Can’t find a family doctor? Well-off more likely to secure appointments, Canadian research suggests

Dr. Olveen Carrasquillo (L), Chief of General Internal Medicine University of Miami, sits with Juan Gonzalez as he conducts a checkup on him. Getty Images

TORONTO – Are you having trouble finding a doctor who will commit to being your family physician?

A new Canadian study suggests that those who make more money or have high socioeconomic status are more likely to secure a doctor’s appointment compared to their lower-income counterparts.

In their research, St. Michael’s Hospital and University of Toronto scientists phoned 568 doctors’ offices playing a role of being either a bank employee or a welfare recipient to see if socioeconomic factors helped or hindered the odds of booking an appointment.

Turns out, the person working in the financial industry was more than twice as likely to secure a spot as a new patient compared to the person on welfare.

“There’s definitely evidence that there’s a preference for people of higher socio-economic status,” lead author Dr. Stephen Hwang told Global News.

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Twenty-three per cent of those who made cues that suggested they’re from an economically sound background received an appointment, screening visit or were placed on a waiting list while only 14 per cent of those on welfare were offered the same conditions.

Hwang said it’s unclear why this discrimination occurs, though.

“We don’t know why exactly people who are apparently wealthier are more likely to get a family doctor,” he said.

He pointed to three potential explanations: office staff has explicit bias against people who have low income, or they have an “unconscious bias” influencing them. The third theory is that the physician for whom they work has given them specific direction about the kinds of patients that they would like to take.

Hwang’s complete findings were published Monday in the Canadian Medical Association Journal.

Read the full report here.

Patients with medical problems more likely to receive appointment

Hwang’s team also looked into whether health conditions affected your likelihood of getting an appointment. They posited that having medical issues hurt your chances of getting an appointment, but results suggested otherwise.

“We thought offices would actually favour healthier patients. We, in fact, found the opposite,” he said.

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Those who identified chronic health problems when they called were more likely to get an appointment than those who asked for a routine checkup.

The callers were two medical students –male and female – who read a script in a neutral tone of voice so that the calls were standardized as much as possible. There were no accents or language barriers.

Some doctors screening patients before taking them on

Another troubling finding from Hwang’s research was that nine per cent of receptionists fielding these calls asked for the patient to come in and be seen by the doctor to determine if they’d be accepted as a primary care patient.

In Toronto resident Amanda Middlebrook’s case, she and her husband spent two years looking for a doctor. They had one outside of the city and decided it was time to find a physician closer to home.

Middlebrook says she went to a “meet appointment” with a doctor who spent time interviewing them instead of addressing their medical concerns. Ultimately, the doctor turned the couple away because they didn’t fit his criteria, she alleges.

Middlebrook is a customer service representative while he husband works in construction.

The College of Physicians and Surgeons in Ontario has a policy against screening patients, though. Instead, it urges doctors to accept new patients on a first-come, first-serve basis.

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That policy was established in 2008.

“It is not appropriate for physicians to screen potential patients because it can compromise public trust in the profession, and may also result in discriminatory actions against potential patients,” the organization said in a statement to Global News.

The college says it’ll investigate complaints from patients related to accessing primary care and screening concerns, noting that it takes these complaints seriously.

If you’ve been screened by doctors, contact the college’s Advisory Services line at 1-800-268-7096 ext. 603.


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