Is there a doctor in the house?

What’s the prescription for fixing health care in Atlantic Canada?

Well, the first thing you need for any prescription is to find a doctor willing to write it for you.

And that’s part of the problem.

Right now, as a Saltwire Network special report pointed out last week, there are at least 174,894 people in Atlantic Canada who need a family doctor, but can’t find one.

But patients without doctors are the symptom, not the disease.

To put that in perspective, if you could somehow track down 146 new family doctors willing to work across the Atlantic provinces, and if each of them would agree to take on some 1,200 new patients, well, shortage over.

Fact is, despite the best efforts of four different provincial governments, the required doctors haven’t turned up. More often than not, the stories you see most regularly are about people suddenly finding they don’t have access to any doctors at all.

There are a number of reasons. Family practice isn’t for everyone. It’s taxing work with long hours, and seems routine until it suddenly isn’t.

The long hours can get suddenly longer, until they aren’t sustainable.

It might be retirements, it might be doctors who find rural practices too taxing or too allconsuming, or it might be the snowball effect. Say you’re in a practice with three other doctors, with plenty of patients. One of the three other doctors retires and everyone’s workload goes up by a third while you search for a new doctor to fill the spot. Certainly, you stop taking new patients. Then, one of the remaining doctors says, “I didn’t sign up for this. I hardly see my family.” And that doctor leaves, too.

You can see where that’s going.

But it doesn’t stop there, because people don’t stop getting sick – and instead of having family doctors, their care falls to other parts of the health-care system, some of which are far from financially sensible ways to deal with primary care.

Among other things, the shortage of family doctors puts burdens onto walk-in clinics and emergency rooms, neither of which are suited to offer primary care. Walk-in clinics can address an immediate issue, but they are not meant to be long-term stewards of your health needs or your overall medical condition. Giving you treatment for an acute condition is one thing; a long-term plan to address health issues that may arise or worsen is where a family doctor fits in.

An ounce of prevention can be worth a pound of acute care.

And emergency rooms? The 24-7 of top-line emergency care is expensive and is no more likely to help your long-term health than a walk-in clinic.

Family doctors are a critical piece of health care. And right now, we’re missing too many.