Dying for a Doctor
Half a million Torontonians are without a primary care physician. The search is maddening, exhausting and often futile. Doctors and patients alike are fed up with the broken system. Dispatches from the front lines
Believe it or not, Canadians used to worry that the country had too many doctors. From 1961 to 1981, the number of physicians grew three times faster than the population. By the early 1990s, the prevailing fear was that taxpayers could be on the hook for doctors they didn’t need.
In 1992, in the midst of a crushing recession, ministers of health from across the country gathered to hatch a plan to reduce budgets and slash the number of physicians in the country. One of the agreed-upon measures: cap the number of doctors that universities could train. The federal government soon followed up with massive cuts to cash transfers for the provinces.
Both decisions proved to be wildly short-sighted. The economy roared back to life, and the population continued to grow until it outpaced the supply of doctors. And then there was the pandemic, which exacerbated an already bad situation. The stress of Covid proved unbearable for many health care professionals. Between March and September of 2020, three per cent of Ontario’s family doctors stopped working, leaving 170,000 patients in the lurch.
These days, according to the Ontario College of Family Physicians, 2.5 million of the province’s residents don’t have access to a family doctor. A recent report from the C. D. Howe Institute estimated that filling today’s shortage would take 10 years, but when ongoing retirement and population growth are factored in, we’re unlikely to meet demand even then. And with more and more family doctors decamping for hospitals, subspecialties or private clinics, the situation is poised to get worse.
Compounding matters further is the fact that Canada is actively turning people away from the profession: provinces have caps on how many international medical graduates can be matched to residencies. Last year, 1,060 of these would-be doctors applied to family medicine residencies across the country, yet only 364 were given placements.
It doesn’t help that family medicine is increasingly unattractive to med students. In most circumstances, family doctors in Ontario can bill just $37.95 per patient—and each year they pull in, on average across Canada, $148,778 less than dermatologists and $204,656 less than cardiologists. To comparatively low pay, add high overhead costs and long hours. Most family doctors operate as independent businesses, with all the administrative work that entails. According to a 2023 survey, they work an average of 47.7 hours per week, 40 per cent of which is spent on drudgery like dealing with lab reports and filling out insurance forms. Across Canada, family docs are spending 18.5 million hours per year on paperwork—time that would be far better spent seeing patients.
The doctors and patients featured below believe that access to quality health care is a fundamental right—and they are fed up with a system that rarely, if ever, works the way it should.
Dying for a Doctor
This story appears in the October 2024 issue of Toronto Life magazine. To subscribe for just $39.99 a year, click here. To purchase single issues, click here.
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