Access to primary healthcare remains a pressing concern across Canada, with a recent report revealing significant disparities between provinces and territories. The Our Care survey, led by Toronto family physician Dr. Tara Kiran in collaboration with the Canadian Medical Association, indicates that around 5.8 million adults lack access to a family doctor or primary care provider. Alarmingly, the findings show that residents in regions like New Brunswick, Newfoundland, Prince Edward Island, Quebec, and the territories face greater challenges compared to those in provinces such as Ontario, British Columbia, and Manitoba.
Dissecting the Data: A National Overview
The survey, which garnered responses from 16,876 Canadians, aimed to determine whether individuals had a regular family doctor, nurse practitioner, or a designated primary care setting for their healthcare needs. New Brunswick emerged as one of the provinces with the lowest reported access, with only 65.9 per cent of respondents indicating they had a primary care clinician. If this statistic is representative of the entire population, it suggests that approximately 240,000 individuals in the province are without adequate primary care.
Dr. Lise Babin, a family physician practicing in New Brunswick, commented on the findings, stating, “It’s not surprising to see that we’re lagging behind other provinces with regards to access to family physicians.” She attributed this shortfall to insufficient investment in primary healthcare over the years, a trend that has contributed to the province’s difficulties in attracting and retaining family doctors.
In stark contrast, Alberta, Ontario, and Manitoba showcased more favourable statistics, with 87.4 per cent, 88.5 per cent, and 88.8 per cent of respondents respectively reporting access to a clinician. Dr. Kiran suggested that factors such as investment in team-based care and competitive compensation packages for healthcare professionals play a crucial role in these disparities.
The Impact on Health Outcomes
The consequences of lacking a family doctor can be profound, particularly for Canadians with chronic health conditions. A study conducted in Ontario corroborates Dr. Babin’s concerns, revealing that individuals with multiple chronic illnesses who do not have a family doctor for two or more years are at a staggering 12-fold higher risk of mortality, with an even greater likelihood of premature death.
Moreover, the CMA report examined the ability of those with a clinician to receive care for urgent health concerns on the same or the following day. Nationally, only 37 per cent reported being able to do so, with Ontario performing slightly better at 44.6 per cent. In contrast, provinces like Nova Scotia and Newfoundland reported significantly lower figures, highlighting systemic inefficiencies.
Dr. Kiran remarked on the operational challenges within the healthcare system, 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 be able to make that easy.”
After-Hours Care: A Persistent Challenge
The report also assessed the availability of after-hours care, revealing that only 31 per cent of Canadians could access assistance from their primary care clinic for urgent matters outside regular hours. Provinces such as British Columbia, Alberta, and those in Atlantic Canada reported markedly lower rates than the national average.
Dr. Eddy Lang, an emergency room physician in Calgary, noted that while some patients may seek advice during late hours, often the situation is urgent enough to require emergency care. “If they’re coming to see us, they genuinely feel they have an urgent problem that requires attention,” he explained.
Despite these challenges, the survey indicated that among those who do have access to primary care, around 67 per cent felt supported in their general well-being. However, overall satisfaction with the primary healthcare system remains low, with only 27.8 per cent of respondents expressing contentment regarding how the system operates.
Dr. Babin expressed cautious optimism, stating, “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 targeted investments to enhance the quality of care and accessibility.
The Quest for Improvement
Dr. Kiran underscored the importance of viewing primary care as a multifaceted issue, stating that satisfaction is not solely dependent on having a family doctor. “People are looking not just for a family doctor, but being able to get in in a timely way, have access to their records, be treated with respect and feel empowered to be able to take care of themselves with the information that they need,” she remarked.
As the government continues to explore avenues for healthcare improvement, these findings serve as a crucial reminder of the need for a cohesive and equitable healthcare system that truly serves all Canadians, regardless of their geographic location.
Why it Matters
The disparities in access to primary care across Canada reflect a deeper systemic issue that impacts the health and well-being of millions. With significant portions of the population lacking a family doctor, the implications for public health are profound. Addressing these gaps is not merely a matter of healthcare policy; it is a question of equity and social justice. Ensuring that all Canadians have access to timely, respectful, and comprehensive healthcare is essential for fostering a healthier nation and reducing long-term healthcare costs. The urgency for reform has never been clearer, as the health of the country depends on it.
