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Millions can't find family doctor (Ah, The Joys of socialized medicine)
Toronto Star | 6/15/04 | DENNIS BUECKERT
3.6 million Canadians don't have regular doctor, problem cascades across health system
OTTAWA - More than 3.6 million Canadians didn't have a regular doctor last year, and many of them suffered a lack of basic preventive care, winding up in emergency rooms at far higher rates than those with doctors. The problem was almost as serious in urban as rural areas, according to a new Statistics Canada survey, the most comprehensive picture to date of the country's doctor shortage and its consequences.
Of the 3.6 million who didn't have a doctor, 2.4 million hadn't bothered to look, the Canadian Community Health Survey released today says.
But 1.2 million searched, some long and hard, with no success.
Marnie Clement, one of 366,000 people - 3.6 per cent - in Ontario who couldn't find a doctor, is among them.
When she contracted pneumonia last year she called her family doctor's office several times to report she was having trouble breathing, but all she got was an answering machine.
After trying repeatedly to get through, the Peterborough resident learned that her family doctor - whom she had taken months to find - had left town without notice.
After much delay she visited a walk-in clinic, where she was prescribed medication that cleared her symptoms quickly.
She had endured six months of unnecessary agony and uncertainty.
"I felt kind of helpless and that's why it went so long," she says. "It seemed whatever I did I wasn't hitting on anything and no one was helping me."
The lack of doctors was most acute in the Northwest Territories, where fully 29.6 per cent of the population (9,824 people) couldn't find a doctor. Only 47.1 per cent had a regular doctor; 22.7 per cent hadn't looked for one.
In other provinces and territories, the figures ranged from 2.2 per cent unable to find a doctor in Nova Scotia to 7.4 per cent in Yukon.
Of the 10 provinces, Quebec fared worst despite its reputation for some of the best social programs in Canada.
Almost half a million Quebecers - 7.7 per cent of the province's population - couldn't find a doctor last year.
Stephanie Haddad knows that first-hand: It took her two-and-a-half years to find a doctor after she moved to Hull, Que.
It is recommended that women go every year for a pap smear test, which can detect early warning signs of cancer, but many walk-in clinics don't do such routine screenings.
"So I went for a few years without getting one, which isn't recommended," said Haddad, whose father was president of the Canadian Medical Association at the time.
The survey confirms that people who can't find a regular doctor are less likely to have received basic diagnostic services, such as mammograms, pap smears and blood pressure tests.
"The shortage of physicians and other health professionals is one of the most significant challenges facing our health system today," says a recent discussion paper published by the Ontario College of Physicians and Surgeons.
Patients with no family doctor can go to a walk-in clinic, but there's a lack of consistent care because the patient sees a different doctor at every visit, and a full range of services might not be available.
The result? Emergency rooms are flooded with routine problems that would be better dealt with in a doctor's office. That means urgent problems might not be treated as quickly as they should.
There was only a small gap between the proportion of urban and rural Canadians unable to find a doctor: 5.5 per cent (273,357) in rural areas compared to 4.5 per cent (965,023) among urbanites.
Many experts trace Canada's shortage of physicians to the Barer-Stoddart report of 1991.
At the time, Canada was thought to have a doctor surplus; the report recommended a 10 per cent reduction in medical school enrolments.
The theory was that medical costs could by curbed by reducing the number of doctors. Not only medical schools but nursing schools saw enrolments cut.
There's consensus now that those policies were wrong.
Many planners see the solution in a team approach, where nurse practitioners, dietitians, physical therapists and other health providers pitch in to do work that used to be handled by physicians.
But teamwork is not the whole solution, says Joy Parsons-Nicota, a nurse practitioner at Ottawa's Civic Hospital.
"I think it will help ease the burden on the health care system but there's still a shortage of nurses and physicians and we're going to be facing an even greater shortage over the next five years, because of the aging population.
"The average age of nurses is about 48 right now. The majority of physicians are baby boomers as well."
The provinces have boosted medical enrolments in recent years, but it takes eight years or more to train a physician.
Politicians have suggested the problem can be eased by speeding up accreditation for foreign-trained doctors. Many are already in Canada, but they are in other jobs because they can't get accreditation.
But the process of assessing immigrants' skills and providing any training they need to meet Canadian standards has been hampered by a lack of funding for training positions.
Men were less likely than women to look for a doctor - almost 1.7 million or 12.8 per cent of men, compared to only 765,208 or 5.7 per cent of women. Those in the 20 to 34 age group were least likely to look, according to the survey of 135,000 Canadians conducted between January and December 2003.
