Family medicine access in Canada drops since 2016, survey suggests

Family doctors are often the first place Canadians turn for medical care, but the proportion of adults with access to a primary care provider has declined, a new survey suggests.

The international survey was conducted in 10 high-income countries by the Commonwealth Fund, a U.S.-based non-profit foundation that funds surveys of patients and health-care providers in multiple countries. A partner, the Canadian Institute for Health Information, released the findings on Thursday.

More than 4,500 Canadians were asked if they had a regular doctor or place of care, which may include a physician or a general health-care clinic and excludes emergency visits and hospital care.

Lack of access to a primary care provider negatively impacts the health of both individuals and the population, the institute said. 

"The percentage of Canadians who reported having a regular doctor or place that they go for care dropped from 93 per cent in 2016 to 86 per cent in 2023," said Cheryl Chui, director of health system analytics at CIHI in Toronto, in an interview. 

In comparison, 93 per cent of adults in peer countries have a doctor or place they usually go to for medical care.

Respondents were also asked how difficult is was to get same- or next-day medical appointments. The 2023 results showed that Canadians are still struggling with timely access to primary care, Chui said.

The researchers at CIHI found that not having a primary care provider was more common among Canadians with lower levels of household income, younger adults from 18 to 34 and men. 

Chui said they're seeing variation and maybe inequities in the data. Why isn't known, but geography could also play a role. 

About 93 per cent of those earning more than $150,000 a year reported having a regular primary care provider such as a family physician or nurse practitioner. For those with a household income under $30,000, 81 per cent said they did.

Dr. David Barber, who chairs the section on general and family practice at the Ontario Medical Association, said primary care has often been shown in research studies to be the most important factor when it comes to people leading healthier and longer lives.

But primary care isn't prioritized by governments, he said. 

"It seems that the hospitals tend to run the show, and that's where the money goes."

Barber said other wealthy countries are spending 50 per cent more on primary care than Canada.