WHEN Sue MacKinnon heard a doctor at a St. James clinic was accepting new patients, she jumped at the chance to find a physician close to home.
MacKinnon went to the clinic and filled out a form detailing her medical history, including her Type 2 diabetes, high blood pressure, cholesterol and chronic sleep disorder.
Sue MacKinnon was taken aback when a doctor who was accepting new patients turned her down.
Weeks later, MacKinnon found out she didn't make the cut -- the physician rejected her as a patient because of her health troubles.
"I got a letter saying that I had too many medical problems," said MacKinnon, 51.
"I was too complicated to take."
According to Manitoba Health, 29 doctors were accepting new patients in Winnipeg as of last Wednesday -- 10 of whom have certain restrictions on who they will accept as patients.
Dr. Bill Pope, registrar of the College of Physicians and Surgeons of Manitoba, said most patients don't realize family physicians can accept or refuse a patient based on their current patient load and knowledge of certain health problems.
For example, a family doctor with an interest in geriatrics may take a lot of elderly patients with chronic conditions -- like a subspecialty. However, if the same family doctor is accepting new patients, she may exclude geriatric patients. Pope said family doctors still must have a mix of patients and taking on too many geriatric patients or patients with chronic health conditions could be overly time-consuming because of the complexity of certain diseases.
"Firstly, physicians have always had the opportunity to choose whether to have a relationship with a patient or not," Pope said.
"There are many physicians, actually, who don't see children or women who might be pregnant because they basically don't have that area of practice enough to remain competent in it."
Doctors cannot discriminate against a patient based on race, gender, or anything outlined in the Charter of Rights and Freedoms. Pope said the idea is for physicians to acknowledge areas of medicine they know well and other areas of practice they may be less competent in.
However, he said, it does make it more complicated for people to find a family doctor.
"It does make it more complex."
Dr. Darcy Johnson, president of the Manitoba Medical Association, said part of the problem is that the way doctors bill the province for their time doesn't accurately reflect all the work they do -- one of the factors, he said, that has led to the declining interest in family medicine.
Aside from being overrun with older patients with complex, chronic diseases, Johnson said administrative paperwork and telephone medical advice eat up time a physician could be spending with a patient. Doctors are not reimbursed for dispensing medical advice over the phone, talking to pharmacists about prescription orders or discussing the health of a patient with hospital staff.
Johnson, a family physician of 25 years, said doctors have a limited amount of time and many new medical graduates do not want such an intensive medical practice.
"You've got an aging population, people with multiple conditions, an epidemic of diabetes, the issues of patients in hospital, the fact we're so short of family doctors," Johnson said. "The heavy lifters of the health-care system are overwhelmed."
MacKinnon, a Grade 3 teacher, said she didn't realize physicians can pick and choose their patients based on certain criteria and is frustrated some physicians don't have enough time to deal with a patient with a multitude of conditions.
Although she has since found a different family doctor, MacKinnon said her new doctor told her she has to make a separate appointment for each of her health woes since he doesn't have enough time to address them all at once.
"You have to be your own advocate because if you're not, you won't get anywhere in the medical system," MacKinnon said. "It's too overloaded."
jen.skerritt@freepress.mb.ca
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