A recent report reveals significant disparities in access to family doctors across Canada, as millions of adults continue to lack primary care. The findings from the Canadian Medical Association’s Our Care survey indicate that around 5.8 million Canadians are still without a family physician. The research underscores that access to healthcare varies dramatically by province and territory, with residents in regions like New Brunswick and Newfoundland facing notable challenges compared to those in provinces such as Ontario and British Columbia.
Access to Primary Care: A Provincial Snapshot
The Our Care survey, which involved responses from 16,876 adults nationwide, aimed to assess whether Canadians have a regular family doctor or nurse practitioner. Alarmingly, New Brunswick reported the lowest access rates, with only 65.9 per cent of respondents indicating they had a primary care clinician. If this statistic reflects the entire population, it suggests that approximately 240,000 individuals in the province are without a family doctor.
Dr. Lise Babin, a family physician in New Brunswick, noted that the province has consistently lagged in family physician access due to insufficient investment in primary care over recent years. “The numbers have been telling us for a long time that we are falling behind our peers,” she remarked. In stark contrast, provinces like Alberta, Ontario, and Manitoba recorded much higher access rates, with figures of 87.4 per cent, 88.5 per cent, and 88.8 per cent, respectively.
Factors Influencing Access
Several factors contribute to these disparities. Dr. Tara Kiran, who collaborated with the CMA on the survey, pointed out that regions with robust funding for team-based care, such as Ontario and Alberta, tend to attract and retain more healthcare professionals. This investment not only improves clinician availability but also enhances the quality of care provided to patients.
Babin further emphasised the implications of lacking a family doctor, particularly for those with chronic health conditions. A recent study from Ontario corroborates her concerns, revealing 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. Such statistics highlight the critical nature of accessible primary care in safeguarding public health.
Urgent Care Access and Patient Satisfaction
The survey also explored the ability of Canadians with a clinician to receive care for urgent concerns. Nationally, only 37 per cent reported that they could access care the same or the following day, with Ontario outperforming the national average at 44.6 per cent. In contrast, Nova Scotia, Newfoundland, and the Northwest Territories demonstrated lower rates of timely access, raising concerns about the overall responsiveness of the healthcare system.
Dr. Kiran noted that the systemic issues affecting access are not due to a lack of commitment from healthcare providers but rather the inefficiencies ingrained within the system itself. “We haven’t designed our systems to facilitate easy access,” she stated. To remedy this, she advocates for increased investment in inter-professional teams, which could bolster the capacity of family doctors and nurse practitioners to address patients’ needs more effectively.
The report also revealed that only 31 per cent of Canadians could obtain assistance for urgent issues outside regular hours, indicating a concerning gap in after-hours care. Regions like British Columbia and Alberta ranked lower than the national average, potentially leading patients to seek emergency care when they should be able to consult their primary care provider.
The Bigger Picture: Satisfaction with Primary Care
Despite the challenges highlighted by the survey, around 67 per cent of those with primary care access expressed that their doctor or nurse practitioner supports their overall well-being. However, satisfaction with the primary care system remains low, with only 27.8 per cent of Canadians feeling content with its operation.
Dr. Babin believes that the report’s findings indicate a long-standing issue with the healthcare system, yet she remains hopeful for future improvements. “We haven’t been doing well for many years, but I am optimistic that with appropriate investments, we can effect change,” she said. Kiran echoed her sentiments, emphasising that patient satisfaction encompasses more than mere access to a clinician; factors like timely appointments, respect, and access to medical records are equally vital.
Why it Matters
The disparities in access to family doctors across Canada underscore a pressing public health concern that requires immediate attention. As millions remain without primary care, the implications for health outcomes are dire, particularly for vulnerable populations. Addressing these inequities is not merely a matter of policy; it is a moral imperative that impacts the health and well-being of Canadians. With the right investments and systemic reforms, there is potential for an equitable healthcare system that truly serves all citizens.
