Edited by Taylor Stolfi
Canada’s once admired and efficient healthcare system is currently crumbling. Primary care is becoming less accessible and patients are being hit with longer wait times, delayed diagnosis, and distress.
The facts:
Closing practise
A recent study was led by St. Michael’s Hospital and Unity Health Toronto and published in the journal Canadian Family Physician. The study suggests that nearly 20% of the family doctors working in Toronto will be closing their practises within the next five years. This finding is an alarming statistic in the health-care field and adds to current difficulties Canadians face in finding a family doctor. In the study, more than 1000 family physicians were surveyed, and along with the previous stated finding, 4% of the sample said that they plan to close their private practice within the next year. Although a small percentage did indicate their intentions to run their own private practices, the alarming 20% is not a number to dismiss1.
The current model in place for physicians is not optimal. The model of care leads to added financial and bureaucratic repsonsibilties. This stress is especially prevelant in younger family doctors. As a family doctor, you are not only a physician, but also running your own business. There are many sacrifices involved in this, such as difficulties in taking vacation time or parental leave. Furthermore, the decline in income for many physicians during the early days of the pandemic is taxing on the financial and mental state of many doctors1.
The Ontario Medical Association’s (OMA) president, Dr. Rose Zacharias, expressed her sympathies with family physicians and agreed that they are increasingly concerned with the administrative burdens of their practices. As a result of this, many physicians are shifting their line of work to sports medicine, palliative care, and other specializations1.
Lack of documentation
Another paper published by a team of health reporters indicated that there may be a lack of resources and infrastructure to track every practicing family doctor in the country. Moreover, there is a lack of documentation and information on available family doctors2.
The long lines and camps set up outside of clinics is indicative of this issue. In Victoria, BC, there is currently a two hour wait time on average for patients to see a doctor. However, based on reports, Victoria is reported to have a sufficient number of family doctors; three times more the national average. So why are there such long wait times?
The answer: a significant gap in data is to blame. Apparently these numbers are reflective of all the licensed family doctors, instead of the actual number of family physicians currently working. On paper, there seems to be a sufficient number of doctors; however, the true capacity of primary care in Victoria, or anywhere in the country, is nowhere in these reports. This lack of information is making it difficult to deal with the growing crisis within the Canadian healthcare system.
The effect on the people:
A British Columbia resident, Sandra McCulloch shares her story in which the recent retirement of her family doctor resulted in a life altering event3.
Sanda McCulloch was diagnosed with diabetes by Dexcom; a machine that monitors her glucose levels every few minutes. Initially, she was using her surplus money acquired through an inheritance to cover the $300 monthly fees. In 2021, B.C. declared that Dexcom would be covered by PharmaCare, through special authority. Hence, if the family doctor of the patient requests it, the product can be covered by PharmaCare. McCulloch’s family doctor made a request and she was cleared to use the product. Sandra was relieved and thrilled, and she used the product for six months before her doctor retired.
However, her next monthly subscription of Dexcom was denied and she was asked to pay $300; the special authority expired as her doctor retired. McCulloch did not have anyone to do her paperwork and request for special authority. Without a family doctor, Sandra found herself having to join the rest of the population in lining up outside for two hours before opening to get a chance to see a doctor and initiate the process of continuing her Dexcom.
During her hunt for a doctor, McCulloch’s financial situation was changing, and she could no longer pay $300 out of pocket monthly, so she resorted to checking her blood sugar levels with the finger-prick test. Thus, she was not constantly keeping track of her blood sugar levels.
One day, Sandra woke up and was feeling ill, and when she tested her glucose levels she found that they were alarmingly low. If Sandra had Dexcom, she would have instantly been alarmed of her dropping blood sugar levels and would have simply fueled her body with some sugar.
Sandra’s story is only one of many, and demonstrates how the lack of support and access to physicians is detrimental for Canadians.
sOLUTION:
Alleviating Canada’s Acute Shortage of Family physicians
British Columbia has announced a plan to boost the incomes of family physicians. Furthermore, the governemnt has added the number of graduate and undergraduate seats at medical schools across the province of Ontario1.
As stated previously, this mass exodus of family doctors from the field was accelerated during the pandemic. The government’s top priority right now is to increase recruitment of health care professionals to fulfill the current demand.
Canada’s top priority currently, however, should be to redesign and build a health care system that supports both the patients and doctors within the system. The future of family medicine in Canada has to be a collaborative effort, as all members are necessary for the efficient and satisfactory primary healthcare that we should continue aspiring to achieve.
References:
1. CBC/Radio Canada. (2022, November 17). Survey showing Toronto family doctors leaving practice is a ‘wake-up call,’ researcher says | CBC News. CBCnews. Retrieved November 30, 2022, from https://www.cbc.ca/news/canada/toronto/family-doctors-quitting-toronto-survey-shows-1.6653832
2. Howlett, K., Grant, K., & Ha, T. T. (2022, November 26). Canada has more family doctors than ever. why is it so hard to see them? The Globe and Mail. Retrieved November 30, 2022, from https://www.theglobeandmail.com/canada/article-family-doctors-canada-shortages/
3. CBC/Radio Canada. (2022, November 28). Family doctor shortage complicates access to ‘life-changing’ drug for B.C. diabetes patient | CBC news. CBCnews. Retrieved November 30, 2022, from https://www.cbc.ca/news/canada/british-columbia/family-doctor-diabetes-drug-1.6665312