Source: The Standard
A family doctor who moves to the city of Niagara Falls, Ont. — pop. 105,000 — will receive a $100,000 signing bonus for opening a new practice.
A short drive away, St. Catharines, the region’s largest city, offers a comparatively meagre $5,000 relocation grant in its bid to attract family doctors.
Up in cottage country, Huntsville provides up to $80,000 to doctors who move to the town to either establish or take over a family medicine practice. The incentive package — which may also include a one-year car lease donated by the community — comes with a swim and skate membership to the town’s community centre and a family pass to Muskoka Heritage Place.
As Ontario grapples with a family doctor shortage, municipalities across the province are shelling out thousands of dollars to lure physicians to their communities. Incentive packages, which largely come from municipal coffers, include everything from signing bonuses to free housing to financial help for relocation expenses. As a guarantee, many cities, including Niagara Falls and Huntsville, require doctors to stay for at least five years, hoping that’s enough time for physicians to put down roots.
But even as recruitment efforts ramp up across the province some cities and towns don’t have the means to join the intense competition.
“This has been referred to as the Hunger Games,” said Jill Croteau, chair of the Ontario Physicians Recruitment Alliance, a not-for-profit coalition of hospital and community-based physician recruiters. “If a municipality doesn’t have the resources for financial incentives, then they’re being held at a disadvantage.”
Last week, Ontario’s auditor general called out the fragmented approach to doctor recruitment in her annual report to the legislature.
In her audit of the province’s oversight of access to primary care, Shelley Spence concluded the Health Ministry was failing to get more Ontarians a family doctor. Among her findings, she pointed to a lack of provincial co-ordination in physician recruitment, which is leading to both competition and duplication between communities. For municipalities that don’t have the resources to attract doctors, Spence said the current practice raises “an issue of fairness for Ontarians.”
What did the auditor general find on physician recruitment?
The report, released Dec. 2, stated that Ontario Health, the super-agency formed by the Ford government to oversee health administration, is not responsible for overall physician recruitment in the province.
That has left individual municipalities to spend public dollars on recruitment committees, to employ physician recruiters and to provide financial incentives to address the primary care needs of their communities, the report said. Some two million Ontarians do not have access to primary care, a crisis the provincial government has pledged to fix by 2029.
The report cited a 2025 survey by the Association of Municipalities of Ontario (AMO) that found that the responding municipalities, which account for 89 per cent of the province’s population, collectively spent more than $6.3 million a year on recruitment and incentives. It stated that Ontario is the only province that has not developed a centralized physician recruitment strategy and stressed that failing to create one could “lead to greater inequities in primary care access.”
What Ontario municipalities say about recruitment
The AMO said in a statement that many municipal governments go above and beyond their responsibilities to “shore up local gaps” by spending their own dollars to attract doctors to their communities.
Association president Robin Jones said the 2025 survey showed the $6.3 million that municipalities used to recruit doctors include financial incentives but also housing subsidies and “other carrots.” She said the fragmented approach leads to long lines for new clinics and municipalities competing for the same medical professionals, adding that a more co-ordinated, provincial recruitment strategy would ensure residents have fair access to health care.
“Every municipal dollar that subsidizes provincial areas of responsibility is one less dollar for core municipal services like public safety, transportation, and community parks and recreation,” Jones said.
London Mayor Josh Morgan is opposed to using municipal dollars to fund financial incentives for doctors, saying the practice should be banned in the province.
He said his council has resisted using signing bonuses and other cash incentives, despite criticism and even though the fast-growing city is in dire need of family doctors. Some 84,000 people in London and the surrounding area don’t have a family physician.
Municipalities can boost recruitment in other ways, such as helping with zoning and permitting, and can support province-wide recruitment and retention efforts, Morgan said.
“What I can’t support is us using property tax dollars in a race-to-the-bottom competition with other municipalities.”
What is the Health Ministry’s response?
The auditor general recommended that Ontario Health and the Ministry of Health co-ordinate their physician recruitment efforts, including with municipal partners. The ministry agreed and in the report said it “recognizes the importance of recruiting family physicians … in an equitable manner,” adding that work is underway through Ontario’s Primary Care Action Plan (PCAT).
In a statement to the Star, a spokesperson for Health Minister Sylvia Jones said the $2.1 billion PCAT includes the expansion of primary care teams and that the province this summer announced nearly 80 new and expanded teams in regions with the highest rates of unattached patients. Ema Popovic said teams target people on the Health Care Connect wait-list, which she said has shrunk by 65 per cent since Jan. 1, a point not accounted for by the auditor general.
The statement did not address questions about how the government will expand its work on equitable physician recruitment, or on the practice of municipalities providing financial incentives to recruit doctors. Rather, Popovic listed the province’s primary care efforts, including the addition of nearly 20,000 new doctors since 2018, the expansion of medical school seats and the modernization of the Family Health Organization model to help attract and retain physicians.
Why physician recruiters are working together
Croteau of the Ontario Physicians Recruitment Alliance said the organization, which connects almost 60 recruitment programs across five provincial regions, welcomes the auditor general’s findings, which validated its experience of municipalities filling in provincial gaps.
She said recruitment work, including marketing, community tours, clinic set-up and retention, is being done by staff funded by municipalities, hospitals and regional programs. She said OPRA agrees more provincial co-ordination is needed, and that clear provincial partnerships and stable funding would prevent more inequity among communities.
Already, OPRA’s members communicate recruiting tips and best practices and share doctor candidates among municipalities, said Croteau, the physician recruitment program manager for the Niagara Region. The goal, she said, is to help doctors find a community that’s the right fit, both for their professional goals and for their family life.
“We want them to have the best experience. If they’re happy, they are going to stay.”