Where have all the doctors gone?

Canadians are having trouble finding a family doctor.

Take the case of 59-year-old Edith Paulus. She had already spent two years searching for a family physician in Barrie, Ontario when she responded to Dr. Derek Nesdoly’s ad in a local community newspaper.

The ad said the general practitioner was seeking new patients. But by the time Paulus called for a consultation, she was told the doctor was no longer accepting patients older than 55.

Dr. Nesdoly told CTV News that it was not a matter of age discrimination, but he was attempting to balance out his practice – which already served many elderly patients – by offering the still available slots to younger families.

“Then people felt rejected, turned away, belittled, or unimportant — that was never our intent,” the doctor told CTV. “You have to say at some point (that) you can’t fix the whole problem.”

Activists for older Canadians warn that if Canada’s aging population is denied timely access to treatment, it will end up costing the health care system a lot more.

“We talk about prevention, and healthy living,” said Judy Cutler, co-director of adcacy and media relations for Canada’s Association for the Fifty-Plus (CARP). “But how are you supposed to do that on your own if no one is there to work with you and help you?”

According to a 2002 survey by Decima Research, nearly 33 per cent of Canadians said that either they or someone they knew had difficulty finding a family doctor.

And to make matters worse, physicians, along with the rest of the country’s population, are aging. Just as baby boomers enter an age where they may require even more medical care, doctors are approaching retirement.

In November of last year, an Ontario Medical Association study said the province could have a 2,800-doctor shortage by 2010 if action isn’t taken immediately.

As doctors, nurses and other health care workers face an overwhelming work burden, a Canadian Medical Association (CMA) survey said that half the doctors in Canada were in an advanced stage of burn-out. One in 10 were using sedatives and one in five used tranquilizers. Other studies have also indicated high rates of suicide among doctors.

“We have a doctor ratio of 1.9 per thousand, and that compares with 3.5 per thousand in a recent survey of 12 European countries,” Dr. Brian Day, incoming CMA president told Macleans magazine. “And doctors are leaving the workforce, they’re retiring early, and that puts more load on the existing workforce.”

Day says the current shortage is a result of a 1993 government-imposed reduction of medical school enrolments. As a cost saving measure, medical schools were forced to restrict enrolment by 10 per cent.

“That’s not easily fixable,” says Dr. Day. “You can’t just produce new doctors in a year.”