Doctors call for reforms as people in Sask. struggle to find a family doctor

There are currently no doctor's clinics in Saskatoon accepting new patients, according to the database on the Saskatchewan Health Authority website — part of a primary health care crisis that one doctor says has been looming for years.

"Sorry for the inconvenience," reads the health authority's site under the heading "clinics accepting general patients."

Dr. Adam Ogieglo says the situation has never been this bad in Saskatoon.

"It's always been slim pickings, but when I started 10 years ago as a family physician, you would find there would be a full page of doctors that were taking patients," said Ogieglo, a family physician and partner at Lakeside Medical Clinic in Saskatoon.

"I've never seen the lists have zero doctors and zero clinics taking patients before."

Ogieglo said that's concerning because family physicians play a critical role in the health-care system. 

"People that have a family physician live longer than people that don't," he said, adding that level of medical care can reduce the time people spend in hospital, downstream costs and backlogs at other types of care clinics. 

Ogieglo said while the problem has worsened in Saskatoon, it's an issue across Canada.

Unable to find care 

The inability to access primary health care is concerning and frustrating, said Stevie, a 27-year-old who lives in Regina. CBC has agreed not to use the last name of Stevie, who uses the pronouns they and them.

They've had the same family doctor their entire life. That doctor has treated Stevie's parents and extended family, but he's retiring soon.

Stevie said when their doctor first talked about retirement, he said a new doctor would ideally take over the practice. 

"But that's not happening because there's no one to take over the practice," they said. "It definitely makes me anxious." 

Stevie said they are eager to find a new doctor because they have a two-month-old son. So far, they've had no luck. 

"When I looked online at the list of available practitioners in Regina, it was a really small list," they said, adding doctors on the list actually weren't accepting new patients and some who were had questionable track records. 

"One doctor that I researched had several complaints against them, so that made me a little bit nervous." 

Calls for reform 

Ogieglo said the primary health-care system needs reform. The way family physicians are paid is problematic, he said.

"We are paid under a fee-for-service model, which scares away a lot of graduates from starting practices. They don't necessarily want to run a business," said Ogieglo.

"They're concerned about generating enough income," he said, while "if they got a job at the hospital … they have a guaranteed hourly income." 

Dr. Brady Bouchard agrees that the existing model puts too much pressure on family doctors, who have to deal with overhead costs, administrative work, rent, utilities, insurance and staff and supply management — on top of caring for patients.

Bouchard, a doctor in North Battleford and president of the College of Family Physicians of Canada, suggested revamping the clinic structure could be a solution, on top of payment and management changes. That's because even if the finances are changed, there will still be too few family physicians to address growing demands, he said.

A team-based approach in a large clinic setting could help meet the needs of patients. The clinic could be run by physicians, but they could work alongside pharmacists, nurses and other health-care providers, he said. 

Ripple effect

Both Bouchard and Ogieglo said without access to family doctors, people are seeking care at emergency rooms, walk-in clinics and urgent care centres.

When Stevie's son was about 20 days old, they had to take him to a walk-in clinic. They arrived before the clinic opened and joined a lineup of people already waiting outside. People kept coming, said Stevie.

"It was really overwhelming. It was a weekend, there was one doctor working, one person working the front desk, and there was a huge lineup out the door," they said.

"I really feel for the doctor that was working that day, because how do you even handle that many people?"

Ogieglo said his urgent care clinic used to see 4,000 patients every month. Since January, it's seen 5,000 every month. He said it's now not uncommon for people to wait hours for care.

Dr.James Stempien, the provincial head of emergency medicine, said the inability to get family doctor care in Saskatchewan is also affecting the emergency room — a place not designed for followup or ongoing care. 

He said ideally, a family physician would follow up with patients after they leave emergency for additional X-rays, tests or consultations. He said many people showing up in ERs don't have a family doctor, so that's not possible. 

Stempien said there used to be a list of doctors taking new patients but that doesn't exist anymore. 

Ogieglo said people deserve access to timely and continuing care. 

"There needs to be co-operation among various levels of government to find solutions with [doctors] at the table to find solutions to this problem."