Doctors’ prescription for physician shortage

by richard.mahoney@eap.on.ca
http://www.tribune-express.ca

HAWKESBURY – “The government has made strides in addressing the family doctor shortage, but we cannot get complacent now,” says Dr. Renée Arnold. “More than 600,000 Ontarians without a family doctor is far too many. The family doctor shortage must remain a burning priority for our government,” adds the Hawkesbury physician, who is president of the Ontario College of Family Physicians (OCFP).

She was commenting on an OCFP study that found as many Ontarians, including about 250,000 people over the age of 50, are still without a family doctor. “If you detect disease early, it’s often easier to treat. But without a family doctor, people don’t have access to the routine tests needed for the early detection and management of chronic illnesses,” says Dr. Arnold. “This is a problem, particularly for those in the 50 plus age bracket who are more prone to illnesses like diabetes and heart disease as they age, but are only seeking medical attention in emergency rooms (ERs) or walk-in clinics as an urgent need unfolds.”

In the past three years, almost half a million Ontarians have been forced to seek medical care from walk-in clinics or the overburdened emergency room at their local hospital because they do not have a family physician – even though the majority of them agree they would receive better care from their own doctor than they would from a doctor in an ER or clinic whom they are seeing on a one-time basis.

“In Hawkesbury, we are doing OK,” says Dr. Arnold. Local doctors, some of whom have as many as 2,400 patients, work at the hospital, emergency ward, nursing homes and their own office. ‘”We are overworked, but we are having fun. There is nothing more rewarding,” says Dr. Arnold, who began practicing medicine 25 years.

According to the OCFP, reorganizing the existing family doctors into health teams will enhance the care they are delivering to patients who already have them as their family doctor, but it will not help address the patients who do not have a family doctor. Plus allowing nurses to provide primary care as a substitute to doctors is not accepted by a wide margin of the public. Ontarians need and expect more family doctors to be pumped into the system.

The creation of a registry describing the local of patients requiring doctors, and their specific needs, would be a big step in improving care in rural areas, says Dr. Arnold. “We need more of a local picture so we can come up with local solutions,” she comments.

According to the OCFP survey, Ontarians without a family doctor recognize that not having one is a problem. For example, 24 per cent feel that not having a family doctor denies them important access to routine physical exams for preventative care, and others indicate they do not have access to consistent care for major illnesses. Twenty-one per cent feel they cannot gain access to a specialist when they need one, and others feel they do not have access to guidance and advice for mental health issues. They also feel there is no continuity in their medical records and that the health care system has no knowledge of their medical history.

Almost all Ontarians (92 per cent) believe the health care system in Ontario would be improved if more emphasis was placed on family doctors providing preventative care.

In spite of the progress made, 90 per cent of Ontarians agree there is a shortage of family physicians in Ontario and 72 per cent, or more than 6 million people, believe the shortage is very serious. This is an eight per cent increase since the last time the OCFP polled Ontarians on this topic in September 2003.

In fact, more than half (59 per cent) of all Ontarians who are without a doctor have tried to find one. This translates into almost a half million Ontarians searching for a family doctor, of which many are over 50 years of age.

Overall, 63 per cent of Ontarians say they are not satisfied with the way the Ontario government is handling the shortage of family physicians.

While an overwhelming number of Ontarians feel that their family doctor is the most important health care professional in the system, they feel their care would be enhanced if their doctor had nurses and other health care professionals working with them. However, the overwhelming majority (95 per cent) say it is important that their family doctor provides the majority of their care and coordinates the care provided by others. In addition, many Ontarians do not prefer alternative deliveries of primary care – such as their care being delivered by a nurse who would send them to a doctor only when they think a physician’s assessment is needed.

The full OCFP poll findings can be found on their website www.ocfp.on.ca/What’sNew.

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