Family doctor crisis could be helped by these key fixes, report says

A new report says patients across Canada see more primary health-care teams, access to their own electronic records and faster licensing of foreign-trained physicians as key ways to solve the country’s family doctor shortage crisis.

Researchers at St. Michael’s Hospital in Toronto surveyed more than 9,000 people online and had in-person discussions with dozens more across Canada to talk about their experiences with primary care and how to fix it.

Lead researcher Dr. Tara Kiran says more than one in five people across Canada do not have access to a family doctor or nurse practitioner they can see regularly.

Kiran says researchers spoke to diverse groups of people from both urban and rural Canada, as well as patients from different ethnic backgrounds and people with disabilities, about what the health-care standard should be.

She says across the board, all agreed there should be guaranteed access to primary care for everyone living in Canada.

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Kiran says she hopes federal, provincial and territorial governments will listen to what patients want and use their feedback to reform the primary-care system.

“If you are in a position of any power … I hope those people use the standard kind of as a North Star to say, ‘OK, well, we’re wanting to change the system. We’re going to introduce reforms. Let’s use this. Let’s make sure that these reforms are in alignment with what people said was important to them,'” said Kiran, who is a family doctor and scientist with the MAP Centre for Urban Health Solutions at St. Michael’s Hospital.

The findings were published online on Monday, in the “Our Care” report.

Participants said that team-based primary care should include family doctors, nurse practitioners, and other health professionals such as dietitians, pharmacists and social workers.

Adding more multidisciplinary primary-care teams across the country —  on top of those that already exist in some provinces — would “increase access to care, reduce clinician burnout and enable a more holistic approach to care,” the report said.

Patients also said having access to their health records is important not only so they can have ownership of their own health, but because they could ensure multiple health-care providers have vital information.  

“A common example that we heard (was) people might have moved cities or moved provinces or their doctor retired and then they didn’t have access to their records. And those records, for example, might have contained an important diagnosis,” said Kiran.

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Increasing the number of primary health-care providers in Canada is also a vital step, participants said — and they offered ideas on how to do that.

“Grow the primary-care workforce by accelerating the licensing of foreign-trained health-care professionals, by training, recruiting and retaining more people to work in primary care, and by creating a workforce more representative of the people it serves,” the report said.

Other key recommendations include expanding virtual care to improve accessibility in rural and remote communities, and primary care partnerships with community organizations to help address social issues affecting patients’ health.

The report also emphasized addressing racism and discrimination in primary care, integrating Indigenous models of care and providing care in different languages.