Join a FHO or FHN Enrolment Model (PEM) Group

Information for primary care physicians who are planning to join a FHO or FHN Patient Enrolment Model (PEM) group as a replacement or through the Managed Entry Process

  • To initiate an application to a FHO/FHN group either as a replacement or as a new addition to the group, an invitation from the Lead Physician is required.  It is recommended that this invitation be provided to the new physician(s) in a letter of intent.
  • New physicians must have their CPSO Independent License to start an application process to join a FHO group either as a replacement physician or as a new addition to the group.
  • The physician who is joining the PEM should contact the MOHLTC to obtain a tracking # and instructions for the application.
  • Completed applications take 6 to 8 weeks to process.
  • Only FHO/FHN groups located in the Areas of High Need can apply to add a new physician to the group.  The MOHLTC does not make exceptions.  For more information about FHO/FHN groups in areas of High Need, see Resources for Family Physicians.
  • Changes to the Areas of High Need List are recommended by the WWLHIN based on health system planning criteria related to access to patient care.  Engagement with stakeholders is undertaken as part of the process to update the Areas of High Needs List.  The frequency of changes to the High Needs List is determined by the MOHLTC.
  • The MOHLTC may consider replacing a physician with more than 1 replacement physician if there is a case to do so.  Decisions are made on a case-by-case basis and require submission of a business case that includes detailed information about the patient roster, demographics, physicians in the group, impact on patient access to care.
    1. If a roster is going to be split, a template is provided by the MOHLTC and the patient list must be provided with new doctor identified for each patient.  The split must be made randomly, unless there is a good reason for patients to go to a specific doctor, such as when they reside in a LTC home. 
  • Once approved, a replacement PEM physician has 6 months to re-enroll patients.


  1. When a replacement cannot be found for a physician transitioning out, the lead physician should work with the other doctors in the group to take the patients.  The other physicians are considered to be responsible for the patients.
  2. It is possible to transfer all of some of the patients to another physician as long as they are in a PEM model (CCM, FHG, FHO, FHN).


Ministry of Health & Long-Term Care

Kate Borthwick
HealthForceOntario, Regional Advisor or 226-750-5106

Sarah Farwell
WWLHIN, Manager, Health System Integration  or  519-650-4472 x 213