As governments work to improve Canadians’ access to a family doctor, a new report shows the ability to access primary care varies depending on the province or territory.
The report, based on the Our Care survey conducted by Toronto family physician-researcher Dr. Tara Kiran in partnership with the Canadian Medical Association, shows about 5.8 million adults remain without primary care access. But when narrowing down, fewer Canadians in New Brunswick, Newfoundland, Prince Edward Island, Quebec, and two territories have access compared to others such as Ontario, British Columbia or Manitoba.
“I think the report findings really illustrate how we don’t have one national health-care system, instead we have 13 or more primary care systems,” said Kiran, who practices medicine at St. Michael’s Hospital.
The survey gathered responses from 16,876 Canadian adults from across the country. They were asked if they had a regular family doctor or nurse practitioner, or a primary care setting to receive care.
New Brunswick ranked among the lowest, with 65.9 per cent of respondents reporting they had a primary care clinician — meaning if that number held true for the full population about an estimated 240,000 people are without.
“It’s not surprising to see that we’re lagging behind other provinces with regards to access to family physicians,” said Dr. Lise Babin, a family physician in New Brunswick.
“That’s what the numbers have been telling us for the last years and the fact there has not been much investment in primary care in New Brunswick like in the past years, that has definitely contributed to us lagging behind.”
By comparison, Alberta, Ontario and Manitoba saw the highest numbers of people reporting having a clinician at 87.4 per cent, 88.5 per cent and 88.8 per cent, respectively.
Kiran said there could be multiple factors behind this including investments in team-based care, such as in Ontario and Alberta, or better pay that attracts doctors to those provinces.
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Babin said in an interview with Global News the lack of a family doctor can lead to issues for Canadians’ health, especially those with chronic health problems.
A recent study from Ontario backs up Babin’s assertions, with researchers finding Ontarians with multiple chronic conditions who went without a family doctor for two or more years had 12-fold higher odds of death, and a nearly 16-fold higher chance of premature death.
The report by the CMA also looked at whether those with a clinician could get care for an urgent concern the same or following day, with only 37 per cent nationally saying they could.
Ontario reported higher than the national average at 44.6 per cent, while Nova Scotia, Newfoundland and the Northwest Territories reported lower than average rates.
“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,” said Kiran.
She said one way to improve that is more investment in inter-professional teams to “grow the capacity” of family doctors and nurse practitioners to care for people.
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After-hours care was also examined, with 31 per cent of Canadians reporting someone from their primary care clinic was able to help with urgent issues outside regular weekday hours.
B.C., Alberta, and Atlantic Canadian provinces all ranked “significantly” lower than the national average.
“So there are circumstances when patients could maybe get some advice late in the evening, and that’s where 811 comes in, and there are situations where patients don’t generally abuse the emergency department,” said Dr. Eddy Lang, an emergency room physician in Calgary.
“If they’re coming to see us, they genuinely feel they have an urgent problem that requires attention.”
Overall, the report found that among those with primary care access, about 67 per cent said their doctor or nurse practitioner supports their general well-being.
But it also found satisfaction by Canadians in the primary system was still low, with just 27.8 per cent nationally saying they were satisfied with how it is working.
“I think the conclusion is that we haven’t been doing OK for many years, but I think there is optimism,” said Babin. “We just have to go with it (investments) and then just try to do as much as we can with the investments we have now and I remain optimistic that we’re going to see a difference.”
Kiran adds that since the satisfaction rate is consistent regardless if a province or territory has more people with a family doctor or not, it shows primary care is about more than just having a clinician.
“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 said.
—with files from Global News’ Katherine Ward
They seem to think pouring money into a broken system will fix things. The issue is simple, get them moving in the hospital’s! I have been, they are Lazy where I am from, more concerned about what’s going on outside of work than the actual patiences! They need to move! If I my productivity was ike that I would be fired!
James Bilodeau what are you talking about, you idiot. This is Canada not the U.S. How the f ** k does having lots of money buy me a Family doctor faster or get surgery fast than someone else unless you’re travelling outside the country?? Get lost, you head case
How rich you are determines speed of treatment and depth of treatment. The rich never wait for a doctor. Or treatment. Come on this is fact! We have a two tier healthcare system that caters to the rich. Politicians and folks with stature get the best of it all, thats no brainer, everyone can see that. Cancer diagnosis anywhere at all, treatment begins in hours or days, not months if theirs a bed and doctor for you. TRUTH GLOBAL!