Faced with an aging population requiring increasingly complex care, overwhelmed Canadian doctors are feeling more and more frustrated by their inability to serve their patients' health needs, a national survey reports.
In the survey of more than 20,000 doctors and doctors-in-training from across the country, 75 per cent reported that inadequate funding of the health-care system, a shortage of physicians and other health professionals, paperwork and bureaucracy are curtailing the amount and level of care they want to provide patients.
While that attitude was expressed by all the specialties, it is perhaps most pronounced among family physicians, simply because of their number and the nature of their practice: almost half of Canada's roughly 60,000 doctors are family practitioners and the specialty usually seen most often by patients, said Dr. Calvin Gutkin, executive director and CEO of the College of Family Physicians of Canada.
"I think the frustration remains related to just the capacity within the family medicine community to address all of the needs of the population," said Gutkin, whose organization conducts the triennial survey with the Canadian Medical Association (CMA) and the Royal College of Physicians and Surgeons of Canada.
"Physicians in most communities across the country are doing their best to try to see as many patients as they can," he said Tuesday. "But still, many of them have had to ... limit the number of new patients they can take.
"And we have community after community with patients who are unable to access a family physician for themselves or for their families. And the family physicians themselves are aware of this and are very frustrated by this."
Recruits should be encouraged: CMA
In fact, an estimated four million to five million Canadians do not have a family doctor, and physicians groups lay the blame in part on a woefully understaffed health-care system.
CMA president Dr. Brian Day said the survey shows that about 4,000 doctors plan to retire in the next two years and medical school graduates will barely cover that loss. As well, 35 per cent of physicians surveyed said they plan to slow down and cut back on their practice.
To bring Canada's medical workforce even up to minimum standards set by the Organization for Economic Co-operation and Development, the country would need to immediately add 26,000 doctors, Day said from Vancouver.
"That's not going to happen," he said. "But we should start to make efforts to try and attract 1,500 young Canadians at medical schools outside of Canada."
Day was referring to Canadian students unable to win one of the 2,000 to 2,500 openings at Canada's 17 medical schools, who went outside the country for training. Although highly qualified, he said, Canada makes it difficult for these new doctors to get certification to practise back home.
"We know from tracing them that very few of them come back to Canada. I think that's a particular group we need to target. We need to make it easier for their qualifications to be verified ... Because it's made difficult for them to come back here, they tend to go elsewhere — because they're in demand in the United States, in Europe and Australia, and so on."
"The ideal solution, of course, would be to expand medical schools here so that Canada becomes self sufficient."
More specialists needed
Dr. Louise Samson, president of the Royal College of Physicians and Surgeons of Canada, said more specialists are needed as well to meet the growing needs of the patient population, which is getting older, living longer and beset by more complex health issues as a result.
As a radiologist in Montreal, Samson sees first-hand the long wait patients have for MRIs and CT scans because there are not enough technicians to perform the tests or radiologists to interpret the results.
"When I look at the results of the survey, I'm not surprised at all because this is exactly what I live in my practice," she said, noting that almost 49 per cent of those surveyed reported having difficulty accessing radiology services for patients.
Even though government investment has resulted in progress to reduce wait times in key areas such as cancer treatment, heart procedures, diagnostic imaging, joint replacements and sight restoration, there is still a long way to go to trim patient queues, doctors say.
And in some areas, such as mental health services, patients are waiting far too long for help, Samson said. "It takes too long for a patient to get an appointment with a specialist."
The medical groups hope the survey results will spur federal, provincial and territorial governments to work with health professionals to develop a pan-Canadian approach to train, recruit and retain a sufficient number of physicians to meet the needs of Canadians.
"We have kind of had a system that runs by the seat of its pants ... if there is a problem that becomes critical, then everybody starts jumping, governments start jumping and they start trying to figure out ways to plug the holes," said Gutkin.