Life without a Family Physician is a Reality for Many Canadian Seniors
When Rita Flanagan’s family physician retired after 35 years in practice, many of his Fredericton patients were left without a doctor. In her seventies with a history of breast cancer, multiple surgeries, rheumatoid arthritis and heart problems, Rita spent two years on a waiting list of thousands before she got a new family doctor, and she feels like one of the lucky ones. “I know people who have been on that list for three to five years.” While waiting, seniors like Rita are forced to manage their own care by visiting packed walk-in clinics and their local hospital emergency departments .
This problem is far from exclusive to New Brunswick. Dr. Kari Sampsel, an emergency physician in Ottawa, says that caring for patients without a family doctor is an everyday occurrence. “On an average day about one-quarter of the patients coming to our emergency room do not have a family doctor and a good portion of those are seniors.”
Without electronic records or a family doctor to contact, emergency department staff are often required to start from the beginning with each patient they see. “It is really challenging for medically complex seniors to provide us with their entire medical history and list of medications, especially when they feel unwell or are in distress. Difficulties with speech, hearing and cognitive function can create further communication barriers.”
Dr. Sampsel estimates that solving the medical puzzles of senior patients without family doctors takes hours at a minimum. “They need to be kept longer and we may perform additional tests to make sure that something important isn’t being missed. If we are concerned for their safety, they will be admitted.”
When patients have nowhere to go for follow-up, Dr. Sampsel will often see them more than once. “Senior patients often return to the emergency room to have us check skin infections or help resolve the side effects of drugs like antibiotics.”
Asked why she thinks there is currently a shortage of family physicians in Canada, Dr. Sampsel sighs. “It is a hard, hard job especially given the patient volume and complexity of health issues associated with aging. Family practices are expensive to run and current fee codes vastly undervalue the work being done. It is no surprise that burnout is becoming common.”
Calling family doctors “the quarterbacks of health care,” Dr. Sampsel insists that their role cannot be underestimated. “We need more family medicine residency spots and to do a better job marketing this area of medicine and supporting those who choose it. Family doctors are the only ones who can provide a global picture of a patient, including their baseline. Their regular interactions with patients provide the crucial preventive medicine needed for the survival of our system and proper care of all Canadians.”