Being Unattached: Access to Primary Care in Rural Ontario Continues to Decline
In our fast-paced lives, it's not uncommon for individuals to put their health on the back burner. Once upon a time, having access to primary care was somewhat of a given. Perhaps back then it was not a big deal to drag your heels on some concerns because you knew you could simply call up your provider’s office anytime to get booked in.
As many readers will know intimately, this is no longer the case. Having worked in the Ontario health care system for the last 15 years, I have watched and experienced the breakdown of the community based healthcare I know and love. The healthcare providers are exhausted, morally injured and underpaid. The system they work within has attempted too many landlord specials, and the cracks in the foundation are weeping.
Did you know that in two short years, 1 in 4 Ontarians are expected to not have regular primary care access?
What's the situation today?
Having recently worked in the ‘unattached patient programs’ this year, I can tell you timely access to a primary care clinic is just not happening in very many places. I am commonly seeing 80 year old rural Ontarians whose family doctors have retired, are on a myriad of medications and have no one to renew them. Imagine, taking life saving medications and not knowing where you might get them from next? Moreover, the main options for unattached care are virtual, which most NP/MDs would agree is suboptimal for truly assessing most concerns.
Not old, don’t care?
I get it, you might be young, or very healthy and this simply doesn’t affect you. Let me tell you, it does. If your parents or children get sick, who do you think is on the hook to help with phone calls, ER visits and trying to find walk-in clinics that are open and able to help. Live in a rural area? ER is usually your only choice, and we know how rural ERs are fairing out this year.
Primary Care Access in Rural Ontario
In rural Ontario, the landscape of primary care access presents a unique set of challenges. Many Family Doctors are everything to everyone in small communities. They are the Community Physician, Hospital Chief, Long Term Care MD, Coroner, Soccer Coach, Quality Committee Lead and general burnout extraordinaire. The fact that these individuals can keep any sense of time, person and place is remarkable to me. To add insult to injury, the Ontario Government is squeezing these MDs further by reducing their capacity to be adequately compensated for their time.
Things are hard for rural Primary Care providers. This translates to MDs leaving their small communities, or taking up alternative careers that take up less space in their lives. Hence the lack of access to primary care, hence the ER closures, hence the precarious position we find ourselves in today.
The Importance of Primary Care
Regular primary care is the cornerstone of a healthy lifestyle. Primary care providers play a crucial role in preventive healthcare, helping to identify potential health issues before they become serious. From managing chronic conditions to providing vaccinations, primary care offers a comprehensive approach to maintaining overall well-being.
Mental Health and Wellness
Primary care is not only about physical health but also encompasses mental well-being. Mental health screenings, counseling, and support for stress management are crucial aspects of primary care. Without access to these services, individuals may neglect their mental health, leading to increased stress, anxiety, and other mental health challenges.
What Can be Done to Increase Access to Primary Care in Rural Ontario?
Make the job humanly possible- team based care is the way forward here, and has been studied to death. We don’t need more studies, we need more teams.
Next, we can pay an adequate salary that reflects the amount of time and energy it takes to commit yourself to your community and its needs. If the Government isn’t willing to pay, how can we ensure our local providers are compensated for the work they do for us?
Lastly, we need to be open to alternative models such as more Nurse Practitioner led clinics. Everyone needs access to a primary care provider, Nurse Practitioners are excellent primary care providers and offer the equivalent services to a Family Doctor in a primary care clinic setting. Not only do they offer the service, but they have shown to be equivalent in quality of care received!
We Can’t Keep Waiting
The dangers of not having access to a regular primary care provider are numerous and far-reaching. From missed opportunities for early detection to inadequate management of chronic conditions, the risks are impacting both physical and mental well-being of our community.
As a rural community member, and Primary Care Provider, I am working with the local and provincial government to adequately fund primary care for us all. However, if there continues to be a shortage of critical primary infrastructure, I am not willing to wait and watch my community and beloved patients languish. New models of care and payment might be needed if the Ontario Government won’t invest in us. Don't compromise on your health – we need to make primary care a priority for a better, more secure future.
