Thousands in Hamilton underserved by lack of family doctors accepting new patients

Ja'miil Millar has been looking for a family doctor in Hamilton for four years.

The 26-year-old compares it to a job search, and has done everything from making cold calls and searching online to relying on word of mouth and recommendations from friends.

She's come close at times, but said she still hasn't managed to find a physician to take her on.

It's an experience she describes as "discouraging."

"You do all of the things you're supposed to in terms of actually finding someone and calling and then you're told that they're not accepting patients or you don't even get through," said Millar.

She's one of many without a family physician, at a time when health officials have recommended residents contact their primary healthcare provider because hospitals are overwhelmed by the Omicron variant.

There are at least 1,279 patients in Hamilton, Niagara, Haldimand and Brant, including those with high needs, registered with Health Care Connect, a program that refers people to physicians who are accepting new patients.

However, the program is voluntary and people need to sign up, meaning it likely doesn't capture everyone seeking care.

There were 323 permanent family doctors in Hamilton as of January last year, according to the city's physician recruitment and retention committee. While that may sound like a significant number, it's actually a shortage of 66. 

That figure is calculated based on Hamilton's population and the provincial standard of 1,380 patients per doctor, according to Brad van den Heuvel, a member of the committee.

The exact number of those searching is difficult to calculate, as patient roster sizes often exceed the provincial standard, some patients have access to contracted physicians at walk-ins or through long-term care, and recruitment figures from 2021 efforts have not yet been released, says van den Heuvel.

However the shortage of dozens of doctors does indicate the community is currently greatly underserved.

The majority of family doctors in the city are part of two groups, the Hamilton Family Health Team with 165 physicians and the McMaster Family Health Team with 37, most of whom share practices with 35 to 40 resident physicians who are completing their training.

The Hamilton team covers 280,000 patients, roughly half of the city's population, according to spokesperson Sabrena Dorris.

It also includes a feature on its website that allows people seeking a doctor to search for any still accepting patients.

However, as of Jan. 31, its website showed only two were taking on new patients and, when contacted by CBC, the group said it hadn't been able to confirm if there were spots available.

"With the additional demands on the practices right now, particularly around Covid, I think its safer to assume that they aren't accepting patients," wrote Dorris in an email.

While many doctors will consider "ad hoc" opportunities to fill vacancies when a patient moves away, "most of our physicians already have large rosters so taking on new patients is difficult," she added.

Dorris said some doctors keep "short lists" for people seeking care, in case vacancies open up, but noted most family physicians have stable practices that care for families throughout their lifetimes.

"Vacancies are unfortunately infrequent," she said.

Dr. Cathy Risdon, chair of the family medicine department at McMaster, said its team cares for 41,000 patients.

All of its doctors take on a "small number" of new patients each month when there's turnover, she said, and the McMaster group also serves vulnerable community members who need to urgently see a family physician.

That said, "there are no physicians starting or building a new practice at the moment," she wrote.

Risdon said waitlists are "challenging" when the group can't bring in new doctors.

"Hundreds of people will sign up but we are unable to move through the queue, quickly," the doctor said. "We do our best to ensure a waitlist will not run past a year."

Tools for finding a doctor

Hamilton Family Health Team said it's seen a spike in calls from people asking for advice.

It suggested anyone looking for a doctor may want to try Health Care Connect, the provincially run page with direction on how to find a nurse or physician.

Dr. Teresa Chan, an emergency physician and associate professor at McMaster University, pointed to NeedADoc.ca, a website aimed at helping people in the Hamilton area find care.

The site, along with growing access to telemedicine during the pandemic, may help. But, she noted, those tools only work for people with reliable internet access.

"I always worry about the patients who are from marginalized populations or non-English-reading or speaking populations, since care can be more complex for these individuals," she wrote in an email.

Chan called family doctors the "backbone" of Canada's healthcare system but said even if someone doesn't have "their own" at a doctor's office, they can still be accessed within the system, from emergency departments to COVID-19 care clinics.

Other organizations, such as Refuge: Hamilton Centre for Newcomer Health, The Shelter Health Network or De dwa da dehs nye>s Aboriginal Health Centre, aim to bridge the gap in care for specific populations in the city. However, the strain on healthcare services is impacting those groups, too. A message on De dwa da dehs nye>s's website says "due to overwhelming demand, [we are] not currently accepting new patients."

Millar said she and a number of friends also on the hunt for a doctor have created a support group of sorts, but based on the lack of availability it may be beyond their control.

The situation highlights the strain the pandemic has had on doctors, said the 26-year-old, but not having a primary contact to talk to about COVID-19 and other concerns has left her in a precarious position.

"It's just really frustrating and then concerning as well," she said. "If I need these supports … and I'm not getting the access I need ... on top of our current reality it gets very difficult to have that as an added pressure."