Ontario’s family doctor crisis: Here is what the auditor general’s report got wrong
- Iris Gorfinkel
- Dec 6, 2025
- 2 min read
Dec. 5, 2025
By Iris Gorfinkel, Contributor
Iris Gorfinkel is a family physician and clinical researcher in Toronto.
The auditor general’s latest report on primary care focuses on how many people cannot get attached to a family doctor, but it fails to recognize that the number of family doctors per person has actually grown. That’s a crucial omission.
Shelley Spence’s report glosses over the main reason why one-in-four Ontarians will have no family doctor by 2026. No, it’s not because of a gap in provincial coordination. Nor is it because of a lack of training spots in family medicine. The real problem? Family doctors providing comprehensive care are leaving in droves.
The number of family physicians per capita has actually outpaced Ontario’s population growth. But there’s been a slow drain because one-in-five practice in niche areas, such as pain medicine or hospital care. They’re doing this in search of higher pay, lower overhead costs, and better working hours. It’s a logical response to a system that rewards volume and quick visits over longer-term relationships and complex care.
But rather than focus on these basic points, the auditor general’s report fixates on planning failures. To be clear, it’s not a lack of training spots that leaves an estimated 4.4 million Ontarians without a family doctor in 2026. It’s because providing cradle-to-grave care is physically, emotionally and financially exhausting.
Most GP offices run like small businesses. Doctors are financially on the hook for the lease, supplies, staff, payroll and other office needs. There’s no paid sickness, vacation, disability or retirement. When away on holidays, responsibilities remain — including for patients, office overhead and employee payroll.
One study found a family doctor would need a 27-hour day to provide all recommended preventive care, chronic and acute care, documentation and reviewing results. It’s impossible to do it all without the assistance of a health-care team, but that’s Step Two. Step One is having enough family doctors willing to provide comprehensive care.
Expanding training spots doesn’t guarantee they’ll go on to provide comprehensive care. The supply of family physicians per 100,000 people has increased faster than population growth over the past decade, yet the share of family doctors offering cradle-to-grave care dropped from 77 per cent in 2008 to 65 per cent in 2022.
The problem has never been too few family doctors, but not enough who are willing to look after patients across their lifespan.
Ontario should stop fixating on the total number of GPs and start measuring the number of comprehensive family doctors per 100,000 residents.
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