All some people want for Christmas is a family doctor. A report released earlier this month from the Canadian Institute for Health Information (CIHI) shows one in seven visits to the emergency department is for a condition that can be treated by a primary care provider – a family doctor or a nurse practitioner.
But more than 650,000 people in Alberta do not have a regular health care provider and are sometimes forced to wait long hours in the emergency room for conditions better managed in primary care such as sore throats, viral infections and prescription refills.
With 5.4 million adults without a family doctor, a recent survey found Canada ranks at the bottom of 10 high-income countries when it comes to access to primary care. About three-quarters of Canadians do not have same- or next-day access and after-hours and weekend care. People living in rural and remote areas are even worse off.
Primary care is the foundation of our health system and covers the everyday needs of patients. Primary care providers prevent, detect and treat illnesses; give advice regarding healthy living; and manage chronic conditions like diabetes, hypertension and asthma. They have trusted, long-term relationships with their patients and often provide health services from cradle to grave for their community.
Studies show patients who see a regular primary care provider have better long-term health than those who don't. They experience better access to health care, fewer duplications of tests and referrals and fewer hospitalizations. Ultimately, they live longer and in better health.
What’s more, primary care provides all these benefits while at the same time lowering health care expenditures, increasing patient satisfaction and contributing to a more equal society.
In the last provincial elections, both the NDP and the UCP parties committed to better access to primary care. The current premier, Danielle Smith, promised every Albertan a primary care provider, but has not put forth a convincing plan to make good on her pledge.
Smith would do well to look toward her counterpart in Ontario. Doug Ford reached across party lines to appoint Dr. Jane Philpott, former federal health minister and member of the Liberal cabinet, to lead a primary care action team whose mandate is to attach every person in Ontario with a primary care provider within the next five years.
Philpott was chosen for the job because she sets out a very clear proposal for universal access to primary care in her book Health for All, launched earlier this year. Since the book release, leaders from several provinces and of all political stripes, have courted her help to make reality the idea of a primary care provider for every person.
Philpott’s vision is simple but bold: everyone will be guaranteed access to a primary care team within a half hour of where they live. Just as every child is automatically assigned a public school in their neighbourhood, everyone will have access to ongoing, comprehensive primary care even if they were to move residences.
In addition to family doctors and/or nurse practitioners, a primary care home will include other health professionals such as physiotherapists, social workers and mental health counsellors who can provide services that are customized to the needs of the local population.
Ontario already has the highest proportion of residents attached to a regular health provider and Philpott is going to take them across the finish line of attaching everybody to primary care. We in Alberta need to demand the same from our government.
We need to make our voices heard strong and clear through conversations with our MLAs, letters to Minister of Health Adriana LaGrange and unequivocal signals to Premier Smith that we too want the advantages of universal access to primary care. We need to urge our government to set up a primary care action team, choose the best person to lead that team and give full support and adequate resources to get the job done.
Furthermore, there needs to be a sense of urgency in supporting family doctors currently in practice. It has been a year since the Alberta Medical Association and the provincial government agreed in principle to sustainable funding for primary care clinic overhead costs and fair compensation for extra time and effort spent in the care of complex patients.
However, 12 months later there is still no date for implementation of this funding. Meanwhile, more than 90 per cent of family physicians in Alberta are concerned about the financial viability of their practices and 61 per cent of family physicians are thinking of leaving this province’s healthcare system.
The time for action is now. Instead of the expensive smoke and mirrors exercise of dismantling Alberta Health Services, our government needs to make meaningful changes in the lives of Albertans. We need them to invest adequate resources into primary care to build a strong and reliable foundation for the rest of the healthcare system. Every Albertan deserves the right to be healthy, and universal access to primary care is crucial to achieving this goal.
Vamini Selvanandan is a family physician and public health practitioner in Alberta. Her commentaries appear in the Rocky Mountain Outlook. For more articles like this, visit www.engagedcitizen.ca.
