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Access to primary healthcare remains a pressing issue in Canada, as highlighted by a new report indicating significant variations in the availability of family doctors across the country. The findings, derived from the Our Care survey conducted by Dr. Tara Kiran, a family physician in Toronto, in collaboration with the Canadian Medical Association, reveal that approximately 5.8 million adults lack access to a primary care provider. Alarmingly, certain provinces and territories, particularly New Brunswick, Newfoundland, Prince Edward Island, Quebec, and two territories, exhibit far lower access rates compared to their counterparts in Ontario, British Columbia, and Manitoba.
Widespread Disparities in Access
The survey garnered responses from 16,876 adults nationwide, assessing whether they had a regular family doctor or nurse practitioner. The results are telling: in New Brunswick, only 65.9 per cent of participants reported having access to a primary care clinician, suggesting that close to 240,000 individuals may be without a family doctor.
Dr. Lise Babin, a family physician in New Brunswick, commented on the stark reality, stating, “It’s not surprising to see that we’re lagging behind other provinces regarding access to family physicians. This has been evident in the data for years, and the lack of investment in primary care here has certainly contributed to our struggles.”
In contrast, provinces like Alberta, Ontario, and Manitoba reported significantly higher access rates, with figures standing at 87.4 per cent, 88.5 per cent, and 88.8 per cent, respectively. The differences raise questions about the underlying factors contributing to these disparities.
Factors Influencing Access
Dr. Kiran pointed out that various elements could explain the differences in access to primary care across provinces. Investments in team-based care models, prevalent in Ontario and Alberta, could play a crucial role, as could the remuneration structures that entice healthcare professionals to work in those regions.
Dr. Babin further elaborated on the implications of lacking a family doctor, particularly for individuals with chronic health conditions. A recent Ontario study corroborates her concerns, revealing that individuals with multiple chronic illnesses who went without a family doctor for two or more years had a twelve-fold increase in mortality risk and a nearly sixteen-fold increase in the likelihood of premature death.
Urgent Care Access Challenges
The report also examined the ability of Canadians with a primary care provider to receive timely attention for urgent health concerns. Nationwide, only 37 per cent reported they could access care for urgent issues on the same or the following day. Ontario fared slightly better, with 44.6 per cent of respondents indicating they could receive timely care. In stark contrast, provinces like Nova Scotia, Newfoundland, and the Northwest Territories reported even lower rates.
“It’s not that doctors are unwilling to provide timely care; rather, our healthcare systems are not designed to facilitate this effectively,” Dr. Kiran observed. She advocates for increased investment in inter-professional teams to enhance the capacity of family doctors and nurse practitioners to meet patient needs more efficiently.
The survey also addressed after-hours care, revealing that only 31 per cent of Canadians could access assistance for urgent issues outside standard weekday hours, with provinces like British Columbia, Alberta, and those in Atlantic Canada scoring significantly below the national average.
Public Satisfaction with the Healthcare System
Despite the challenges outlined, the survey found that among those with access to primary care, approximately 67 per cent reported that their clinician supported their overall well-being. However, dissatisfaction remains prevalent, with only 27.8 per cent expressing contentment with the current primary care system.
Dr. Babin reflected on these findings, stating, “The conclusion is that we haven’t been performing well for many years, but I remain hopeful. If we can secure the necessary investments, we have the potential to make meaningful improvements.”
Dr. Kiran added that the satisfaction levels highlight a critical issue: primary care encompasses more than just having a clinician. “Canadians are looking for timely access, the ability to access their medical records, respectful treatment, and empowerment to manage their health with the right information,” she noted.
Why it Matters
The disparities in access to family doctors across Canada underscore a profound inequity in the healthcare system that could have dire consequences for public health. With millions lacking primary care, particularly in certain regions, the ramifications extend beyond individual well-being, potentially straining emergency services and leading to poorer health outcomes. Addressing these access issues is not merely a matter of policy; it is a crucial step towards ensuring that all Canadians receive the quality healthcare they deserve. As discussions around healthcare reform continue, the urgency for targeted investment and systemic change has never been clearer.
