Doctors

[KayTheCurler]

This morning my guy took a short note from me to my Family Doctor. Just an update that didn't need an appointment. While delivering it he discovered that we are losing three more doctors. In an ideal world we would have 14 to serve the town, surrounding smaller towns and several Reserves. We will be down to 5 at the end of this month.
How bad is this situation where you live?
Here the ER is being used as the only way to see a doctor. 'Our' doctor has NO appointments available unnti October!

 

[Northwind]

BC has made at least one billing related change to help family docs. I think that has made some difference. There is also a plan to create a new urgent care clinic to take the burden off Emerg. I think that won't open for awhile though. Rumour has it we're gaining Alberta doctors who are tired of the crap going on there.

It's a big problem and I'm not sure the powers that be are on the right track to fix it.

 

[Mendalla]

We got in with a guy in a family health team, which means he has a support network including after hours clinic, which helps. And I think he gets paid based on patient load rather than a fee per service billing so he has some incentive to focus more rather than rushing through as many visits as possible in a day. But finding him was a challenge. He appears to have been the only family doc in London taking patients at the time we got in and that only because he was new (finished his residency just before the pandemic). We were kind of stuck because our old guy retired in the middle of the pandemic and was just sending his files to a walk-in place. Given my diabetes and my wife having conditions needing ongoing attention as well, that did not work for us so we hunted until we found this guy. Don't really like him that much, but there aren't really any options right now. And getting in with specialists is quite a challenge here, too. We've had one either retire or move (not clear which) and getting a replacement is turning into an epic quest of its own. So I don't have numbers, but even here in a largish (by Canadian standards) city with a major teaching hospital and med school, we seem to be seeing shortages in almost every specialty including family medicine.

 

[Mendalla]

Here the ER is being used as the only way to see a doctor.

Mercifully, family health teams offer after hours service with appointments, i.e. not just a walk-in. We can call after 4pm (and there's weekend hours, too) and make an appointment and the doctor on duty sees us. We can also use that as a backup if our doctor is on vacation. Our old doctor had this, too, but had to pay for it since he was in independent practice rather than a team. Seemed to work well, though. Which means the ER is back to being for genuine emergencies.

'Our' doctor has NO appointments available unnti October!

Ours is usually booking a couple weeks out (save recently when he has been on vac), maybe three. But as I said, I think FHT docs are paid per patient according to some formula rather than fee for service so he's not cramming his calendar to the gills just to make enough money to keep the doors open and the lights on like a doc in independent practice. I imagine the backlog would be worse in a practice like that.

In general, I think the FHT model is the way to go for family practice. Better, more stable payment system for the doctors and more support services for the patients. Ours has a number of professionals attached for things like psychology.

The problem is staffing even those. Apparently most med students are targetting other, higher paying specialties so we are not graduating enough family docs in Ontario.

 

[Jae]

Have never experienced any problem going to see a doctor here. That's largely because we live fairly close to a major university hospital , which is nice. My grasp, though, is that there is a shortage of doctors nationwide, with the rural areas being the most impacted by that

 

[Mendalla]

the rural areas being the most impacted by that

Which is an ongoing issue here, too. Government incentives, communities offering things like housing, and other ideas have been tried to induce doctors to move to underserviced rural areas and there still seem to be issues getting doctors to locate outside cities. I think there's been discussion of forgiving student loans if med school grads practice in a rural area for a certain amount of time but I forget if that has actually been tried.

 

[BetteTheRed]

I haven't met my new doctor yet, although my old doc sold his practice to her 3 years or so ago. Reason is, practice comes with a nurse-practitioner, whom I love, and so I just see her. She diagnoses, orders tests, refers to specialists....

I'm also loving the new Ontario model which allows pharmacists to diagnose and treat a number of common ailments, like UTIs:

|"As of October 1, 2023, Ontario pharmacists are authorized to prescribe medications for 19 minor ailments that include:

• Acne
• Allergic rhinitis
• Aphthous Ulcers (canker sores)
• Candidal stomatitis (oral thrush)
• Conjunctivitis (bacterial, allergic and viral)
• Dermatitis (atopic, eczema, allergic and contact)
• Diaper dermatitis
• Dysmenorrhea
• Gastroesophageal reflux disease (GERD)
• Hemorrhoids
• Herpes labialis (cold sores)
• Impetigo
• Insect bites and urticaria (hives)
• Tick bites, post-exposure prophylaxis to prevent Lyme disease
• Musculoskeletal sprains and strains
• Nausea and vomiting of pregnancy
• Pinworms and threadworms
• Urinary tract infections (uncomplicated)
• Vulvovaginal candidiasis (yeast infection)"

Source: Minor Ailments - OCPInfo.com

 

[Northwind]

Our doctor in Ontario was on a model similar to what you describe @Mendalla. He was on a salary I think so had more time to spend with each patient. That was when it wasn't so hard to find a doctor.

Our clinic has a doctor of the day instead of a walk in clinic. It works well.