Family doctor shortage worsening across Canada
National survey conducted in 2022–2023 found close to one-in-five Canadian adults do not have access to a family doctor
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The shortage of family doctors affects millions of Canadians.
Of the 22 per cent of Canadians without a family doctor, 29 per cent say they have been looking for one but the effort has been unsuccessful. Thirty per cent of those who have stopped looking say they aren’t doing so because there is none available in their area. Twenty per cent have simply given up looking.
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The majority of respondents to a Unity Health Toronto survey who say they have been looking for a doctor have been doing so for one to two years.
What is happening that is creating this shortage and what are provinces doing to try to fix it? Here’s everything you need to know about Canada’s doctor shortage.
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How many Canadians don’t have a family doctor?
A national survey conducted by OurCare between 2022–2023 found that close to one-in-five Canadian adults do not have access to a family doctor. The survey of 10,000 people also found that 77 per cent of Canadians have a family doctor.
But while that percentage seems high, it belies the hard fact that in 2023, 6.5 million Canadians were without a family doctor or nurse practitioner, according to the OurCare survey.
What is the cause of the shortage?
There are multiple factors that can be attributed to the growing shortage. One of them is that family doctors are aging.
Tingting Zhang, a junior policy analyst at the C.D. Howe Institute found that if normal retirement patterns play out with 57 per cent of family doctors over the age of 75 retiring, Canada will be short 13,845 family doctors by 2032.
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That means over the next decade, more than 9.5-million Canadians could be without a family doctor.
More and more medical students and professionals are moving away from family practice and choosing to focus on other specialties, such as sports medicine, emergency medicine and mental health. So, with fewer family doctors, demand is increasingly unmet.
The lack of interest in family medicine among medical students is partly due to remuneration. Family doctors make less than other medical professionals. They are also required to complete administrative tasks, such as providing sick notes, for which they are not always compensated. Physicians spend up to 20 hours a week working on administrative and office tasks. That means time away from providing care, as well as an extra-heavy workload, which can lead to burnout.
Physician burnout has increased since the COVID-19 pandemic. As the demand for family doctors grew, “which led to notable levels of physician burnout and an increase in retirements,” states a C.D. Howe study. Another study by the Canadian Medical Association found that more than 50 per cent of physicians polled “showed high rates of burnout.” It also found that 49 per cent of respondents are considering making changes to their work.
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What is the situation like across the country?
British Columbia is one of the provinces with a high percentage of Canadian adults without a family doctor. Around 27 per cent of the province’s residents do not have access to care. Yet, B.C. has the most licensed family doctors per capita in the country. There are more than 6,000 licensed family doctors in the province but more than 2,000 of them not working. Advocates argue that B.C. doctors are the lowest paid in the country.
In neighbouring Alberta, about 16 per cent of adults do not have a family doctor, while more than 60 per cent of family doctors are considering retiring early. The Alberta government has been embroiled for years in a dispute with Alberta physicians over compensation. Nearly half of Alberta doctors, according to a survey by the Alberta Medical Association, are considering leaving for other provinces by 2029.
According to the Saskatchewan Medical Association, one-in-six people living in the province are without a family doctor. The province also has the lowest number of physicians per 100,000 people.
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Dr. Michael Boroditsky, president of Doctors Manitoba, said in a Manitoba national report that the province’s doctor shortage is getting worse each year. The report showed that per capita, Manitoba has the lowest number of family doctors in the country.
Ontario has the highest number of adults with family doctors in the country, with only 13 per cent being without. Still, the Ontario College of Family Physicians predicts more than four-million Ontarians won’t have access to a family doctor by 2026, as the number of graduates going into family medicine is the lowest it has been in 15 years. The Ontario Medical Association says half of physicians in Northern Ontario are set to retire within five years.
In 2022, Quebec lost more family doctors to retirement than they gained. Around 31 per cent of the population is without a family doctor.
Similar to Quebec, around 31 per cent of adults don’t have a family doctor across Atlantic Canada. Fifteen per cent of Nova Scotians are on waitlists. Data from MediMap shows that in 2022, Nova Scotia experienced the longest wait times in the country at walk-in clinics.
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How many new family doctors do we need?
The Canadian government projects that between 2022–2031 the number of job openings for family physicians will be 48,900. The expected number of physician “job seekers” is 29,400. This means almost 20,000 positions will be unfilled. With the decline in graduates going into family practice, the country will simply not be able to keep up with demand.
What are the provinces doing to fight the shortage?
In several provinces, governments have moved to modify payment models, hoping to keep doctors instead of having them move to sunnier pastures. In recent years, the B.C. government revamped its payment model. It now pays doctors based on the number of patients seen in a day, the time spent with them and the complexity of the patient’s problems.
Alberta, too, is working on reforming its compensation agreements.
Saskatchewan is moving towards a care model that is “physician-led and team-based.” The head of the Saskatchewan Medical Association, Dr. Andre Grobler, has argued that this model will increase family physician recruitment.
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Manitoba has made strides to decrease the province’s shortage. Its initiative includes expanding training and resources. They are also aiming to reduce “administrative burdens.”
The Ontario government under Premier Doug Ford announced recently that it will cover costs of tuition for students who are committed to becoming family doctors in Ontario. Further, by the fall of 2026, the government plans for 95 per cent of medical school seats in the province to be given to Ontario residents.
Quebec announced plans earlier in the year to train more than 200 doctors a year in order to help keep up with the province’s demand.
In 2022, Nova Scotia helped make residency more available to international medical graduates. Similar to B.C., they pay family doctors in alternative models.
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