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Halo

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Wanted: One Family Doctor. (Get In Line)

Hunting for a GP in Toronto sure isn't as easy as it used to be writes
CAROL SHERMAN
Special to The Globe and Mail

When my mother's doctor retired 12 years ago, she opened the Yellow Pages to "Physicians & Surgeons," closed her eyes and, with a random stab of her finger, picked a replacement. It worked for her. All these years later, my mother couldn't be happier with her choice.

Times, however, have changed. Finding a doctor in Toronto today is not easy. Four years ago when I was looking for a new doctor, grabbing the phone book was not my style. Instead, I followed advice from articles about finding a doctor and called my friends and relatives for suggestions.

With more than one million Ontarians currently lacking a doctor, the quest to find a new one is a challenge. There are more than 10,000 general practitioners practising in the province, but the Ontario Medical Association says that the province still needs more than 2,000 physicians to meet its current needs.

On Thursday, the College of Physicians and Surgeons of Ontario released its annual report, saying that 3,000 doctors received licences in Ontario in 2006. However, it also revealed that just 9.6 per cent of doctors asked were accepting new patients in 2006. That was a sharp decline from 1999, when 39per cent of family doctors reported they were accepting new patients

And when the 1,000 GPs in Ontario who are over the age of 65 retire, you can add their patients to the numbers scrambling to find a good MD.

Armed with a list of about a dozen recommendations, I started calling around. Most of the time, I couldn't get through. When I did, the answer was invariably the same: "The doctor is not accepting new patients." I left messages. One doctor wanted to interview me before accepting me as a patient. (This practice is becoming more common as overbooked doctors strive to find the right fit with their patients.) A friend mentioned that another friend from high school had become a doctor and maybe he would see me. (Like Pap smears aren't awkward enough.)

When I got wind of a doctor who was possibly accepting new patients, the stampede to his office rivalled the rush for the latest video game console. I was so hopeful that I incessantly hit the redial button one morning trying to get through to an actual human being. I left a message on his voice mail, but I never did hear back from him. I felt like an orphan. And incredibly vulnerable -- I was doctorless.

Let me be clear, I wasn't sick; I just wanted a doctor so I could remain healthy. "An ongoing relationship with a doctor is important," says Dr. Sofia Bazios of the Balmoral Health Group. It helps him or her to recognize changes, "and will help detect illness at an early stage when it's more readily treatable."

I was so desperate, I called a doctor I had had 20 years ago. I left her because she had six children in a row and I was always seeing her temporary replacement. That was in the days when you could give up a perfectly good doctor for a minor inconvenience. This time, I hadn't given my doctor up willingly. He lost his medical licence and I, like a lot of his patients, had to move on.

I wasn't being fussy, but I wanted a doctor affiliated with a hospital, or at least connected enough to help when I needed a specialist, a doctor who took his or her time with me and didn't rush me out of the office.

"Hopefully, your doctor will be approachable and empathetic," Dr. Bazios says, "so that you will feel comfortable coming to them with any new concerns and symptoms." In short, I wanted the Good Doctor.

It took me just over a year to finally find my good doctor and even then it was through sheer luck. I had called a doctor at a clinic recommended by a friend and once again was told that the doctor's practice was closed. I actually begged this time, and my pleading got me passed to an office manager, who, I believe, took pity on me.

Fortunately, a new doctor had just joined the clinic and she was taking new patients. I've been seeing her now for just over four years. She's young and knowledgeable and kind and not about to retire. She did have two babies in a row but never mind; I love her and am thrilled to have her as my doctor. But even more thrilled that she'll have me.

Don't ask me for her name, though, because her practice is now closed.

IS THERE A DOCTOR IN THE CITY?

According to a 2005 survey by the Ontario Medical Association, 85 per cent of Ontario physicians report being at full workload capacity. How to find the 15 per cent who are not:

The College of Physicians and Surgeons of Ontario provides a Doctor Search link that is updated four times a year. A recent hunt turned up the names of 181 family doctors in the Toronto area who were accepting new patients. Go to www.cpso.on.ca/ and click on "Doctor Search."

Medical students graduate in June and usually make their decisions at the beginning of July whether to enter family practice. A clinic that may not have been accepting new patients in the fall might in the summer if a recent graduate has joined the group.

