A few months ago, I received a letter from my doctor notifying me that he was retiring. It went on to say that he'd been unable to find anyone to take over his practice. And no other physicians at the medical clinic in which he was located were taking new patients.
The letter said that my medical records were being sent to a document storage company and could be accessed for a fee should I want to forward them to someone else.
And that was it.
I have to say I loved my doctor and was devastated by the news. I had seen him for 22 years and in that time he had become an indispensable part of my life. I had no idea, however, how difficult he would be to replace.
No doctors in my community, a 25-minute drive from downtown Vancouver, are taking on new patients. There are no physicians in the next town over with openings, either. I'm now on a waiting list with thousands of others in the area in which I live who are looking for a general practitioner. Tens of thousands in British Columbia are in the same predicament. And it is a phenomenon occurring across the country.
The B.C. government had pledged during the 2013 election to match every person in the province with a family doctor by 2015. It has now abandoned that promise. In the interim, the number of people looking for a physician has grown, not shrunk. Now, the government talks about redefining what primary care looks like. And what it looks like is people going to walk-in clinics instead of seeing a doctor they've come to know and trust with the most important aspect of their life – their health.
There are an estimated 200,000 people without a family doctor in British Columbia, about half of that number in Vancouver. The irony is there are more doctors than ever in the province, and across the country for that matter. Most provinces are seeing increases in numbers much higher than population growth. The city of Vancouver has 169 GPs per 100,000 – the Canadian average is a bit more than 100. So the city has one GP for 600 people and yet there are 100,000 without one. (It's estimated that about one-third aren't looking for one.)
So what's going on? The answer is complex, but largely centres around the fact that young doctors today don't want to take on a big family practice with 2,000 patients. Today, many prefer the more hassle-free existence found in a clinic, where they can work in a more collaborative setting, something that is being encouraged in medical school.
One person who has looked into the situation is Steven Lewis, a prominent health-policy consultant based in Saskatoon. He said the problem is a structural one with a number of possible explanations, including the fact young GPs today are less entrepreneurial and have lower income expectations. If they can make a decent living by working regular hours, without huge responsibilities and live in a big, attractive city such as Vancouver, they will.
"One explanation is that the increased numbers [of doctors], far from bringing comprehensive care to more people and better care for the frail and elderly and people with multiple chronic conditions, actually saturated the market and created an incentive for many GPs to do less," Mr. Lewis told me. "Irony indeed."
In other words, Marcus Welby, M.D., is dead.
This is a tough pill to swallow. Just as many Canadians are entering an age when trips to the doctor become more necessary, they are being told they'll have to head to a clinic and take a number. I'm sure the doctors are perfectly fine there, but it is not the same at all; you can't replace the bond you establish with your family doctor at a clinic.
If this is the new reality, so be it. My guess, however, is that many Canadians will simply abandon the search for a GP and let many health issues slide. Or they will visit emergency rooms for routine matters that their family doctor would have once taken care of.
Meanwhile, if there is a doctor out there taking patients, please let me know. I tell very funny stories and have been known to lavish my GP with very expensive Scotch.
Gary Mason