Access to family doctors remains a pressing issue for millions of Canadians, with a new report highlighting stark variations in primary care availability depending on region. The findings from the Canadian Medical Association’s (CMA) Our Care survey indicate that approximately 5.8 million adults lack a regular family doctor or nurse practitioner. The report underscores that residents in certain provinces, particularly New Brunswick and the Atlantic region, face significantly greater challenges in securing primary care compared to their counterparts in more populated areas like Ontario and British Columbia.
Regional Disparities in Access
The survey, which collected data from 16,876 Canadians, indicates that New Brunswick has one of the lowest rates of primary care access, with only 65.9% of respondents reporting a primary care clinician. If this figure reflects the broader population, it suggests that around 240,000 individuals may be without a family doctor. Dr. Lise Babin, a family physician in New Brunswick, expressed concern over the province’s lagging performance, attributing it to years of inadequate investment in primary care. “We have known for years that our access to family physicians is not where it should be,” she stated.
In contrast, provinces such as Alberta, Ontario, and Manitoba reported considerably higher access rates, with 87.4%, 88.5%, and 88.8% of respondents, respectively, saying they have a clinician. Dr. Tara Kiran, who assisted with the CMA report, pointed out that these discrepancies likely stem from various factors, including the adoption of team-based care models and competitive remuneration that attract healthcare professionals to these regions.
The Consequences of Lack of Access
Dr. Babin highlighted the potential health repercussions of not having a family doctor, especially for individuals with chronic conditions. A related study from Ontario found that those without a family doctor for two years or more had a twelvefold increase in mortality risk and a nearly sixteenfold likelihood of premature death. These statistics affirm the critical role primary care plays in maintaining public health.
The CMA report also examined the ability of individuals with a clinician to receive urgent care, revealing that only 37% of Canadians felt they could access timely attention for urgent issues. Ontario fared better than the national average, with 44.6% reporting they could get care the same or following day, while regions like Nova Scotia and Newfoundland fell below average.
Systemic Challenges in Primary Care
Dr. Kiran emphasised that the issues surrounding access to care are not solely about the willingness of physicians to see patients. “The problem lies in our healthcare system’s design; it simply hasn’t been structured to facilitate easy access,” she stated. To address these challenges, she advocates for increased investment in inter-professional teams that could enhance the capacity of family doctors and nurse practitioners to meet patient needs.
The report further explored after-hours care, with only 31% of Canadians indicating that their primary care clinic could assist with urgent issues outside regular hours. Provinces like British Columbia and those in Atlantic Canada reported significantly lower access. Emergency room physician Dr. Eddy Lang noted that patients who seek emergency care typically feel they have urgent health concerns that require immediate attention, underscoring the strain on emergency services when primary care access is limited.
Patient Satisfaction and Future Outlook
Despite the challenges, the report found that among those with access to a primary care provider, approximately 67% feel their clinician supports their overall well-being. However, only 27.8% of Canadians expressed satisfaction with the current state of their primary care system. Dr. Babin remains hopeful, stating, “We haven’t been okay for many years, but I believe there is potential for positive change with the right investments.”
Dr. Kiran added that satisfaction levels appear to be consistent, regardless of the number of individuals with a family doctor in a province. This suggests that effective primary care involves more than just having a clinician; it requires timely access, respect, and the empowerment of patients to manage their health.
Why it Matters
The disparities in primary care access across Canada reveal a deeper systemic issue within the healthcare framework, impacting not only individual health outcomes but also the broader public health landscape. As the nation grapples with these inequities, it is essential for policymakers to prioritise investment in primary care infrastructure and innovative healthcare models. Addressing these gaps is not merely a healthcare concern—it is a matter of social justice that affects the quality of life for millions of Canadians. A robust primary care system is foundational to a healthier society, ultimately leading to better health outcomes and reduced strain on emergency services.
