Without a family doctor? Physicians offer some short-term solutions
Suggestions include tips for finding a family doctor to keeping copies of your medical records
Millions of Canadians are without a family doctor, and with long waits at ERs and walk-in clinics, many are wondering where they can get the care they need.
So how can people make sure their health is taken care of when they don't have a regular primary care provider?
There isn't one answer, as individual health needs are complex and can vary based on factors like age, family history and any existing chronic illnesses. The first tip is not to give up on finding a family physician, as many doctors agree that people should have a family doctor or primary care provider.
"We need that continuity of care to make sure that you don't get into trouble," Dr. Peter Lin, a family doctor in Toronto, and a director of the Canadian Heart Research Centre, told Dr. Brian Goldman on The Dose.
"Family doctors … primary care [providers], nurse practitioners … are really good at pattern recognition to try and figure out what's going on and put the pieces together."
Family doctors say there are some ways people can take care of themselves in the short-term, but that they should continue looking for a primary care provider.
"Even if you're healthy, you should look for a family doctor, because you don't know when you're going to get sick," said Dr. Yvette Lu, a community family physician who works in Surrey, B.C.
How can I find a family doctor accepting patients?
Doctors say there are several ways to find a family doctor, as the process can vary from province to province.
Lin suggests people start by asking family or friends if their doctor is accepting new patients.
If that isn't an option, he suggests looking for clinics and physician groups still accepting new patients on the website for their province or territory's College of Physicians and Surgeons or other regulating body.
Depending on where you live, there may be specific services available to find a family doctor.
For example, in B.C. — a province where almost a million residents don't have a family doctor — the website Pathways Medical Directory is an option to help find a provider, Lu said.
In Ontario, residents can sign up for Health Care Connect, a service that connects someone with a nurse who will "search for a doctor or nurse practitioner who is accepting new patients in your community," according to the provincial website.
Lu says the provincial healthline that exists in many provinces — call 811 in B.C. and Alberta — can also help people access services in their community.
Sometimes, specialists can also recommend a doctor willing to take you on as a patient, she said.
And don't forget to ask if a local clinic has a waiting list, Lu said.
"It is important to remember that sometimes spots do open up because people move away or they leave a practice for other reasons," she said. "So even if a practice is closed, it is worth checking back in every now and then to see if they are accepting new patients."
When should I go to ER if I don't have a family doctor?
If there is a medical emergency, like you're having trouble breathing, having chest pain or bleeding excessively, call 911 or go to the closest emergency room, advises Dr. Rita McCracken, a family physician and assistant professor in the University of British Columbia's family practice department.
If over the last three to six months you've had issues such as unintended weight loss of more than 10 pounds, drenching night sweats, blood in your stool or urine or have a breast lump, she advises that you should see a doctor within two weeks.
Most provinces and territories have a 24/7 service that connects people with a nurse or other qualified professional to advise on health issues and health information.
What about walk-ins or urgent primary care centres?
Depending on where someone lives, walk-in clinics or primary care centres may also be options, Lin said.
He advises people to be prepared when visiting a walk-in clinic by having a list of their medications, diseases or recent diagnoses and new symptoms. He said it can help the doctor.
"They're trying to make decisions quickly," Lin said, and to do that, it's best to be able "to have all the information available to them right away."
In some provinces, community health centres are also an option. And there are also virtual clinics, McCracken said.
"Although the waits can be significant in some areas, you can get in," she said.
How can I stay healthy without a family doctor?
There are ways people can take charge of their health while still looking for a family doctor.
🩺❤️🩹<br>The <a href="https://twitter.com/hashtag/FamilyDoctorShortage?src=hash&ref_src=twsrc%5Etfw">#FamilyDoctorShortage</a> in 🇨🇦 is ... bad.<br><br>What can you do to keep yourself as healthy as possible if you don't have a family doctor?<br><br>A🧵of (unofficial) ideas for "the unattached" 1/11
—@DrRitaMcMcCracken's top suggestion is to get up to date on vaccinations, whether they be routine vaccinations like the flu shot or COVID-19 vaccines.
"To the best of my knowledge, everywhere in Canada you can access vaccines in an alternate way besides your family doctor. So either through public health or through pharmacies," she said.
She also recommends people wash their hands and wear a mask around people who are sick and says more practical advice can help people maintain their health.
"All the things that our moms and grandmas have been telling us: Stay hydrated, wear your seat belt, floss your teeth, don't drink too much alcohol or smoke other things, get enough sleep, make more friends, and get a hobby. All of that stuff is actually tied to better health outcomes," she said.
Lin said quitting smoking, managing your weight and eating healthy are also important factors in your health.
How can I get routine screening?
Depending on your age, there are recommended routine screening tests you can complete.
McCracken said if you have a cervix, a Pap test is essential to have done every three years if you are not having any symptoms. In B.C., you don't need a family doctor to have the test, she said.
Lin recognizes that it can be tough to get these routine tests done without a primary care provider. He suggests visiting walk-in clinics to help get a referral.
"This is where you will have to, as the person in charge of your health, figure out what screening tests you need to do because you don't have a family doctor sort of quarterbacking for you," he said, noting that the organizations for specific cancers and diseases often have websites that explain when people should get screened.
Some provinces also have self-referral for some cancer screening tests. Lin recommends contacting your provincial cancer care agency to find out.
He also recommends checking your blood pressure regularly at a local pharmacy and keeping track of the results.
If people are turning to walk-in clinics for follow-up care, Lu suggests going to the same one every time as doctors will often work regular shifts at those clinics.
"If you go to the same walk-in clinic or urgent care clinic, then they'll have your records so that would make it easier for the doctor who is seeing you to care for you," she said.
What about medical records?
It's important that patients get copies of their test results or other health records, ideally in a digital format, Lin said. Lu agrees that this can help doctors better understand a patient's medical history.
"If you end up going to different walk-in clinics, then you'll still have a copy of, say, an ultrasound that you did," she said, adding that sometimes those tests also advise patients to follow-up in six months or a year.
She says patients can take note of that follow-up date by scheduling it in their phones or calendars.
"Don't rely on the doctor to call you," she said.
McCracken's parting advice to those without a family doctor is to write a letter to their political representatives.
"If you really want it to change, put your story down on paper and send it to your provincial Member of Parliament and your federal Member of Parliament and demand that we secure funding and evidence-based solutions to address the primary care crisis once and for all."
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