Future of our healthcare: Family doctors wanted
- Cynthia Yuen
- Nov 30, 2022
- 3 min read
Family doctors can provide continuity care to patients. Continuity of care is a longitudinal relationship with a personal physician or care team (Nowak et al., 2021). The continuity of care provided by family doctors yields a higher quality of care, more preventive care, decreased emergency department visits, and reduced odds of avoidable hospitalization (Nowak et al., 2021). However, Canada is facing a shortage of family doctors (CBC News, 2022 - b). Fewer family doctors mean reduced access to care for people across Canada, worsening health outcomes, and a less efficient healthcare system.
Why is there a shortage of family doctors in Canada?
CBC News (2022) reports the rising expectations placed on family practices without appropriate resources and the resulting physician burnout, from 33% in 2017 to 57% in 2021. Maintaining a family practice is becoming unsustainable with insufficient administrative support and stagnant payment models (CFPC, 2022).
Possible solutions?
Some of the possible solutions (CBC - b, 2022):
Instead of one doctor opening an office, several doctors collaborate and share the overhead and expenses. They can also cover for each other for on-call.
Collaborating with other healthcare professionals, such as physiotherapists, social workers, dietitians and pharmacists, offers direct care access.
Capitation - Instead of billing for service, doctors will get paid a set amount based on the number of patients they have while they can still bill for other services.
Recruiting international medical graduates (IMGs) could be another possible solution to the shortage of family doctors, especially in rural areas. However, there is an ethical aspect that should consider, i.e. whether it is ethically justified to recruit IMGs from developing countries that also suffer from acute shortages of trained physicians (Islam, 2014). Islam (2014) suggested that Canada can learn from the UK; the UK has changed its policy to make it harder to recruit IMGs from developing countries.
Lemire (2022) stated that some family physicians came out of retirement to help with COVID-19; continuing to support these physicians with a funding and retention plan might encourage them to practise even though it is part-time. Lemire (2022) also emphasized that Canada needs more family doctors and data strategies to capture the scope of work of family doctors and apply the data to providers' career trajectories. Other solutions are (Lemire, 2022):
modernizing family practice models to support team-based care
improving the practice environment with a positive learning atmosphere
reinforcing training for family physicians to treat complex patients in the community
An agreement has been reached between the Government of Alberta and the Alberta Medical Association (AMA) (Government of Alberta, 2022). In this agreement, the provincial government has agreed to invest Up to $15 million annually to support the recruitment and retention of physicians who practice full-time in underserved areas. Also, $12 million annually to enhance certain physician support programs, including the medical liability reimbursement program, continuing medical education program, and physician locum programs. The agreement will be in force for four fiscal years, from April 1, 2022, to March 31, 2026 (Government of Alberta, 2022).
Nursing practitioners are looking to set up independent practices in Alberta. They submitted a proposal for a salary model change last year so that they would be paid directly by the province (CBC, 2022 - a). Hopefully, this will relieve the family physician shortage, and Albertans can benefit from continuity of care.
There may be no quick fix to increase the number of family physicians. Since family medicine is essential to the healthcare system, our government should react quickly and wisely to find solutions - through restructuring the existing system - so that residents can stay well and receive healthcare in the community rather than in the hospital if possible.
References:
CBC News. (2022 - a). Alberta's nurse practitioners seek autonomy as family doctor shortage worsens.
CBC News: The National. (2022 - b). Why is it so hard to find a family doctor in Canada?
Dominik Alex Nowak, Natasha Yasmin Sheikhan, Sumana Christina Naidu, Kerry Kuluski, Ross E.G. Upshur. Why does continuity of care with family doctors matter? Canadian Family Physician. Sep 2021, 67 (9) 679–688. DOI: https://doi.org/10.46747/cfp.6709679
Government of Alberta. (n.d.b). New physician agreement.
Islam N. (2014). The dilemma of the physician shortage and international recruitment in Canada. International journal of health policy and management, 3(1), 29–32.
Lemire F. (2022). Addressing family physician shortages. Canadian family physician Medecin de famille canadien, 68(5), 392. https://doi.org/10.46747/cfp.6805392
The College of Family Physicians in Canada (CFPC). 2022. Family doctor shortage in Canada.
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