What kind of family doctor do Canadians want?

Hey there, time traveller!
This article was published 17/10/2022 (1446 days ago), so information in it may no longer be current.

Family doctors are the front door of our health system. They’re where you go when you are sick. And they keep you from getting sick in the first place — providing immunizations, screening tests and care for chronic conditions like diabetes or asthma.

Family doctors connect you to other parts of the health system so you can get extra help when you need it. They know you as a person and can help guide you through tough decisions.

But for too many people in Canada, that front door is now closed. Even before the pandemic, 4.6 million people in Canada didn’t have a family doctor. The pandemic has just made things worse.

Research we published earlier this month found twice as many family doctors stopped working during the first six months of the pandemic compared to what would have been expected based on trends from the past decade.

Other research we’ve done has found one in five family doctors are thinking about closing their practice in the next five years.

At the same time, our population is aging, and fewer medical students are choosing family medicine as a career. Even those who do are more likely to specialize in something afterward rather than open a family practice.

The situation is bleak. But that also means there is momentum for change. There are many ideas out there to create a better system. But most require investment or trade-offs.

For example, in some jurisdictions around the world, family doctor care is organized like the public school system in Canada. When you move into a new neighbourhood, you have a choice of a few practices that are nearby. Those practices have to accept you. And they are resourced based on the needs of the community they serve.

But when you move, you’re asked to leave the practice and sign up with one in your new neighbourhood. You can’t keep seeing the same family doctor you’ve come to know.

And you may have less of a relationship with one family doctor and instead see any of the family doctors, nurses or nurse practitioners in the practice. They would all have access to your records, but they may not know you as well personally.

This is just one example of how we could reimagine our system and how that reimagining might involve trade-offs. Ultimately, those trade-offs need to be informed by patients and the public.

That’s why our research team has launched OurCare/NosSoins — what we believe to be the largest-ever initiative to engage the public about the future of primary care in Canada.

We think a better system is possible and that better needs to be informed by the values, needs, preferences and priorities of people living in Canada. We’ve designed a year-long engagement process in which we hope to hear not just from the loudest voices but also those who are most often left behind.

We’re starting with a national research survey that explores people’s experiences with primary care, what aspects are most important to them and what they want to see in a future system.

The pandemic has widened the cracks in our health-care system. But that also means it’s opened opportunities for change. Visit OurCare.ca and tell us how we can make family doctor care better.

Tara Kiran is a family physician and scientist at St. Michael’s Hospital, Unity Health Toronto and the Fidani Chair of Improvement and Innovation at the University of Toronto.

OurCare.ca wants to hear from you! Take the research survey, part of the OurCare project based at MAP Centre for Urban Health Solutions, Unity Health Toronto. Participation is completely voluntary and anonymous. The survey is open until Oct. 25.