A recent report has shed light on the significant disparities in access to primary healthcare across Canada, revealing that nearly 5.8 million adults remain without a dedicated family doctor. Conducted by Dr. Tara Kiran, a family physician in Toronto, in collaboration with the Canadian Medical Association (CMA), the Our Care survey illustrates that access to primary care services varies dramatically depending on the province or territory. While regions like Ontario, British Columbia, and Manitoba report higher levels of access, provinces such as New Brunswick, Newfoundland, and Quebec lag significantly behind.
Unequal Access Across Provinces
The findings from the survey indicate that only 65.9% of respondents in New Brunswick reported having a primary care clinician. Given the province’s population, this suggests that approximately 240,000 residents are without a family doctor. Dr. Lise Babin, a family physician in New Brunswick, commented on the report’s implications, stating, “It’s not surprising to see that we’re lagging behind other provinces regarding access to family physicians. The lack of investment in primary care in New Brunswick over the years has contributed to this gap.”
In stark contrast, Alberta, Ontario, and Manitoba boast some of the highest access rates, with 87.4%, 88.5%, and 88.8% of residents respectively reporting they have a clinician. Dr. Kiran attributes these differences to several factors, including investments in team-based care models and competitive compensation structures that attract healthcare professionals to these provinces.
The Health Consequences of Inaccessibility
The implications of not having a family doctor are profound, particularly for those managing chronic health conditions. A recent study from Ontario revealed that individuals with multiple chronic illnesses who lacked a family doctor for two years or more faced a twelve-fold increase in mortality risk and nearly a sixteen-fold increase in the likelihood of premature death. Dr. Babin emphasised the critical need for accessible primary care, highlighting that the absence of a family doctor can exacerbate health issues for many Canadians.
The CMA’s report also examined the ability of individuals with a primary care clinician to receive urgent care. Nationally, only 37% of respondents reported being able to access care for urgent issues on the same day or the following day. Ontario exceeded the national average at 44.6%, while provinces like Nova Scotia and Newfoundland fell below this threshold, indicating a pressing need for improvements in urgent care accessibility.
Systemic Issues in Healthcare Delivery
Dr. Kiran noted that the difficulties in accessing timely care stem from systemic design flaws rather than a lack of effort from individual healthcare providers. She argues that enhancing inter-professional teams and increasing resources for family doctors and nurse practitioners could significantly improve patient care capacity.
The report also highlighted after-hours care, revealing that only 31% of Canadians could reach someone from their primary care clinic for urgent issues outside regular hours. This lack of access during evenings and weekends is particularly concerning, as many Canadians rely on emergency services when they cannot connect with their primary care provider.
Patient Satisfaction Remains Low
Despite some positive findings, such as 67% of respondents feeling their clinician supports their overall well-being, overall satisfaction with the primary care system remains troublingly low. Only 27.8% of Canadians expressed satisfaction with how the system is functioning, signalling a deep-rooted discontent with current healthcare delivery.
Dr. Babin expressed cautious optimism, stating, “I think the conclusion is that we haven’t been doing okay for many years, but I believe there is hope. If we invest wisely, we can make a difference.” Dr. Kiran echoed this sentiment, emphasising that access to care involves more than merely having a clinician; it also encompasses timely appointments, respectful treatment, and the empowerment of patients to manage their health effectively.
Why it Matters
The findings of this report underscore the urgent need for action to rectify the disparities in access to primary care across Canada. With millions lacking a family doctor, the implications for public health are severe, particularly for vulnerable populations struggling with chronic conditions. Addressing these inequities is not only a moral imperative but also a crucial step towards ensuring the overall well-being of Canadians. Investing in primary care systems will ultimately foster healthier communities and reduce the long-term strain on the healthcare system.
