BY STEVEN KASZAB
Have you or someone you know been having difficulty finding a family doctor? Have you applied for admittance to a doctor’s practice, or called asking to become a patient only to be refused? Well friend you are not alone in this endeavour. About 3% of family doctors across the province of Ontario, some 385 stopped practicing between March and September 2020 (Unity Health Toronto). That accounts for an estimated 170,000 patients losing access to primary care, and was higher than the 1.6% of family doctors who stopped working during a comparable period between 2010 and 2019.
The pandemic has made a bad situation even worse in primary care. Ontarians and Canadians need to address this issue by supporting those who wish to go into family medicine and primary care. This is a near crisis situation that the province and federal governments seem to be neglecting. As of March 2020, 1.8 million Ontarians did not have a family doctor, and a further 1.7 million Ontarians have a family doctor older than 65 years old. Yes, that is retirement age.
When Ontario locked down the province in 2020, they directed doctors to not see patients unless absolutely necessary. This pushed visits, either in person or virtually down by more than 30%. Doctors who charge the province by a fee-for-service modal lost most of their income while keeping their offices open for the few who visited.
Patients in need visited the emergency offices of hospitals, filling these venues. Then hospitals redirected the patients to private or walk-in clinics that were limited in how many patients they can help. Family doctors were placed in the middle of a healthcare storm, with patients in need on one side, and provincial governments on the other. Those doctors that had smaller practices, fewer than 500 patients, left the job at a higher rate.
Between 2010-2019, Ontario had 12.247 active family doctors, while from 2019 to September 2020 there were only 11,862. Regionally, north-western Ontario, the Niagara Region and Bruce Peninsula Region, Toronto, and Ottawa lost the most doctors. This situation hit hardest in rural communities, where the numbers of doctors were smaller to begin with, and the doctor’s influence upon the community was greater. The trend towards retirement found within the medical field places our health system into a present and future crisis.
While the provinces are attempting to move patients without crisis needs out of their hospitals, opening up their surgical and emergency wards, the doctors in need continue to place their efforts in peril. Those patients in need continue to go to ER’s, often to find rural and smaller community ER’s periodically closed for a few days or a week. The province needs to deal with the increasing costs to maintain their health systems. Medical professionals leave the health system only to return better paid through temp firms.
Is the province trying to bring in some form of privatization within our health system? Two-tiered medicine is already here, with doctor’s offices charging for things once taken care of by the province. Universal Healthcare seems to not work these days, especially when the province ties medical professionals hands and denies them the funds they need. Preventive medicine, the most cost-effective healthcare has gone out the window, replaced by triage and reactive medicine.
What can the government do?
- Institute homecare as the basis for the health system. If a problem can be done at home, medical professionals visit domestically
- Emergency departments are only for emergencies
- Allow new Canadians who are medically trained to enter the system as quickly as possible. End the Medical Associations stranglehold upon who works in the province and where
- Make strict annual medical check-ups legally essential. Preventive medicine must become legally binding to all citizens.
- Medical professionals must be the highest paid of civil servants
- The medical system must be independent from provincial management, with active and powerful auditors present to make sure the system is operating cost effectively and properly
- Those studying to become a medical professional should receive full allowance for their studies. If they graduate into the system, the province should pay all their educational expenses
- Complete family services should be offered to medical professionals, such as childcare, and family emergency crisis management
New doctors should begin their residency in rural areas of the province, generating experience, people skills, and patience in service. Nursing should be treated in the same manner. The public must give these professionals what they want and need, and demand of them provincial service for a five year period, perhaps longer.
The staffing shortage within the most important department our government has must not happen again. Taxes will go up, but what are you worried about when your loved one is ill; money or their welfare?
