by David Korzinski | September 7, 2022 10:00 pm
September 8, 2022 – When Dr. David Eaton retires later this year, 1,400 of the approximately 2,800 people of Wheatley, Ont. will be losing their family doctor, with nobody lined up to take his place.
Across the country, in Victoria, B.C., a woman took out an ad in a local paper imploring a qualified doctor to come forward and help her 82-year-old husband renew his expiring prescription, having hit a roadblock at every turn in her attempts to find care.
These are the types of stories emerging this summer as a family doctor shortage hits crisis levels across the country. The lack of an intimate relationship with health care through a family physician is causing Canadians considerable consternation and compounding their ability to receive adequate care.
The latest study from the non-profit Angus Reid Institute – the second in a three-part health care series – finds half of Canadians either unable to see the doctor they have within a week (33%) or trying but unable to find a doctor at all (17%). Few, 14 per cent, say they have a doctor, and can get an appointment quickly, while one-in-three say it usually takes longer than they’d like, but if it were urgent, they could get an appointment promptly.
Among those who report difficult access or none at all, specialist appointments and diagnostic tests are additionally challenging to secure.
Consider that Canadians who have easy access to a doctor are half as likely to say it was difficult or impossible to see a specialist or book a diagnostic test than those who have difficult access or don’t have a doctor at all. Further, both latter groups are three times as likely as those with easier access to their GP to say their health has worsened over the past six months.
As part of this comprehensive survey canvassing attitudes regarding access to primary and secondary care in Canada, the Angus Reid Institute also surveyed Americans to better understand their experiences. The data show that while a near-identical number of adults on both sides of the border report having a family doctor, Americans are twice as likely to have easy access to a timely appointment. Additionally, Canadians who have a doctor are four times as likely (32%) as Americans (8%) to say they’ve been seeing their doctor virtually over the past year or so.
The Angus Reid Institute (ARI) was founded in October 2014 by pollster and sociologist, Dr. Angus Reid. ARI is a national, not-for-profit, non-partisan public opinion research foundation established to advance education by commissioning, conducting and disseminating to the public accessible and impartial statistical data, research and policy analysis on economics, political science, philanthropy, public administration, domestic and international affairs and other socio-economic issues of importance to Canada and its world.
For most Canadians, a family doctor is their primary point of contact with the health-care system. However, as doctors retire, and fewer medical school graduates choose to go into family practice, millions of Canadians have been struggling to find that professional to meet their health care needs.
The Canadian Medical Association has called the family physician shortage “critical”. At fault, according to critics and doctors, is a system which pays too little to GPs per patient and requires too much work. Many medical graduates avoid entering family medicine, and instead choose jobs in other parts of the health-care system with more predictable hours and better pay. Whatever the reasons, a shortage of family doctors persists in the country, despite there being more doctors per capita than ever before.
Overall, four-in-five Canadian adults say they have a family doctor. One-in-five do not, a figure that represents over six million Canadian adults. These data align with the most recent data from Statistics Canada.
Younger people are less likely to report having a family doctor; three-in-ten (31%) adults under the age of 35 say they don’t:
But having a family doctor represents only part of the story around access to primary care in Canada. What if you have a doctor, but can’t get in to see them when you need to? Among those with a family physician, just 18 per cent report that they can secure an appointment within a day or two:
Combining these responses with those who are unable to find a doctor, the picture is much more descriptive of what Canadians are facing in 2022.
Put another way, the system seems to work for 14 per cent of Canadian adults or 4.4 million Canadians. These people not only have a doctor but have easy access to that medical professional when needed.
For almost everyone else, there are issues. One-in-three say that it would take them a few days to see their doctor but if it were an emergency, they would be able to speed this process up. The same number (33%) say they have difficulty getting a doctor’s appointment when needed, waiting a week or more.
