The restrictions came at the same time the province imposed $580 million in cuts on Ontario's 28,000 doctors after the OMA and the government failed to reach a contract settlement.

"We continue to believe that the model holds tremendous potential," said Health Minister Dr. Eric Hoskins in a statement to The Spectator about family health teams. "But it's still a new model and … we need to make sure that as we move forward, we're tying investments to improving outcomes for patients and to improving system performance and accountability."

He says the ministry is "currently reviewing criteria for underserviced areas to ensure that we expand in areas where they are needed the most and where they can make the most significant impact for patients."

But local doctors say even large urban centres like Hamilton are short physicians and looking to expand family health teams.

"We need new doctors to come in and help us, not replace us," said family physician Dr. Richard Tytus who represents this district at the OMA and believes the teams are being restricted to curb costs.

"You're going to see big ramifications."

Doctors wanting to set up a practice in Hamilton are now limited to fee-for-service or a comprehensive care model, getting premiums and bonuses for providing chronic disease management and preventive care. They can work alone or in a family health group with other doctors.

"I don't think anyone is enthused about a fee-for-service model," said Jessica Cuppage who is in her first year at McMaster's medical school. "I want to work in a team but now I'm not sure about getting a job."

As a result, she's considering internal medicine instead of primary care.

"I'd like to be able to practice where I want to practice," she said. "I want to practice in an urban, academic centre."

Without the draw of family health teams, there is concern about Hamilton's ability to recruit.

The city's physician recruitment and retention program attracted 15 permanent family doctors and 5 locums to work here temporarily in 2014. That is already lower than the 24 to 29 permanent and locum family doctors recruited annually from 2011 to 2013.

Although, the program had unprecedented success last year bringing eight new specialists to the city. The most it had attracted before that was four in 2006.

Hamilton's physician recruitment and retention steering committee will meet Wednesday to discuss funding for the program in 2015.

jfrketich@thespec.com

905-526-3349 | @Jfrketich