Canadian Medical Association

Patients are scrambling. 

In Kingston, Ont., hundreds lined up in hope of signing on with a family health clinic taking new patients. On social media, one man described the process as “the Hunger Games of health care in Canada.”  

In Sault Ste. Marie, 10,000 patients are being cut loose by a major medical centre that has been unable to recruit enough medical professionals to replace the ones retiring or leaving practice.  

It’s a similar refrain in Victoria, BC, where a retiring family doctor couldn’t find anyone to take over his 3,500 patients.  

Even some walk-in clinics are closing their doors due to a shortage of medical staff.  

What’s behind the breakdown in primary care?  

More family doctors are nearing retirement 

According to the Ontario College of Family Physicians, an estimated 2,100 family physicians are aged 65+ and nearing retirement — impacting nearly 2.5 million patients. Another 38% of family doctors in the province are over 55. This scenario is playing out across the country and is compounded by two factors: fewer medical students choosing to specialize in family medicine, and younger physicians not wanting to take over traditional clinical practices.  

Not all family doctors are working in family practice 

There was a time when most family physicians practised comprehensive or “cradle-to-grave” primary care, following patients through every phase of life. Today, many family physicians — across all career stages — are choosing to or have an obligation to work in hospitals, long-term care facilities and in other areas of practice including obstetrics and emergency medicine.  

Patient care is more complex 

Family physicians now serve a diverse, aging population with many chronic and complex medical conditions. Especially in a solo medical practice, the time physicians need and want to spend caring for these patients has increased, contributing to heavier workloads, and difficulties with work-life balance and burnout.  

The administrative tasks are overwhelming  

Despite the promise of new technologies such as electronic medical records (EMRs), on average physicians currently spend more than 10 hours per week outside of their normal workday on administrative tasks. The burden is greater for family physicians, who are significantly more likely to spend time on EMRs at home compared to their specialist colleagues. The burden of tackling additional forms, sick notes and paperwork takes time away from patient care and can lead to widespread physician burnout.  

The model of care is outdated 

The system for delivering primary care in Canada — where physicians own and manage their own practices — is little changed from the 1960s when Medicare was introduced. More than 50 years later, there is growing consensus that the model must adapt to new realities: 

  • The proportion of Canadian medical graduates choosing family medicine as their first choice for postgraduate training has dropped from 38.5% in 2016 to 30.3% in 2023.  

  • Family doctors are pushing for more team-based care, where they can share decision-making about patients with nurse practitioners, occupational therapists and pharmacists, for example.  

  • They are also advocating for greater physician mobility and expanded virtual care, so more Canadians can access care when and where they need it.

Now is the time for bold reform in primary care — reform that should be centred on the values and priorities of those the system is meant to serve.

Learn more about how the CMA is driving action on the health care crisis

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