There’s bad news and good for Nova Scotians in the land of doctor shortages and lengthy patient waits.
First the bad news. Getting in for a physical appointment with a family doctor during the day is harder here and elsewhere in Canada than in many other countries, according to a new Commonwealth Fund study conducted by the Canadian Institute for Health Information, Canada’s centre for health-care stats.
Getting to see a doctor in the evening or weekends, harder still.
Canada fell at the tail-end of 11 prosperous countries in terms of things like the length of time patients have to wait to see a specialist, behind Switzerland, the Netherlands, the United States, Germany, Australia, France, Britain, Sweden, New Zealand and Norway (in that order.)
Nova Scotia falls right in line with the Canadian average for that, and for things like how quickly could a patient get in to see their regular doctor and the length of emergency department waits, said Christina Lawand, senior researcher for health system analysis and emerging issues at CIHI.
Who will take care of me?
In Dartmouth, Dr. Frances Moriarty is planning to retire in a couple of years. But telling her 2,000-plus patients to go find another primary care physician has been problematic.
“If I walk out the door, who do they go to? Who provides their primary care? In the meantime, where are people supposed to go? How are they supposed to get adequate care?” she said in a quick interview between patients.
Her patients ask, “Who will take care of me?” and she tells them to start looking for a doctor now.
And the prospective patients keep coming. Daily there are patient referrals, calls, walk-ins, from area residents hoping Moriarty will be their primary care doctor.
That’s a problem, she said.
“If people don’t have a primary care contact or family doctor, they often have to seek service in other ways — a walk-in clinic or the emergency room, or maybe they don’t get care at all,” she said.
For people with chronic health care issues like diabetes, high blood pressure or mental health disorders, slipping between the cracks in the system can be disastrous.
“This shortage was anticipated many, many years ago — now it’s hit the point where it’s become a reality and there’s no quick fix,” Moriarty said. “It’s all boiled over.”
Band-aid where stitches are needed
Cape Breton West MLA Alfie MacLeod has zeroed in on the doctor shortage for the past year and the Progressive Conservative politician said he’s hearing more people than ever complain about not getting to see a doctor.
“The trouble is, a lot of people have to go to walk-in clinics . . . there’s a real problem with consistency. If you need to see a specialist and you don’t have a regular (primary care) doctor, they have no one to send results to,” he said.
MacLeod said he has heard of women being told there’s no point in a mammogram because there’s no specific doctor to send the results to.
Last year’s announcement that a new collaborative clinic with three doctors would provide primary care for thousands of Capers came on the heels of a public meeting to talk about doctor shortages in Cape Breton, and the facility has yet to materialize, he said.
“I asked the minister in Question Period what the status was and he said, ‘Stay tuned.’ The people of Nova Scotia have been staying tuned for a long, long time and nothing has happened,” MacLeod said.
“They’ve tried to put a band-aid on something that needed stitches and it still hasn’t worked out.”
A little good news
The good news is that Canadians top the list in terms of the quality of care — once they actually get in to see a doctor.
The really good news for Nova Scotians is that getting an answer back about an enquiry seems to be faster than elsewhere in Canada — and waits for elective surgeries are shorter for Bluenosers than elsewhere in the country.
“There’s a couple places where Nova Scotia results were more similar to the international average and better than Canadian results,” Lawand said.
“Sixty-four percent of Nova Scotians said they were able to get an answer the same day (when they called their doctor’s office) — and that’s closer to the international average,” she said.
“And on waits for elective surgery, only five per cent of Nova Scotians said they had to wait more than four months,” Lawand said, comparing that to the Canadian average of about 20 per cent.
Nova Scotians like the care they’re getting, with 78 per cent of patients rating the care they receive from their regular doctor as “very good” or “excellent.” That’s a shade over the Canadian average of 75 per cent.
In Nova Scotia, that translates to an above average person-centred care focus — doctors who explain things to the patients, involve the patients in their care, teach preventative health strategies and encourage exercise.
“Doctors seem to be doing a lot of the right things,” Lawand said.
By the Numbers (CIHI)
– 93 per cent of Canadians have a regular doctor or place of care, but they generally report longer wait times for medical care than adults in comparable countries. Canadians consult with physicians more often than people in other countries.
– Only 43 per cent of Canadians report that they were able to get a same- or next-day appointment at their regular place of care the last time they needed medical attention — the lowest percentage of all countries.
– Only 34 per cent of Canadians report that they could get care on evenings or weekends without going to an emergency department.
– Canadian patients are generally not seeing improvements in timely access to primary care over time.
– Canadians visit emergency departments more often than people in other countries and wait longer for emergency care; Canada has the highest proportion of patients waiting four or more hours during a visit.