Who will write the prescription to treat Canada’s family doctor shortage? Statistics Canada reports that about 4.4 million (15.2%) of Canadians do not have a regular medical doctor. Even Canadians with a place on a doctor or family health team roster are aware that too many of their fellow citizens are forced to resort to emergency rooms and walk-in clinics for primary care. There is a general sense of fear that as doctors age and retire that the problem will worsen over the next decade. Graduates in recent years have shown less of a desire to work the traditionally long hours of the family physician – they hope to maintain a better balance in their lives. Doctors with young families, in particular, may move to part time work for a few years of their career. All is not bad news, however. Arcus has analysed available studies and conducted additional research with stakeholders in the medical community that provide reassurance that physicians and communities are working together to try to improve access to healthcare.
Research shows that family physicians are moving away from small, independent practices towards group practices or family health teams. This different model allows medical staff to work together and serve more patients than they would be able to do working independently. Adding Nurse Practitioners – a nurse qualified to treat certain conditions without the direct supervision of a doctor – to teams can lighten a physician’s patient load so that they can deal with more urgent and high needs chronic care patients. There are some health teams that have included additional specialities, such as chiropractors, dieticians or podiatrists, into their model to allow easier access for their patients.
In municipalities where there are significant shortages, efforts are being made to recruit new graduates to the area. In 2013, the municipality of Cambridge, Ontario organized a Doctor Recruitment Committee. While there are still some people without a family physician, Cambridge has encouraged more than 35 doctors to set up practice in the community. In addition to selling doctors on what the community can offer, the committee helps doctors locate potential office space and help match up doctors with potential patients. Doctors and communities are faster than patients to consider these changes as the way forward. Many Canadians are leery about seeing a Nurse Practitioner over a family doctor and continue to believe that a one patient / one doctor in a long term relationship is the gold standard of care. As doctors and communities work to improve things from their ends, it is important that patients be prepared to advocate for their needs and to educate themselves on the options available in their community.
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A recent study found that high prescribing physicians receive three to five times as many calls from sales reps as they did 10 years ago. Today’s pharmaceutical rep is vying with a massive army of competitors for diminishing physician time. Many sales reps even have to compete with others from their own company.
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