Thursday, June 19, 2008

231,763 More Ontarians without Access to a Family Doctor as a Result of Investments in Family Doctors

Yesterday Statistics Canada released information from the Canadian Community Health Survey related to the ongoing physician shortage that is at odds with previous Ontario government announcements.

The newly released Canadian Community Health Survey, with more than 20 health indicators, reports that the percentage of Ontarians who have a regular doctor has decreased from 91.8 to 90.4% since 2003 (95% CI (Ontario) 91.4-92.2 in 2003, .89.8-91 in 2007). These statistics are at odds with a news release from the Ontario government that “500,000 More Ontarians with Access to a Family Doctor as a Result of Investments in Family Doctors”.

Previous Statements

"For the first time in a decade, the province has seen an increase in the number of Ontarians who have ready access to a family doctor", said Long-term Care Minister George Smitherman on June 21, 2007. Just under a year ago the Minister’s office announced, “Based on independent survey data and data from Statistics Canada, when population growth is accounted for [italics added], the number of Ontarians with regular access to a family doctor has increased by 500,000”.

The Data

Based on 2001 and 2006 population estimates from Census Canada and data included in the CCHS report (2003 and 2007) 518,473 additional Ontarians report having a regular family doctor (see chart below). The more sobering statistic is that 231,763 additional Ontarians report not having a family doctor adding to the evidence of a significant shortage of doctors. When viewed in conjunction with the fact that only 10% of primary care physicians were accepting new patients in 2007, which is down from 20.2 in 2003 and 38.4 in 2000, it is not surprising that 6% of all Ontarians (729,616) are unable to find a regular physician despite looking.

What Can be Done

The typical ratio for primary care providers is 85 per 100,000 citizens. Based on this ratio, Ontario is in urgent need of an additional 620 primary care providers just to care for the 6% of Ontarians seeking primary care.

It is possible that four years of primary care initiatives including FHTs and flat-fee-payment systems are controlling the health care budget but decreasing the overall capacity of the system by diminishing the desire for primary care providers to accept more patients. Perhaps it is easier to motivate all primary care providers to accept 6% more patients than it is to attract new doctors through greater financial incentives and automony.

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