In January, more than a thousand people lined up outside the Royal Canadian Legion office in Walkerton, Ont., hoping to secure one of 500 spots at a new family medicine practice. This type of scene has become common in rural areas, as millions of Canadians face limited access to family doctors.
“That’s not how we want our system to work,” said Dr. Joss Reimer, president-elect of the Canadian Medical Association (CMA).
According to the CMA, more than one in five Canadians—approximately 6.5 million people—do not have a family doctor or nurse practitioner they see regularly. This means over 15 per cent of the total Canadian population does not have frequent access to a family physician.
A Health Canada study found that Canada is facing a shortage of around 23,000 family doctors, while only graduating 1,700 family doctors a year.
Family physicians are becoming increasingly overwhelmed with patient care and unnecessary administrative tasks because of the decrease in staff. The CMA estimates Canadian doctors spend 18.5 million hours a year on paperwork and administrative duties, valuable time that could be used caring for patients.
The gaps in rural family medicine are even more severe. Having grown up in the home of a rural family doctor, Reimer said it was easy to recognize as a kid “how hard our family doctors are working in rural settings.”
Family doctors practising in rural areas have to be a bit of everything for their communities, as even fewer specialists and health care providers are available.
Family doctors and primary care providers are not only essential for managing health conditions, they are also key in providing preventative care so that patients don’t develop complications that would require more complex care. This has adverse effects on hospital systems and emergency rooms in particular.
“Patients are coming in much sicker with multiple comorbidities because they have not been followed routinely by a family MD,” said Kelly Gillespie, a registered nurse and clinical leader for in-patient surgery at Markham Stouffville Hospital.
Pap tests, for example, are a highly important preventative measure that assists in detecting cervical cancer. Without primary care physicians, important procedures like these go unchecked.
To ease the burden on family physicians, “we need to create supportive structures where they can work in teams,” said Reimer.
CMA experts offer a solution: the implementation of primary care teams. These teams could include family doctors, nurse practitioners, pharmacists, social workers and other health care providers, all working together in a shared space, using unified health records. This would allow family doctors to focus on some of the more complex care needs while the other professionals can provide care where they have particular expertise.
In a CMA survey of 9,000 people, 90 per cent of respondents said they would feel comfortable receiving care this way.
Gillespie said primary care teams are essential because they ensure that all of the patient’s needs are addressed.
“Whole health is so important and it can keep patients out of the ER because they have more options available to them,” said Gillespie.
The Northern Connections Clinic in Winnipeg is an example of a successful primary care team. Reimer worked alongside physiotherapists, occupational therapists, social workers, nurses and pharmacists collaboratively to provide patient care.
To ensure Canadians have access to essential health care, primary care teams must receive proper funding from provincial and territorial governments, Reimer stressed.
“We want our family doctors to thrive,” she said, “but that means that we need to do more to support them so they can thrive.”