A recent report has unveiled significant disparities in access to primary healthcare across Canada, revealing that nearly 5.8 million adults are still without a family doctor. The findings from the Our Care survey, spearheaded by Toronto family physician Dr. Tara Kiran in collaboration with the Canadian Medical Association, indicate that access to primary care varies markedly by province and territory. Regions like New Brunswick, Newfoundland and Labrador, Prince Edward Island, Quebec, and two northern territories report considerably lower access levels compared to provinces such as Ontario, British Columbia, and Manitoba.
Access to Care Across Canada
The Our Care survey, which gathered insights from 16,876 adults nationwide, asked respondents whether they had a regular family physician or nurse practitioner. The results showed that New Brunswick had one of the lowest access rates, with only 65.9 per cent of respondents indicating they had a primary care clinician. This suggests that approximately 240,000 residents could be without access to essential healthcare services.
Dr. Lise Babin, a family physician in New Brunswick, expressed concern over the province’s lagging performance in primary care access. “It’s not surprising to see that we’re lagging behind other provinces with regards to access to family physicians,” she noted. Babin attributed the issue to a lack of investment in primary care over recent years, which has exacerbated the situation.
In stark contrast, Alberta, Ontario, and Manitoba reported much higher access rates, with approximately 87.4 per cent, 88.5 per cent, and 88.8 per cent of respondents, respectively, stating they had a clinician. Dr. Kiran pointed out that various factors could influence these disparities, including strategic investments in team-based care and competitive remuneration for healthcare professionals in these provinces.
Consequences of Lack of Access
The implications of inadequate access to family doctors can be dire, especially for patients with chronic health conditions. Recent research from Ontario supports this assertion, revealing that individuals without a family doctor for two or more years faced a twelve-fold increase in mortality risk, along with a nearly sixteen-fold likelihood of premature death.
The CMA report also examined the ability of those with a primary care clinician to receive care for urgent concerns, with only 37 per cent of respondents stating they could access help the same or the following day. Ontario fared somewhat better, with 44.6 per cent able to receive timely care, while Nova Scotia, Newfoundland and Labrador, and the Northwest Territories reported below-average rates in this critical area.
Dr. Kiran commented on the systemic issues contributing to these disparities, stating, “It’s not that the doctor doesn’t want to do a good job and see the patient; it’s just that we haven’t designed our systems to make that easy.” She advocates for increased investment in inter-professional teams to enhance the capacity of family doctors and nurse practitioners.
After-Hours Care and Patient Satisfaction
The report also evaluated after-hours care capabilities, revealing that only 31 per cent of Canadians reported being able to access urgent care from their primary clinic outside of regular hours. Provinces such as British Columbia, Alberta, and those in Atlantic Canada scored significantly lower than the national average in this regard.
Dr. Eddy Lang, an emergency room physician in Calgary, highlighted that patients often resort to emergency departments because they genuinely feel they have urgent healthcare needs. “If they’re coming to see us, they genuinely feel they have an urgent problem that requires attention,” he stated, emphasising the necessity for improved access to timely care.
Despite the challenges, the report found that among those with primary care access, around 67 per cent felt their clinician supported their overall well-being. However, the overall satisfaction with the primary care system remains low, with only 27.8 per cent of Canadians expressing contentment with the current framework.
Dr. Babin remains hopeful. “I think the conclusion is that we haven’t been doing OK for many years, but I think there is optimism,” she remarked. “We just have to go with it and then try to do as much as we can with the investments we have now.”
Dr. Kiran also emphasised that satisfaction with primary care transcends mere access to a clinician. “People are looking not just for a family doctor, but for timely appointments, access to their medical records, and respect in their healthcare interactions,” she concluded, underscoring the need for a holistic approach to healthcare access.
Why it Matters
This report is a crucial reminder that while Canada boasts a publicly funded healthcare system, the reality is a patchwork of access that varies dramatically across regions. The findings highlight the urgent need for targeted investments in primary care, not just in infrastructure but also in the systems that support healthcare professionals. As millions of Canadians continue to navigate a fragmented healthcare landscape, the implications for public health are profound, demanding immediate attention from policymakers to ensure equitable access for all citizens, regardless of where they live.
