Canadian health care was already shifting away from solo family doctors. The pandemic made it worse

The picture of a family physician's practice in Canada today reflects a shift away from solo work that may have accelerated with the heavy demands on health-care workers during the height of the COVID-19 pandemic.

In a report released Thursday, the Canadian Institute for Health Information examined pandemic-driven impacts on the supply, distribution and movement of some health-care workers in the country.

Findings between 2020 and 2021 included:

Dr. Lawrence Loh, CEO of the College of Family Physicians of Canada, said the profession is trying to adapt to the challenging number of patients who lack a primary care provider or ready access to their family doctor.

The consequence for Canadians and the health-care system is that more people wind up waiting longer in emergency departments, Loh said. For some of those patients, the waits mean their diseases have worsened or aren't being treated as well as they could have been if they had better access to family physicians and nurse practitioners.

Family physicians are doing their best, Loh says, but the pandemic hastened retirements in the profession, which has been under resourced for decades.

"The days of the solo family doc kind of doing it themselves with the receptionist, that's becoming increasingly challenging," Loh said in an interview. He was the medical officer of health in hard hit Peel Region, west of Toronto, during the first deadly waves of the pandemic.

The pandemic exposed pressures that have been building for over a decade, the authors of the CIHI report said. 

The report's authors noted that the average annual growth in the supply of primary care physicians slowed from 3.4 per cent between 2012 and 2014 to 1.3 per cent between 2019 and 2021. 

"There needs to be efforts to monitor and manage the health workforce … essential for dealing with the unprecedented demands we've seen," said Lynn McNeely, manager of health workforce information at CIHI.

At the same time, supply rates of nurse practitioners (NPs) increased by nearly 10 per cent over the study period, making it one of the fastest-growing groups of health-care professionals.

In some provinces, nurse practitioners diagnose and treat many illnesses and injuries, make referrals to specialists and prescribe most medications.

Growth in NPs could reduce pressure on health-care systems and improve access to primary care, particularly in rural and remote settings, the report's authors suggested.

Loh said advances in medical knowledge mean more people are living longer with chronic diseases that need to be treated.