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The question: I've been seeing my family doctor for 10 years and she saw me through my husband's death. She now has three children and is only in the office for half-days, three days a week. When I had abdominal pain, I waited one month for an appointment. The nurse practitioner did blood work and ordered a scan but did not provide results, even though I asked for them. When I call the office, I am told to see the nurse practitioner, go to emergency (usually a seven-hour wait or longer) or try the evening clinic, which is always fully booked by the time I call. I understand her wish to be with her children but feel there should be better coverage. Do you agree?

The answer: Your family doctor sounds wonderful, save for the fact that she is not as available as she used to be. That's not unusual. Female physicians work fewer hours than their male counterparts – 47.5 hour weeks, compared to a 53.8-hour week – according to a study by Mark Otto Baerlocher, an interventional radiologist at Royal Victoria Regional Health Centre, who analyzed 2007 National Physician Survey figures.

Women have made great strides in medicine. In 1980, 12.4 per cent of physicians were women; by 2010, 36.1 per cent of doctors were female, according to the Canadian Institute for Health Information. In many medical schools today, at least half of students are women. That's a good thing.

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Danielle Martin, board chair of Canadian Doctors for Medicare says this trend should not be seen as a problem but an opportunity for female physicians to better organize themselves into teams with other doctors and health-care workers, who can cover for each other.

"Doctors have a responsibility to do everything they can to make sure their patients are covered," said Dr. Martin, a family physician at Women's College Hospital in Toronto. "Patients shouldn't think of going to emergency after 5 p.m., they should all have access to primary care. It sounds like this woman's doctor has made arrangements to cover her care."

Many female doctors have children and one should expect them to take time off to raise their families. However, that should not adversely affect patients. Provincial governments have spent a lot of money trying to get doctors to work in teams to provide care after hours; yours should be providing comparable care through either family doctors or other health care providers on a timely basis. It's a lot easier to do in a big city than a smaller one.

I've received complaints from patients who have the identical problems with male doctors; they do not provide appropriate after-hours coverage or timely appointments. On paper, more patients have family physicians than in years past but this hasn't necessarily translated into improved access to care. Waiting a month for an appointment when you have abdominal pain is far too long; ideally, you should see a physician the same day or next day when ill.

So yes, I agree with you, I think your physician should provide better coverage.



The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to patient@globeandmail.com.

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