Toronto Star | 6/15/04 | DENNIS BUECKERT
3.6 million Canadians don't have regular doctor, problem cascades across health system
OTTAWA - More than 3.6 million Canadians didn't have a regular doctor last year, and many of them suffered a lack of basic preventive care, winding up in emergency rooms at far higher rates than those with doctors. The problem was almost as serious in urban as rural areas, according to a new Statistics Canada survey, the most comprehensive picture to date of the country's doctor shortage and its consequences.
Of the 3.6 million who didn't have a doctor, 2.4 million hadn't bothered to look, the Canadian Community Health Survey released today says.
But 1.2 million searched, some long and hard, with no success.
Marnie Clement, one of 366,000 people - 3.6 per cent - in Ontario who couldn't find a doctor, is among them.
When she contracted pneumonia last year she called her family doctor's office several times to report she was having trouble breathing, but all she got was an answering machine.
After trying repeatedly to get through, the Peterborough resident learned that her family doctor - whom she had taken months to find - had left town without notice.
After much delay she visited a walk-in clinic, where she was prescribed medication that cleared her symptoms quickly.
She had endured six months of unnecessary agony and uncertainty.
"I felt kind of helpless and that's why it went so long," she says. "It seemed whatever I did I wasn't hitting on anything and no one was helping me."
The lack of doctors was most acute in the Northwest Territories, where fully 29.6 per cent of the population (9,824 people) couldn't find a doctor. Only 47.1 per cent had a regular doctor; 22.7 per cent hadn't looked for one.
In other provinces and territories, the figures ranged from 2.2 per cent unable to find a doctor in Nova Scotia to 7.4 per cent in Yukon.
Of the 10 provinces, Quebec fared worst despite its reputation for some of the best social programs in Canada.
Almost half a million Quebecers - 7.7 per cent of the province's population - couldn't find a doctor last year.
Stephanie Haddad knows that first-hand: It took her two-and-a-half years to find a doctor after she moved to Hull, Que.
It is recommended that women go every year for a pap smear test, which can detect early warning signs of cancer, but many walk-in clinics don't do such routine screenings.
"So I went for a few years without getting one, which isn't recommended," said Haddad, whose father was president of the Canadian Medical Association at the time.
The survey confirms that people who can't find a regular doctor are less likely to have received basic diagnostic services, such as mammograms, pap smears and blood pressure tests.
"The shortage of physicians and other health professionals is one of the most significant challenges facing our health system today," says a recent discussion paper published by the Ontario College of Physicians and Surgeons.
Patients with no family doctor can go to a walk-in clinic, but there's a lack of consistent care because the patient sees a different doctor at every visit, and a full range of services might not be available.
The result? Emergency rooms are flooded with routine problems that would be better dealt with in a doctor's office. That means urgent problems might not be treated as quickly as they should.
There was only a small gap between the proportion of urban and rural Canadians unable to find a doctor: 5.5 per cent (273,357) in rural areas compared to 4.5 per cent (965,023) among urbanites.
Many experts trace Canada's shortage of physicians to the Barer-Stoddart report of 1991.
At the time, Canada was thought to have a doctor surplus; the report recommended a 10 per cent reduction in medical school enrolments.
The theory was that medical costs could by curbed by reducing the number of doctors. Not only medical schools but nursing schools saw enrolments cut.
There's consensus now that those policies were wrong.
Many planners see the solution in a team approach, where nurse practitioners, dietitians, physical therapists and other health providers pitch in to do work that used to be handled by physicians.
But teamwork is not the whole solution, says Joy Parsons-Nicota, a nurse practitioner at Ottawa's Civic Hospital.
"I think it will help ease the burden on the health care system but there's still a shortage of nurses and physicians and we're going to be facing an even greater shortage over the next five years, because of the aging population.
"The average age of nurses is about 48 right now. The majority of physicians are baby boomers as well."
The provinces have boosted medical enrolments in recent years, but it takes eight years or more to train a physician.
Politicians have suggested the problem can be eased by speeding up accreditation for foreign-trained doctors. Many are already in Canada, but they are in other jobs because they can't get accreditation.
But the process of assessing immigrants' skills and providing any training they need to meet Canadian standards has been hampered by a lack of funding for training positions.
Men were less likely than women to look for a doctor - almost 1.7 million or 12.8 per cent of men, compared to only 765,208 or 5.7 per cent of women. Those in the 20 to 34 age group were least likely to look, according to the survey of 135,000 Canadians conducted between January and December 2003.
