates propose doctors will be subject to an effective tax rate as high as 73%, or even 93%.


This letter is not about that. There are already countless articles on these matters. Just search the hashtags like #TaxFairness, #CareNotCuts, #PatientsFirst, and #ONhealth on social media to read more.


Instead, this letter is meant to raise awareness about why every single person in Canada, and especially in Ontario, should take notice and care about their own health care interests.


The simple fact is that Canada, and especially Ontario, has become an increasingly unattractive place to practice as a doctor. The health care system is strained and underfunded. Physicians are burnt out. They are feeling villainized and underappreciated here. The financial climate and discouragements by both the Provincial, and now the Federal, Governments are evidently incessant.


I have been a family physician in Ontario for over eight years. I love my life here. My young family and I have deep roots in Ontario. I am fortunate to practice in a supportive rural community. I could not wish for better colleagues and staff.


However, something has to give.


For the first time ever, I have frankly started looking at opportunities to move and practice in a different country. Last night, I researched opportunities in New Zealand and Australia, and other countries where my Canadian qualifications are readily transferrable. I also signed up for emails on international job postings. My wife and I had honest discussions about other countries to which we would be interested in moving. The simple facts are: pretty much every other country in the world is also in desperate need of doctors; most developed countries have better functioning health care systems; and many countries have much more hospitable financial and tax incentives along with exemplary work-life balance.


Now, for full disclosure, surely uprooting my family and moving to another country would be an enormous change – so big, in fact, that there is truthfully only a 10-20% likelihood that I will ultimately go through with it. However, this is coming from a deeply rooted physician who would have previously given this less than a zero percent chance. If a physician like me has been pushed from 0% to 20%, it follows that many other doctors have been pushed passed their tipping points. This is not to mention all of the new graduates every year who are free to choose to practice in whatever province and country they wish.


History seems doomed to repeat itself, but worse. Ontario’s doctor shortages are the result of misguided government actions in the 1990’s when then Premiere Bob Rae turned Ontario into an overly unappealing place for doctors. If government policies continue on their current courses, the situation will become even more dire as the health care system is coming under the increased strains of an aging Baby Boomer generation and a progressively complex overall population, compounded by vast underfunding – and, soon to come, far less doctors.


So again, I ask: What if you or your loved one desperately needed to see a doctor, but there were none left, or just as hopeless, the wait list was well over a year long? What if there are not enough doctors to work at all the emergency departments across the country?



If this concerns you, please share articles like this with your friends and families to raise awareness. Please contact your government representatives at every level of government (Municipal, Provincial, and Federal) and speak out against the under-funding to our health care systems as well as the Federal Government’s proposed tax changes.



— Dr. Adam Stewart

August 12th, 2017