Where have all the doctors gone?

One man’s personal story this week about trying to get medical help and the subsequent outpouring of similar “horror stories” from the public speak volumes about the desperate state of our health care system and the urgent need for reform before more people suffer and die.

The time is long past when we can kid ourselves that we have the best “free” health care system in the world or blame the pandemic and believe the problem is temporary with solutions just waiting in the wings.

Wake up, folks. We owe it to ourselves and others to demand that our governments show the courage and implement and finance the changes that are needed. Courage because that’s what is needed to take on the many special interest groups whose turf wars or political philosophies stand in the way of change.

Money now going to yet another study or commission must be directed to solutions that work.

Immigration and regulatory policies must be changed to unlock the skills and training needed to end the critical shortage of health care workers.

I am no expert on health care but I do know that this is a problem that has been allowed to fester for a long time and the breaking point is now in the rearview mirror---not on the horizon.

At a time of bed shortages in our hospitals, 6,000 beds are occupied by people who could be discharged if there were nursing homes available. With an ageing population, how was this situation allowed to develop?

Hardly a day goes by without hearing how a friend or relative needs medical care and the best they can hope for is maybe a phone call from a family doctor—if they’re lucky to have one. Many communities and millions of Canadians don’t.

Where waiting rooms used to be filled with patients and several doctors staffed family practices, they are almost empty and so are the doctors parking spaces.

The lights are on but nobody’s home!

Where have all the doctors gone? Vacations? Early retirement? Too many working too few hours ? Simply missing in action because of stress and fatigue?

The doctor shortage is especially obvious among family practitioners, who are the gatekeepers to the system. Need a new prescription or a repeat on an existing one? You’ll need a doctor and chances are good he/she requires an office visit or at least a phone call and that could take days or even weeks. Thankfully, many pharmacists are pitching in to help but they’re frustrated and over worked, too.

Mammograms and other screening that used to be routine in the prevention of cancer and other diseases? Postponed or cancelled. Time lost means more suffering, higher costs and lives lost.

Referral to a specialist? Same routine. Currently, I have friends with suspected symptoms of cancer and all are depending on their family doctor for an appointment that will hopefully lead to tests and referrals to specialists if needed.

No regular access to a primary care provider? Too bad. You are one of about 5 million Canadians in this dangerous boat—more than a million of them here in Ontario.

The City of Kingston has recruited six new doctors but we apparently lost seven to retirement since the pandemic began. Surely, it should not be up to revenue-poor municipalities to compete with each other for health care workers. Isn’t this the job of our provincial and federal governments with greater access to tax revenues and the power to set policies?

Queen’s Medical School has added 20 seats to its 2023 enrolment for students to become family doctors. This is considered “an ambitious timeline” but is a drop in a very big and leaking bucket.

Meanwhile, the provinces demand more health care money from the federal government and Ottawa demands a say in how that money is spent. Our leaders are bickering while health care continues to burn.

Solutions won’t come cheap—or painlessly. Ontario alone is spending $ 75 billion on health care this year and hospitals are crying poor and restricting and closing emergency departments for lack of staff.

But back to the man who this week shone a heck of a big, much-needed spotlight on the situation out there.

Steve Paikin, a highly regarded journalist, author and broadcaster who is best known for his many years of work with TVOntario, composed a blog about one man’s quest to get a doctor to advise him about a painful knee. The man, it turns out, is Paikin himself.

Paikin is fortunate to have an attentive family doctor but it turns out he was on vacation for two more weeks and the pain was such that Steve couldn’t wait. He was advised to find a walk-in clinic and that’s what he set out to do.

It was Friday and his first clinic choice was closed. The next nearest clinic was open but all of its doctors were on vacation. He called a third clinic but when he described his symptoms, staff told him they didn’t feel they had the right personnel to diagnose the problem and advised him to go elsewhere.

“Several more blocks away, there was another clinic but, alas, it wasn’t a walk-in clinic. You had to have an appointment.” Forms had to be filled out on the clinic’s website and it took two days to even hear back from them.

Our hapless patient limped on.

There was a medical-arts building several blocks away and Paikin decide to give it a try. This was his sixth interaction with a health care provider, the pain was increasing, and he was literally getting nowhere.

A staffer patiently listened to Paikin’s description of his problem but said, “This isn’t a walk-in clinic, I’m afraid. We’re a doctors’ office and we’re not taking new patients. And, besides, there are no doctors here at the moment anyway.”

And then a ray of hope. The door opened and a man arrived and Paikin hoped this could be a real, live physician.

“Sir,”said Paikin,”may I ask your advice about something?”

“The man didn’t look up. He walked right past (Paikin) and through a door to his office in back and said, “No.”

Paikin describes how he was taken aback at the doctor’s response. He himself had been polite in asking the question but given that the doctor had given him “the bum’s rush” he returned to the receptionist, commented on his increasing pain, and asked if she had any advice for him.

Her advice was to find a walk-in clinic or go to a hospital emergency department.

At that point, the doctor returned to the scene, saw him talking to the receptionist and told him, “you have to get out of here right now. If you won’t get out, I’ll call the police.”

Paikin admits he was “gobsmacked.” He thanked the receptionist and left.

I’ve known Steve Paikin for well over 20 years. He is the consummate gentleman and professional. Even in times of great stress and pressure, I have never known him to be anything but polite and respectful.

His health care blog has gone viral and he has been overwhelmed by the response and the kind of similar “horror” stories we’ve all heard or experienced.

If Steve Paikin with his knowledge and experience can’t get primary health care, what are the chances of ordinary working stiffs inexperienced in dealing with bureaucracy and perhaps newcomers with limited language skills?

Today there are signs all over hospital and doctors’ offices and other public offices warning the public that bad behaviour won’t be tolerated.

Let’s face it: the chaos in our health care system is making some people unhinged—including the doctor who threatened to call the police on Steve Paikin, an innocent patient just looking for some advice.

Paikin concludes his blog as follows:

“Yes, Ontario’s health care system has been through the ringer over the two-plus years of COVID-19. And, yes, I’m sure everyone’s nerves are more frayed these days (although interestingly, every assistant I dealt with during my numerous interventions was unfailingly civil.)

“I guess $ 75 billion doesn’t buy you what it used to.”

As usual, Steve, you got that right!

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