Close to one-in-five (17%) have no doctor at all even though they would like one:
Regionally, British Columbia (59%) and Atlantic Canada (60%) are home to the highest number of adults who report difficult access to their current GP or can’t find one at all. The situation is brighter for those in Alberta and Ontario, but still more than two-in-five in both provinces say they either don’t have a doctor or must wait more than a week for an appointment. Overall, approaching one-quarter in B.C. (23%) and Quebec (23%) say they want a family doctor but don’t have one:
Men are more likely to say they can’t find a doctor, while women are more likely to say they face delays getting in to see the doctor they have. Two-in-five women under the age of 55 say it takes more than a week to see their family doctor. Meanwhile, three-in-ten (28%) men under the age of 35 say they have had no luck finding a GP:
For the one-in-five Canadians without a family doctor, many have been searching without luck to get one. Few (8%) began their search in the last six months. More have been looking for up to a year (11%) and more than that for more than a year (35%). Three-in-ten (29%) say they have given up entirely on finding a GP:
Canadians over the age of 34 are much more likely to report an extended – and fruitless – search for a doctor, with two-in-five (43%) in this cohort looking for more than a year. Three-in-ten over the age of 54 say they have given up, despite belonging to a demographic much more likely to need health care:
Part one of the Angus Reid Institute’s three-part series on Canadian health care experiences examined access to secondary care, including surgical procedures, diagnostic testing, and specialist appointments. Canadians’ inability to access the latter two areas of health care are quite clearly connected to their relationship with a family physician. Those who don’t have a doctor, or do but struggle to see them, are also more likely to report problems being referred for tests or appointments with specialists:
The COVID-19 pandemic shifted much human interaction from in-person to at-distance. Doctor visits were no different. Today, one-third of Canadians (32%) report they mostly interact with their family doctor over the phone or by video call. Two-thirds (68%) are more likely to see their GP in person:
For Canadians who see their family doctor mostly over the phone or the internet, most (65%) are okay with the arrangement. Age is a notable driver: younger Canadians – particularly younger women – are more likely to dislike “seeing” their doctor online over the phone or online:
To help contextualize the Canadian data, the Angus Institute conducted a parallel survey with respondents in the United States to assess and compare experiences. Notably, similar numbers of Americans and Canadians report having family doctors. The data correspond closely with those reported by Statistics Canada and recent reporting in the United States. These proportions leave millions of Canadians and tens of millions of Americans without a direct line to reliable primary health care:
While the proportion of Canadian and American adults with a family doctor may be similar, the level of self-reported access is vastly different. Two-in-five (41%) Canadians with a family doctor say it’s difficult to get an appointment right away. Comparatively, one-quarter (24%) of Americans with a GP say the same. Further, one-third (36%) in the U.S. say they can get an appointment with their doctor within a day or two if they need one, double the rate in Canada. This, despite the U.S. facing a similar physician shortage as Canada.
Looking at the overall spectrum of access to primary care by country, three trends are evident. Easy Access is more prevalent in the U.S. and Difficult Access rarer. Notably, however, Americans are four times as likely as Canadians to simply not be seeking a relationship with a family physician.
Canada’s response to the COVID-19 pandemic varied significantly from the United States. Canada experienced stricter and more frequent stay-at-home orders and business and school closures than its southern neighbour. Once the vaccine was widely available, many states lifted any closure orders and did not reinstate them.
Perhaps because of this comparative lack of COVID-19 restrictions, Americans are much less likely to say they have shifted to virtual visits with their family doctor. Nearly all (92%) in the United States say they mostly see their doctor in person. Americans say their doctor visits are virtual at one-quarter the rate of Canadians:
This report contributes further to the challenges Canadians are experiencing accessing health care. Millions lack access and millions more face unreliable scheduling when attempting to secure it. Part Three in this series will look explore Canadian are saying about their health care and what they think can be done to fix it.
The Angus Reid Institute conducted two online surveys in August 2022. Sample in Canada was drawn from Angus Reid Forum, while sample in the United States was drawn from Angus Reid Forum USA. The survey was self-commissioned and paid for by ARI.
In Canada: The Angus Reid Institute conducted an online survey from Aug. 8-10, 2022, among a representative randomized sample of 2,279 Canadian adults who are members of Angus Reid Forum. For comparison purposes only, a probability sample of this size would carry a margin of error of +/- 2.0 percentage points, 19 times out of 20.
In United States: The Angus Reid Institute conducted an online survey from Aug. 16-17, 2022, among a representative randomized sample of 1,209 American adults who are members of Angus Reid Forum USA. For comparison purposes only, a probability sample of this size would carry a margin of error of +/- 3.0 percentage points, 19 times out of 20.
For detailed Canadian results by age, gender, region, education, and other demographics, click here.
For detailed Canadian results by ease of access to family doctor, click here.
For detailed American results by age, gender, region, education, and other demographics, click here.
To read the full report, including detailed tables and methodology, click here.
To read the questionnaire in English and French, click here.
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