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A recent survey has unveiled a troubling reality within Canada’s healthcare system: millions of Canadians are struggling to find access to primary care, with significant disparities evident across provinces and territories. Conducted by Dr. Tara Kiran, a family physician in Toronto, in collaboration with the Canadian Medical Association (CMA), the Our Care survey reveals that approximately 5.8 million adults remain without a regular family doctor. The findings indicate that access to primary care is far from uniform, with residents of New Brunswick, Newfoundland, Prince Edward Island, Quebec, and certain territories facing the most significant challenges compared to those in provinces like Ontario, British Columbia, and Manitoba.
A Fragmented System
Dr. Kiran’s report underscores that Canada does not operate under a single, cohesive healthcare system but rather functions as a collection of 13 or more distinct primary care systems. “The report findings really illustrate how we don’t have one national health-care system,” she stated, emphasising the stark contrasts in care availability. The survey included responses from 16,876 adults across the nation, asking whether they had a regular family doctor, nurse practitioner, or a primary care setting to seek medical attention.
In particular, New Brunswick reported troubling statistics, with only 65.9 per cent of respondents indicating they had access to a primary care clinician. If these figures are representative of the entire population, it translates to roughly 240,000 residents lacking a family doctor. Dr. Lise Babin, a family physician in New Brunswick, acknowledged this issue, noting, “It’s not surprising to see that we’re lagging behind other provinces with regards to access to family physicians.”
Variations in Access
In contrast, provinces such as Alberta, Ontario, and Manitoba reported significantly higher access rates, with 87.4 per cent, 88.5 per cent, and 88.8 per cent of respondents, respectively, indicating they had a clinician. Factors contributing to these disparities may include better investment in team-based care models and improved compensation packages that attract healthcare professionals to these regions.
Dr. Babin highlighted the detrimental health implications of this lack of access, particularly for individuals with chronic health conditions. Supporting her points, a recent study from Ontario found that individuals with multiple chronic conditions who went without a family doctor for two years or more faced a staggering 12-fold increase in mortality risk, alongside a nearly 16-fold higher chance of premature death.
Urgent Care Accessibility
The CMA’s report also examined how accessible urgent care is for those with a primary care clinician. Nationally, only 37 per cent of respondents indicated they could obtain care for urgent concerns either on the same day or the following day. Ontario fared slightly better than the national average, with 44.6 per cent reporting timely access, while provinces like Nova Scotia, Newfoundland, and the Northwest Territories lagged behind.
Dr. Kiran pointed out that the issue lies not in the willingness of physicians to provide care but rather in the systemic obstacles that hinder effective patient access. She advocates for increased investment in inter-professional teams to enhance the capacity of family doctors and nurse practitioners.
The report also delved into after-hours care availability, revealing that only 31 per cent of Canadians could receive assistance from their primary care clinic outside of regular weekday hours. Dr. Eddy Lang, an emergency room physician in Calgary, explained that patients arriving in emergency departments often do so out of genuine concern for urgent health issues, underlining the pressing need for a more responsive primary care system.
Patient Satisfaction and the Road Ahead
While the report noted that approximately 67 per cent of respondents felt their family doctor or nurse practitioner supported their overall well-being, overall satisfaction with the primary care system remains disappointingly low. Only 27.8 per cent of Canadians expressed satisfaction with their primary care experiences.
Dr. Babin, reflecting on the findings, stated, “I think the conclusion is that we haven’t been doing OK for many years, but I think there is optimism.” She emphasised the need for continued investment and innovation within the system to foster improvements. Dr. Kiran echoed this sentiment, asserting that patient needs extend beyond merely having a clinician; they desire timely access, respectful treatment, and the empowerment to manage their own health effectively.
Why it Matters
This report serves as a wake-up call for policymakers and healthcare leaders across Canada. The stark inequities in primary care access not only threaten the health of millions but also highlight the urgent need for a unified approach to healthcare reform. By addressing these disparities, the nation can work towards a more equitable healthcare system that prioritises the well-being of all Canadians, regardless of where they live. Investing in primary care infrastructure and fostering collaborative practices will be essential for bridging the gaps and ensuring that no Canadian is left without the care they need.
