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A recent report has shed light on the stark differences in access to primary healthcare across Canada, revealing that nearly 5.8 million adults are currently without a family doctor. The findings, drawn from the Canadian Medical Association’s (CMA) Our Care survey, indicate that provinces like New Brunswick, Newfoundland and Labrador, Prince Edward Island, and Quebec lag significantly behind others like Ontario and Alberta in terms of healthcare accessibility.
Variability in Access Across Provinces
The CMA survey, which gathered responses from 16,876 adults nationwide, illustrates that access to primary care is not a uniform experience across the country. Dr. Tara Kiran, who collaborated with the CMA on this survey, emphasised that Canada does not operate under a singular healthcare system but rather has 13 or more distinct primary care systems. This fragmentation results in significant disparities; for instance, only 65.9 per cent of respondents in New Brunswick reported having a primary care clinician, suggesting that approximately 240,000 residents are without access to essential healthcare services.
Dr. Lise Babin, a family physician in New Brunswick, pointed out that this situation is not unexpected. “The numbers have been telling us for years that we are falling behind other provinces in terms of access to family physicians,” she stated, attributing the issue to a lack of investment in primary care in recent years.
In contrast, provinces such as Alberta, Ontario, and Manitoba reported higher access rates, with 87.4 per cent, 88.5 per cent, and 88.8 per cent of respondents respectively stating they have a primary care clinician. The differences can be attributed to various factors, including investments in team-based care and more competitive remuneration packages that attract healthcare professionals to these regions.
The Consequences of Limited Access
The lack of access to a family doctor can have dire implications for Canadians’ health, particularly for those with chronic conditions. A recent study from Ontario highlighted that individuals with multiple chronic illnesses who went without a family doctor for two or more years faced a staggering 12-fold increase in mortality risk and a nearly 16-fold increase in the likelihood of premature death.
Dr. Babin voiced her concerns regarding the health repercussions of not having a family doctor, particularly for vulnerable populations. “The absence of a family physician can exacerbate existing health issues and lead to poorer health outcomes in the long run,” she explained.
The CMA report also examined the ability of Canadians with a clinician to receive urgent care, revealing that only 37 per cent reported being able to access care for urgent issues on the same day or the following day. Ontario fared somewhat better with 44.6 per cent, while Nova Scotia, Newfoundland, and the Northwest Territories reported below-average access rates.
Barriers to Urgent Care
Dr. Kiran highlighted systemic issues that hinder timely access to care. “It’s not that physicians do not want to provide excellent care; rather, our healthcare systems have not been designed to facilitate ease of access,” she remarked.
Efforts to improve urgent care access are essential, as only 31 per cent of Canadians indicated that someone from their primary care clinic could assist with urgent concerns outside of standard weekday hours. This statistic is particularly concerning for provinces like British Columbia, Alberta, and various Atlantic regions, which reported significantly lower than average rates of after-hours support.
Dr. Eddy Lang, an emergency room physician in Calgary, noted that patients seeking emergency care often feel they have urgent issues that must be addressed. This underscores the need for better integration and support within primary care systems.
Patient Satisfaction Remains Low
Despite the challenges, the report revealed that among those with access to primary care, around 67 per cent felt their doctor or nurse practitioner supported their overall well-being. However, satisfaction levels with the primary care system remain troublingly low, with only 27.8 per cent of respondents expressing contentment with how the system operates.
Dr. Babin reflected on these findings, stating, “We have not been doing well for many years, but there is a glimmer of optimism. With adequate investments, we can make substantial improvements.” Dr. Kiran echoed this sentiment, emphasising that patient satisfaction encompasses more than merely having a family doctor; it also involves timely access to care, respect, and the ability to manage one’s health effectively.
Why it Matters
The findings from the CMA’s report highlight the urgent need for a cohesive national strategy to address the disparities in healthcare access across Canada. With millions lacking a family doctor, the implications for public health are profound. Efforts must focus on investing in primary care infrastructure, enhancing team-based care, and ensuring that all Canadians have timely and equitable access to essential healthcare services. The health of the nation depends on it, and without immediate action, the gaps in our healthcare system will only widen, jeopardising the well-being of countless individuals.
