This article shows condition of Canadian Health System :
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More than 3.6 million Canadians don't have a family doctor — 1.2 million couldn't find one and 2.4 million haven't even tried — a Statistics Canada survey says.

When those without doctors finally seek medical help, they find it in a crowded hospital emergency room 3.5 times more often than those with a regular doctor, Statistics Canada said yesterday in its most comprehensive look yet at Canada's doctor shortage.

But Dr. Sunil Patel, president of the Canadian Medical Association, said most of them didn't bother looking because they knew they wouldn't find one.

"If you have tried and tried and banged your head against a system where you can't get care, you have no other option except the emergency room," he said. "It's a serious flaw in the whole system."

In an interview with the Star's Rob Ferguson, Ontario Health Minister George Smitherman said: "In an environment where too many Ontarians right now don't have access to primary care in their communities, you can't really fault them for seeking out care wherever it's available. We are overly reliant on our hospitals but our hospitals have been asked to do more than they're best built to do."

In Ontario, StatsCan's Canadian Community Health Survey found that more than 836,000 people — or 8.2 per cent of the population — don't have a regular doctor. Quebec was the worst province where more than 1.6 million do not have a doctor, almost a quarter of the population.

"We are now suffering from the impacts of political decisions made in the '90s," Patel noted. Those include cutting enrolment in medical and nursing schools, increasing tuitions and a lack of support for family physicians.

The problems will be worse in 10 years, he warned, because Canada needs 2,500 medical graduates a year but is only producing 2,200 annually. While enrolments have increased in recent years, it takes eight years or more to train a doctor.


Ontario won't get any more doctors to solve the shortage problem until it makes the province competitive, warned Dr. John Rapin, president of the Ontario Medical Association.

The province is losing doctors to other parts of the country, particularly Alberta and British Columbia, where fee schedules are significantly higher, he said.

Add to that the fact that family physicians are frustrated because they can't get their patients appointments with specialists or tests like MRIs and CAT scans for six months and "it all impacts on whether doctors would come to Ontario to practise."

Many new medical school graduates are going elsewhere to practise "and I'm very worried the worst is yet to come," Rapin said. "If you have overcrowded hospitals and you have to cancel surgery because there are no beds, that doesn't keep doctors here either."

Patel said governments must start treating family physicians as specialists so they can charge higher fees, because graduates now start out $150,000 in debt and "they're going into specialities to pay it off.

"We have to provide incentives for new graduates to get into family medicine as an attractive specialty and look at incentives like forgiving their debt to get them into family medicine," he said. "Any Canadian graduate can travel across the border and get their debt forgiven."

Smitherman acknowledged that "the production line for doctors is not overnight" which is why his government is creating family health teams of doctors, nurses and other medical professionals to ease the strain on doctors.

"These services (becoming) more available in communities are the best hope we have," he said.

Dr. Douglas Mark, president of the Coalition of Family Physicians of Ontario, said he's alarmed at the low numbers of young people who don't have family doctors.

"There's going to be a whole new generation of Canadians who don't have family doctors," he said. "The future looks quite dismal."

In Ontario, people can search for a family doctor in their area by going to the College of Physicians and Surgeons Web site at http://www.cpso.on.ca and clicking on Doctor Search.

The lack of doctors could lead to serious medical problems down the road, the StatsCan survey found.

Women without a doctor are less likely to get mammograms and Pap smears and both men and women neglect to get their blood pressure checked.

One example of a patient without a doctor is Kyle Robinson who rations the medication that keeps his heart beating. The 33-year-old office manager at a construction company moved to Bethany, Ont., from Newfoundland three years ago but couldn't find a family doctor.

He takes a third of the daily pills needed to regulate his heartbeat because he's never sure if the doctors at the walk-in clinic or emergency room will renew his prescription. His heart is supposed to be monitored regularly.

"It's so hard to get to a community that has walk-in clinics and when I get there, there's no guarantee that I'll fill my prescription so I try to stretch it out as far as I can," he said.

"I've tried everyone and everything I know. I've had friends try to get me into their family doctors to no avail," said Robinson who doesn't drive and has to ask family and friends to take him to Lindsay or Peterborough.

"It's horrendous ... I'm on this vicious roller coaster of visiting walk-in clinics."

The comprehensive survey of 135,000 Canadians aged 12 and over also found that Canadians, especially baby boomers, are getting fatter, although smoking has decreased substantially, especially among teenagers. Here are some other findings:

About 14.1 per cent of adults are considered obese and 32.4 per cent overweight, but those numbers are based on their own estimate of their weight and height and are also probably too low, said Dr. Mark Tremblay, a senior scientific adviser at StatsCan.

"People do the best they can but other surveys suggest they estimate low on weight and high on height," he said.

StatsCan researchers are now out in the field weighing and measuring 30,000 Canadians to get a more accurate reading and "I think it will show the obesity numbers are much higher," he said.

"The important thing is we will find out where we are at and we'll have a much better picture."

The survey found 19.5 per cent of young Canadians 18 to 24 are overweight and 7.8 per cent obese, which could lead to a generation of young people developing diabetes and hypertension much earlier in life, warned Dr. Anthony Graham of the Heart and Stroke Foundation.

"We're seeing adult onset diabetes in teenagers and we've never seen that before," he said. "That could lead to serious complications 20 years from now like heart disease, kidney problems and strokes.

"I don't think we are being alarmist — it's clear if you play this forward what will happen," he said. "People have to understand the downside of this. It's going to have a tremendous impact on the health care system and on quality of life down the line."

The problem is due to a combination of cheap fast food and a lack of exercise because of cutbacks to school physical education programs and easy access to alternatives such as computers, video arcades and television, he said.

For the first time, the survey asked information about sexual orientation "to improve the understanding of health issues, specific to the homosexual and bisexual population," StatsCan said.

While only one per cent of Canadians over 18 said they were homosexual and 0.7 per cent bisexual, the numbers may be low because Canadians are less apt to admit their sexual identity than to say they had sex with a person of the same sex, StatsCan said.

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"Change before you have to" : Jack Welch

This one I have to agree with. I've given up trying to get a good family doctor. Fortunately, I haven't had too many opportunities to give the emergency room a visit, but still....

No wonder walk-in clinics are popping up like mushrooms everywhere.

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