This article originally appeared in the Fall 2023 issue of the Ontario Medical Review magazine.
System failures impacting patient and physician well-being
As an emergency physician for almost 20 years, having worked in both community and academic settings, I am familiar with the challenges patients face in accessing the health-care system.
I have witnessed first-hand the increase in patients who don’t have a family physician visiting the emergency department and the negative impact that their lack of primary care has on their health.
For patients without a family physician, access is the challenge. As a result, the emergency department can become a default location for accessing care for minor conditions, better managed by family physicians. These issues include, but are not limited to, influenza-like viral illnesses, minor injuries, and non-acute presentations of headache, abdominal pain and mental health.
When patients are forced to come to the emergency department for minor ailments they will likely wait for an incredibly long time. And the care they receive is often fragmented and lacking in continuity — even for those who have a family physician.
Family doctors are the foundation of the health-care system. Besides providing comprehensive cradle-to-grave preventive and primary care, they are also the gateway to the rest of the health-care system.
We also see a tragic rise in the number of patients presenting with advanced cancers. Cancers that would have been screened for and either prevented or caught earlier for those patients with family physicians. It is heartbreaking to diagnose and disclose patients’ diagnoses of advanced cancers in the chaotic confines of an emergency department. This is especially true when it is the failure of our system that contributed to the late diagnosis.
Ensuring Ontarians have access to a primary care physician would solve much of this difficulty.
In this issue, we take a closer look at the three urgent priorities identified in the Prescription Progress Report 2023 and the proposed solutions to rectify what plagues our system.
Family doctors are the foundation of the health-care system. Besides providing comprehensive cradle-to-grave preventive and primary care, they are also the gateway to the rest of the health-care system.
I have witnessed firsthand that not having a family doctor can lead to more serious health problems. Right now, one in five Ontarians are on track to be without a family doctor in the next two years. This will only get worse unless we can retain more of the four in 10 family physicians who say they are considering retiring in the next five years, according to the 2022-23 OMA member survey.
We need to address these challenges today — keeping family doctors practising and attracting new ones — to prevent a catastrophic exodus from the profession tomorrow.
Dr. Andew Park
OMA President