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As Canadian policymakers strive to enhance access to family physicians, a recent report reveals significant disparities in primary care availability across provinces and territories. The findings from the Our Care survey, led by Toronto-based Dr. Tara Kiran in collaboration with the Canadian Medical Association, indicate that approximately 5.8 million adults still lack access to a primary care provider. The situation is particularly dire in regions such as New Brunswick, Newfoundland, Prince Edward Island, Quebec, and two territories, where access rates fall behind those in provinces like Ontario, British Columbia, and Manitoba.
Variability in Healthcare Access
The survey, which gathered data from 16,876 Canadian adults, asked respondents whether they had a regular family doctor or nurse practitioner. Alarmingly, New Brunswick reported that only 65.9 per cent of respondents had access to a primary care clinician. This statistic suggests that roughly 240,000 residents may be without adequate care. Dr. Lise Babin, a family physician in New Brunswick, acknowledged the challenges, stating, “It’s not surprising to see that we’re lagging behind other provinces with regards to access to family physicians.” She attributed the ongoing issues to a lack of investment in primary care over recent years.
In contrast, provinces such as Alberta, Ontario, and Manitoba boasted higher access rates, with 87.4 per cent, 88.5 per cent, and 88.8 per cent of respondents respectively indicating they had a clinician. Kiran noted that investment in team-based care and competitive remuneration for physicians could be driving factors behind these more favourable statistics.
Consequences of Insufficient Access
The absence of a family doctor can have serious ramifications for Canadians’ health, particularly for those with chronic conditions. Supporting this concern, a recent Ontario study found that individuals with multiple chronic illnesses who lacked a family doctor for two or more years were 12 times more likely to die and nearly 16 times more at risk of premature death.
The CMA report also examined the ability of those with a clinician to receive timely care for urgent concerns. Nationally, only 37 per cent reported they could access care the same or following day. In Ontario, this figure was slightly above average at 44.6 per cent, while Nova Scotia, Newfoundland, and the Northwest Territories fell below the national average. Kiran emphasised that the limitations are not due to physicians’ dedication, but rather a systemic failure to facilitate timely access to care.
After-Hours Care and Patient Satisfaction
The report further investigated after-hours care, revealing that just 31 per cent of Canadians could receive assistance from their primary care clinic outside regular hours. Provinces such as British Columbia, Alberta, and several Atlantic regions reported significantly lower access rates for after-hours support. Dr. Eddy Lang, an emergency room physician in Calgary, highlighted that while patients often turn to emergency services for urgent issues, many do so out of genuine necessity, reflecting the pressing need for improved primary care access.
Despite the challenges, the report indicated that among those with access to primary care, approximately 67 per cent felt their clinician supported their overall well-being. However, satisfaction with the primary care system remains low, with only 27.8 per cent expressing contentment with 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.”
Kiran added that patient satisfaction transcends merely having a family doctor; it encompasses timely appointments, respectful treatment, and the ability to manage one’s health effectively with accessible information.
Why it Matters
The disparities highlighted by this report underscore the urgent need for a cohesive national strategy to address healthcare inequities across Canada. Access to primary care is not merely a matter of convenience; it is a crucial determinant of health outcomes. As millions remain without adequate care, the implications extend beyond individual health, impacting public health systems and overall societal well-being. It is essential that policymakers prioritise investments in primary care infrastructure and reform to ensure equitable access for all Canadians, fostering a healthier population and a more resilient healthcare system.
