Concerns grow over dwindling family doctor availability in Alberta

Alberta doctors are again raising concerns about access to family physicians throughout the province.

According to data from Alberta's Find a Doctor website — which is managed by Alberta's Primary Care Networks (PCNs) — the number of family physicians accepting new patients via the website from 2020 to 2023 decreased by 79 per cent.

Across Alberta, there were 887 family doctors on the website who were accepting new patients in 2020. Now, as of September 2023, there are only 190.

In a Sept. 25 thread posted on X, formerly Twitter, the Alberta Medical Association (AMA) says that Minister of Health Adriana LaGrange joined the AMA Representative Forum meeting the previous weekend to discuss primary care, which the AMA referred to as a "crisis."

"We are bleeding out. We must retain the physicians we have and restore Alberta's reputation as a destination of choice," the AMA said in the post.

Alberta's PCNs are made up of groups of family doctors that work with allied health professionals operating within a team-based, health-care model. Alberta has 39 PCNs — seven in the Calgary area, and 32 others in the remaining four Alberta Health Zones.

Alberta's PCNs also operate the Find a Doctor website, which as of Friday displayed an alert notifying users of a "limited supply of family physicians."

In a report from Calgary and area PCNs, there were 923,542 visits to the Alberta Find a Doctor website from 2022 to 2023, marking a 29-per-cent increase from the previous year.

The report also notes that there were over 70,000 "clinic connections" in that same time period, which refers to the number of times website users clicked a clinic contact link to find a new doctor, but does not reflect the number of people who were actually able to get one. 

The amount of "clinic connections" also increased, up 42 per cent from the year before.

While the number of Albertans looking for a family doctor "soars," the availability of family physicians accepting new patients "hits new lows," reads the report, which was publicly posted last month.

Keith Bradford, director of communications for Calgary and area PCNs, says the Find a Doctor website's goal is to improve the potential of finding a family doctor in a timely manner.

But being able to search for primary care doesn't necessarily mean more doctor availability.

"Since the site was launched in 2019, the number of doctors taking patients, in all five [health] zones in Alberta, is decreasing year-on-year," he said.

"That's a pretty significant decrease in the options that there are for Albertans who are looking for a family doctor."

There are over 6,000 physicians and nurse practitioners from over 1,200 clinics who use the Alberta Find a Doctor website, and the majority of them are associated with a PCN.

Not every family physician in Alberta is associated with a PCN — although the vast majority of them are. Family doctors are not required to use or update the website.

Updates to the website rely on physicians themselves and communication between clinics and PCNs, which Bradford says makes the actual number of family doctors in Alberta who are accepting new patients difficult to track.

"That's obviously something that changes in real-time," said the PCN spokesperson.

Bradford says that the gradual decline of family doctors who are accepting new patients via the website juxtaposed with Alberta's growing population as just one of "many, many factors" contributing to pressure on primary health.

According to the latest Statistics Canada numbers, Alberta's population grew by 184,400 people between July 2022 and July 2023.

• Canadians flock to Alberta in record numbers as population booms by 184,400 people

But as the population grows, so does Alberta's family physician workforce, according to data from the College of Physicians and Surgeons of Alberta (CPSA).

Since 2020, the number of family physicians licensed with the CPSA has increased by 462.

The CPSA's data on registered family physicians does not include information about where the highest or lowest concentration of family doctors is.

The president of the Alberta College of Family Physicians (ACFP), Dr. Noel DaCunha, says workforce problems add to the shortage of available doctors. 

"Everything we've heard and seen is that family physicians and the primary care system are breaking down," said DaCunha, who is also a family doctor in Westlock, Alta.

Being a family physician can lead to burnout, says DaCunha, especially for rural doctors.

DaCunha says there are various factors impacting the limited availability of family doctors, notably a growing aversion to a career in family health among medical students.

Family medicine residency vacancies soared this year.

The Canadian Resident Matching Service (CaRMS), which is the organization that matches medical school graduates with residencies, reported 268 unfilled family medicine residencies across the country for their first round of matching in 2023.

According to the Canadian Medical Association Journal (CMAJ), 42 of these vacancies were in Alberta. That was the third-highest amount in Canada, behind Ontario with 100 unfilled spots and Quebec with 99.

The second round of the CaRMS matching program in 2023 had 110 unfilled residency spots in total. Family medicine accounted for 100 of those vacancies, 22 of which were in Alberta. 

"Alberta's health system is broken," said DaCunha.

But Dr. Myles Leslie, an associate professor with the Cumming School of Medicine and research director of the School of Public Policy at the University of Calgary, says the decrease in family doctors is not unique to Alberta.

He calls the Alberta Find a Doctor website's data "a micro example of a macro problem." 

"Primary care access is probably the biggest issue facing every health system in the country," said Leslie.

When there is pressure on the supply of family doctors, Leslie says that impacts all aspects of primary care, including nurses, pharmacists and other health professionals that aren't family physicians.

He says the focus should be on assuring that primary care is being delivered by teams of people, rather than just doctors.

Systems under pressure

In a letter to members posted on Wednesday, AMA president Dr. Fredrykka Rinaldi says the provincial government has acknowledged the struggles in the delivery of primary health care. 

"Family medicine practices and clinics are dying, and we must address those needs now," read Rinaldi's announcement.

When asked what he would tell someone struggling to find a family doctor but in need of immediate support, Leslie recommends people seek out nurse practitioners in their area.

"When whatever this acute medical need is has passed, get in touch with your MLA and ask what we're doing about primary care access," said Leslie.

In an email statement to CBC News, Minister of Health Adriana LaGrange says the government is aware that more people need access to primary care providers such as family doctors and nurse practitioners.

"Right now, work is currently underway through Alberta's Health Care Action Plan to increase access to a regular health provider throughout the province. This was a goal established in my mandate from the premier, and we will deliver on that commitment."