As Canadian authorities strive to enhance access to family doctors, a recent report highlights significant disparities in primary care availability across the nation. The Canadian Medical Association’s (CMA) Our Care survey unveils that approximately 5.8 million adults are still without a family doctor. The findings indicate that Canadians in provinces such as New Brunswick, Newfoundland, Prince Edward Island, Quebec, and two territories face greater challenges in securing primary care than their counterparts in regions like Ontario, British Columbia, and Manitoba.
Varied Access to Primary Care
Dr. Tara Kiran, who collaborated with the CMA on the survey, remarked, “The findings truly emphasise that Canada does not operate under a singular healthcare system; rather, we have over 13 distinct primary care systems.” The survey collected responses from 16,876 adults nationwide, querying their access to a regular family physician or nurse practitioner.
New Brunswick emerged as one of the provinces with the lowest access rates, with only 65.9 per cent of respondents confirming they had a primary care clinician. This statistic suggests that, if representative of the entire population, around 240,000 individuals in New Brunswick lack a family doctor. Dr. Lise Babin, a family physician in New Brunswick, noted, “It’s not unexpected that we are falling behind other provinces in terms of access to family physicians. The data has been indicating this trend for years, and the lack of investment in primary care here has undoubtedly contributed to our struggles.”
In stark contrast, Alberta, Ontario, and Manitoba reported significantly higher figures, with 87.4 per cent, 88.5 per cent, and 88.8 per cent of residents, respectively, stating they had access to a clinician.
Factors Influencing Access
The disparities in access can be attributed to various factors. Kiran highlighted that provinces like Ontario and Alberta have benefitted from investments in team-based care and attractive financial incentives for healthcare professionals, which may help draw more doctors to these regions. Dr. Babin stressed the implications of lacking a family doctor, particularly for Canadians managing chronic health conditions, pointing to a study from Ontario. This research revealed that individuals with multiple chronic illnesses who went without a family doctor for two or more years faced a twelve-fold increase in the risk of death and nearly a sixteen-fold increase in the likelihood of premature death.
The CMA report also assessed the ability of individuals with a clinician to obtain care for urgent health concerns on the same or the following day. Nationally, only 37 per cent of respondents reported being able to do so. Ontario fared better with a rate of 44.6 per cent, while Nova Scotia, Newfoundland, and the Northwest Territories reported below-average figures.
Dr. Kiran noted, “It’s not that physicians lack the desire to assist patients; it’s that our systems have not been designed to facilitate such access.”
After-Hours Care and Patient Satisfaction
The survey further examined after-hours care, revealing that only 31 per cent of Canadians reported that their primary care clinic was able to assist with urgent matters outside of normal weekday hours. British Columbia, Alberta, and various Atlantic provinces ranked significantly below the national average in this regard. Dr. Eddy Lang, an emergency room physician in Calgary, commented, “There are instances when patients might seek advice late in the evening, which is where services like 811 come into play. However, when patients arrive at emergency departments, they often believe their situation is urgent and requires immediate attention.”
Despite the challenges, the report found that among those with access to primary care, approximately 67 per cent felt their clinician supported their overall well-being. However, satisfaction levels remained low, with only 27.8 per cent of Canadians expressing contentment with the existing primary care system.
Dr. Babin concluded, “The evidence indicates that we have struggled for many years, yet there is room for optimism. We must focus on investments and make the most of our current resources, and I remain hopeful that improvements will occur.” Dr. Kiran added that the satisfaction rate remains consistent across provinces, indicating that access to a family doctor alone does not encapsulate the primary care experience. “People are looking for timely appointments, access to their medical records, respectful treatment, and the empowerment to manage their health needs effectively,” she explained.
Why it Matters
The findings of the CMA report are critical as they underscore the urgent need for systemic reform in Canada’s healthcare framework. With millions lacking access to essential primary care services, it is imperative for policymakers to address these disparities. Ensuring equitable access to family doctors not only improves individual health outcomes but also strengthens the overall health system, fostering a more resilient and compassionate society. Addressing these gaps is essential for the well-being of all Canadians, especially those with chronic conditions who rely on consistent medical care.
