Local officials are mystified by new Ontario study that effectively proclaims the end of this region’s long-standing doctor shortage with this statistic: that 96 per cent of local adults have a primary care provider.
The number for the Erie St. Clair LHIN is higher than the provincial average (94 per cent), London’s (94) and even Toronto’s (91), according to regional data from Quality in Primary Care, a report released this week by the Health Quality Ontario. Only one of the province’s 14 health regions, in the Belleville area, has a higher percentage of people with a family doctor.
“It makes no sense, mathematically,” said Joan Mavrinac, the Essex County physician recruiter who’s been battling for years to counter the chronic doctor shortage.
“We’ve got the lowest number of family physician-to-population ratios of any of the 14 LHINs (one family doctor for every 1,579 people, compared to one for 1,159 provincially). We have the highest proportion of family physicians over 65 (20 per cent, versus 14 per cent provincially).”
When such a stat comes out, it does this region a disservice, she said, because it plays down the continuing need for family doctors. In recent years, recruitment efforts by Mavrinac, the establishment of a medical school and the creation of a residency programs for family medicine, have helped increase the numbers. About 36 doctors come here each year, while about 20 retire or leave, meaning the numbers are improving by about 16 annually.
But when the campaign began, the shortage in the Windsor-Essex region was dire, said Mavrinac, who has seen the number of psychiatrists rise from 11 to 36 and paediatricians double from eight to 16. There are currently about 430 doctors locally, 40 per cent of whom are family doctors.
The Health Ministry is in the midst of studying radical changes to primary care, with the stated goal of ensuring everyone gets a family doctor. Mavrinac believes that between 83 and 85 per cent of local people have a family doctor.
“I don’t mean to make it sound like it’s all doom and gloom, but to say there are 96 per cent who have family physicians is wrong.”
“I certainly don’t think that’s accurate,” said Dr. Tim O’Callahan, an Amherstburg family doctor and president of the Essex County Medical Association.
Both he and Mavrinac wonder if local people are saying they have a family doctor when what they actually have is a walk-in clinic. Over the years, the local doctor shortage has forced many people to use the clinics like family doctors, they said.
The CEO of Health Quality Ontario, Dr. Joshua Teppers, said the 96 per cent figure is due to the steady increase in the number of family doctors, nurse practitioners and physician assistants in Ontario in recent years. And four per cent — the number locally without a family doctor — is “not an insignificant amount,” he added.
It equates to thousands of people locally who don’t have a family doctor.
“It doesn’t mean we’re done, it doesn’t mean all aspects of access have been addressed, but at least on that one measure I think there has been improvement,” Teppers said.
He said there are other measurements that show considerable inequity when it comes to the quality of primary care people receive. “The experience of Ontarians really does depend on who you are, where you live, what language you speak,” he said.
Across the 14 LHINs, there are big differences in the percentage of adults who can get in to see their doctor the same day or the next day (it’s 42 per cent locally, compared to 44 per cent provincially), the percentage who can reach someone at their doctor’s office when they call (80 per cent locally), and the percentage whose doctors always involve them in decisions about treatment (80 per cent).
The report also provides evidence that poorer people don’t get the same care as wealthier people (half of the adults aged 50 to 74 living in low-income cities are overdue for their colorectal screening compared to 35 per cent in high-income areas). And new immigrants often don’t have the same access to quality primary care.
Athanas Njeru, a program manager at Windsor Women Working with Immigrant Women, said studies have described how immigrants new to Canada start out very healthy and within 10 years their health has deteriorated. Part of that deterioration may be due to how difficult it is for them to access the health-care system, Njeru suggested.
“Most of the people who come here didn’t have a family doctor (in their former country), they just go to the doctor when they’re sick,” said Njeru. When language is a barrier, it’s often difficult to express what’s wrong, she said.
“If you have a doctor who can actually take care of you in your language, you can express yourself and give the information they need.”
