WHAT ARE WE ACTUALLY FACING?

MANY OF THE THOUSANDS LOOKING FOR DOCTORS IN ATLANTIC CANADA ARE ON SOCIETY’S PERIPHERY. THEY LIVE IN POVERTY. THEY LIVE IN RURAL AREAS. THEY LIVE IN FIRST NATIONS COMMUNITIES. THEY’RE TRANSGENDER. NEWCOMERS OR LONG-TIME RESIDENTS, THEY ARE MARGINALIZED AND HAVE STORIES ABOUT THEIR DOCTOR SEARCH, ABOUT HOW SOMETHING IMPORTANT IS MISSING — A CONNECTION WITH A PHYSICIAN WHO KNOWS THEM AND CARES ABOUT THEIR HEALTH. FOR MANY, LOCKING DOWN A FAMILY DOCTOR IS A BIG DEAL. THAT’S WHY WHEN A RECEPTIONIST CALLS A NEW PATIENT TO SAY THEY’RE COVERED, FOR SOME, IT’S LIKE WINNING THE LOTTERY. OFTEN THERE’S SOBBING AND THANK YOUS. AND RELIEF.

In St. George’s, N.L., the last doctor packed his bags years ago and few are feeling that relief. A nurse practitioner visits twice a week. Good luck getting an appointment any time soon. Alison White, St. George’s resident and member of the Qalipu First Nation, recently called and got an appointment that “was like a month off.” “So, it’s a month to see somebody or else you have to go to the emergency room, which a lot of people do in (nearby) Stephenville because they need attention; maybe it’s not an emergency but also you don’t want to wait a month to deal with it.” Finding a doctor has been a struggle in the town of 1,200 people for a while. White remembers rushing an elderly friend to the ER in Stephenville 20 years ago and then waiting all day. “By the time they saw him and he was admitted, I think he was dehydrated at that point … I don’t know if that would have made a difference to his outcome, but he died a week or two later.” While fishing one crisp January morning near her home of Whycocomagh, N.S. (We’koqma’q First Nation), Yvonne Cremo said walk-in and hospital doctors just don’t know her family and their medical history. She has five children, ages nine to 31. Two have health issues. “Our doctor used to have folders so they can look back. On computer, it goes back certain years, but the (folder) files go back to since they were born.” Her doctor in Baddeck retired in 2017. She visits a physician in Inverness, but it’s farther away, and he is difficult to see. She doesn’t trust walk-in doctors much. Her daughter, who has kidney problems, was misdiagnosed by one once. Cremo said her daughter complained of breathing trouble and skin irritation. The physician advised her to change her body wash. It was later determined she had eczema and pneumonia. “It’s not just the native community, it’s off the reserve communities as well have a difficult time and they get frustrated. It’s not fair. If money is a big issue, they should put money away for that,” Cremo said. Marina Pogy expected more of the Canadian health system after moving to P.E.I. from St. Petersburg, Russia, four years ago. “Before moving, I was told about the system of family doctors in Canada, and I thought that is how it works. Did not know that there are walk-in clinics, too.” She was told to put her name on a doctor wait list and to call often. She gave that up a year ago. Pogy said in Russia, each patient has a medical journal so a walk-in doctor can access a full medical history. Not so here. “It is all up to me to remember what should I tell to a therapist on my next visit.” Every day Tara Kinch and Joanne Thompson help people at their lowest point. Many are homeless, deep in poverty and addicted to drugs. Kinch, who works at Chebucto Connections in Halifax, said for many clients, going to a walk-in clinic instead of a family doctor makes a big difference. If someone with a health concern wants more than the basic entitlement on their income assistance, they often need a letter from a doctor. “They have to go to a walk-in clinic and have to pay between $40-$70,” she said. “That’s an extra barrier to getting access to financial supports they require.” And without a doctor tracking their medications, they can fall behind. Many have multiple health needs or mental health issues, or live in risky situations. Many outreach centres like Chebucto Connections and The Gathering Place in St. John’s, host clinics staffed by family doctors and other health professionals who give frontline care. Thompson, executive director of The Gathering Place, said clients look to find a dedicated family doctor once they’re out of immediate crisis. “The point is helping someone reach that highest form of being and what that looks like … it’s that ability to start to reclaim parts of your life, to begin that process of self-care. We have three women today we know have nowhere to sleep tonight and are acutely mentally unwell or on IV drug use and that’s what we’re trying to balance right now. That care cannot be separated from the physician, nursing and social work care. It’s that primary care piece.”

Twice, recently, women have cried in Tara Kinch’s office. They were struggling financially, and had incontinence problems. To get $10 from government to pay for pads, they needed a doctor’s note, plus two quotes. With no family doctor, they needed to go to a walk-in clinic and pay for a doctor’s note. “It’s embarrassing enough for the women to come in and ask for help from me and disclose they’re having these issues,” Kinch said. “The whole process is undignified.”