The Fraser Institute says close to five million Canadians can't find a family doctor. 
But having one doesn't necessarily translate into patient satisfaction. According to a new report some patients are less than enthusiastic about their physician.

TRiG, a US-based survey company, conducted an online study of just under 22,600 adults in 23 countries.  The survey found that two-thirds of patients around the world feel disrespected by their physicians.  Only three in ten of those surveyed said they were pleased with their physician.  Fewer than half said they'd recommend their doctor to friends and family. 

According to the survey, poor communication between doctor and patient is a prime reason for patients' dissatisfaction. About a quarter of patients globally complain that physicians don't answer questions, don't involve them in treatment decisions and use medical terms with no explanation.  Nearly half said their doctor doesn't spend enough time with them.  About a third of patients also believe doctors show disrespect by not being punctual for appointments.

On the face of things, Canadians seem a lot more satisfied with their doctors than patients in other countries.  A 2005 Canadian survey found that a whopping 85% of Canadians were very or somewhat satisfied with the health care services they received.  Satisfaction rates ranged from 78% in Nunavut to 89% in Nova Scotia and New Brunswick. Compare those high satisfaction rates to TRiG survey in which 55% of patients surveyed in China and 51% in German were displeased with the limited time they get from their doctors. Chinese patients were also far more likely than respondents in other countries to say their doctors don't explain medical terminology. Fifty-five percent in Australia, 48% in France and 46% in the US were aggravated by their physicians' lack of punctuality. 

Frankly I doubt Canadians are significantly more satisfied than patients in other countries.  There could be several reasons for the differences in reported satisfaction rates.  At the top of the list, Canadians don't have to pay out of pocket for heath care.  It's hard to complain when you don't have to open your wallet.  Second, there may be something to the notion that we're just too polite to complain about lousy service.  Third, there may be little point in complaining.  If you've ever summoned up the courage to rant to a health professional, you may have received a sanctimonious lecture about how stressed and busy the system is.

If you don't like your physician, you may be tempted to fire him or her. That's not exactly a winning strategy if you can't line up a replacement. More than that, you could be firing your doctor for some trivial reasons. I'm not saying punctuality isn't important. But there are deeper issues between us than that.  The root of many conflicts is that doctor and patient tend to make false assumptions about one another, presumably based upon their history together.  For example, some patients who also go to naturopaths and chiropractors do not tell their physician. Why? Because they assume the doctor will chastise them for doing so. Many patients never tell their doctor that they don't take their medications as directed because they don't want to their doctor to get angry with them. As well, an estimated half of all patients walk out of the doctor's office without making sure they understand their doctor's instructions in part because they assume the doctor is too busy to interrupt and ask for clarification. All of these unspoken assumptions contribute not only to dissatisfaction and a desire to fire the doctor, but can also be hazardous to your health.

I believe there's a middle ground between screaming at your doctor and suffering in silence.  Before giving your doctor the pink slip, try speaking up.  If you don't understand what the doctor is saying, ask for clarification.  Before you walk out the door, say "let me see if I understand what you're asking me to do" and paraphrase what you think the doctor said. 

Never be afraid to disagree with your doctor.  If your doctor seems to be shrugging off your symptoms as "all in your head" or suggesting what seems to be an unreasonable course of action, make sure the doctor knows you disagree.  Challenging your doctor might prevent a big mistake.  Third, if you have a chance, write out your questions to the doctor in advance.  It's common to forget what you wanted to discuss while you're in the examining room. 

These tips won't make everything between us warm and fuzzy.  But they will reduce those incorrect assumptions that seem to plague the increasingly complex relationship between doctor and patient these days.