A nurse practitioner is a registered nurse who has completed additional university education. NPs provide a full range of primary health-care services, including annual physicals, prescriptions, treating illnesses and ordering tests, such as ultrasounds, X-rays and mammograms. They can also monitor and treat such chronic illnesses as diabetes, asthma and high blood pressure. The NP works as part of a health-care team in clinics, community health centres and family practice offices. Go to www.npao.org and click on "Find an NP in Ontario."

Family health centres are run out of many hospitals in the downtown core and new patients are welcome. These hospitals are often affiliated with the teaching unit of the University of Toronto's faculty of medicine. You will see a resident physician (a doctor in training) supervised by a staff physician, or, in some hospitals, a nurse practitioner.

Here's a sampling of what's available: Mount Sinai Hospital's Family Medicine Centre (416-586-4800, x. 5068) is currently booking new patients within six weeks. Toronto Western Hospital's Family Health Centre (416-603-5888) has a catchment area defined by St. Clair Avenue and Lake Ontario, and Yonge Street and Parkside Drive; expect to see a doctor within three to four weeks. Women's College Hospital's Family Practice Health Centre accepts patients throughout Ontario with a current wait list of up to six months (416-323-6060).

The Health Watch clinic at Women's College Hospital provides medical expertise for women 40 to 70 years old, including physical examinations, screening tests and healthy-lifestyle advice. It also has a shortage of doctors and suggests that you contact the centre in the summer. It stresses that its services are not meant to take the place of a family physician. 416-323-6200.

You can use a walk-in clinic, but be prepared for long waits because most operate on a first-come, first-serve basis. Also, because you'll probably see a different doctor each time, there won't be continuity to your health care.

You can move elsewhere. Ontario ranks seventh in a doctor-to-patient ratio in Canada (one physician for every 568 people). The best province is Nova Scotia, with one physician for every 459 people.
 

Daniel

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Wow, that's surprising. Some places in the US, like Miami, seem to have the opposite problem:

Many studies have demonstrated that quality of care does not rise along with the number of doctors...When more doctors are around, patients spend more time in hospitals, and hospitals are risky places. More than 100,000 deaths a year are estimated to be caused by medical mishaps.

Too Many Doctors in the House - New York Times
 

David Baxter

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In the Ottawa area, it's actually even worse. Here, only about 1% of doctors are taking new patients (I think the exact number was something like 9 as of Friday!).
 
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i sure am not looking forward to the day my doctor retires. hopefully that's still a long time away. he's being smart about his practice though and ensures he doesn't burn himself out by having too many hours etc. it would be hard to find someone else like him who takes the time to listen to his patients.
 

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Thankfully my doctor is very young so hopefully I will have her for awhile. I've already begged her to take one of my friends on as patients and now with my parents moving here I'm going to have to beg her to take them on as well...I guess all she can do is say no.

It's pretty scary though...and sad...to be without a primary care physician.
 

Halo

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I envy you BG that your doctor is young because my GP is closer to retirement and that scares me because I have been seeing him for the last 26 years and also like David reported that Ottawa has only about 1% of doctors taking on new patients. I guess I will have to cross that bridge when I come to it but yes it is pretty sad.
 

Miette

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I just don't understand why they can't increase medical school enrollment and residency positions, or perhaps make it easier for foreign physicians with good solid training and years of experience to put their degrees to work. There must be a lot of red tape involved, because people have been talking about this physician shortage for a long time, it won't just magically disappear.

Some info in that article is incorrect, though. The physicians who will be graduating this year have already made their decisions on which specialty they will be training for in residency. Since you start applying to residency positions in October of your final year of training, you have to make your decision way earlier than AFTER you graduate. It's hard to make a decision based on one short year of clinical exposure to the different specialties. I can see many ways in which family medicine could be promoted in the curriculum, ways which aren't taken advantage of. Lots of specialists who teach us have a poor attitude towards family physicians, and it really comes out in their lectures... "Oh, a FAMILY physician didn't do this test or notice this symptom that was SO OBVIOUS"-said with eyes rolling-garbage like that. So students are left with a bad taste in their mouth about family practice that shouldn't exist.
 

David Baxter

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That's sad. I have an amazing family doctor, although he is enormously overworked.

Those medical professors should think about promoting family medicine as an area of practice that needs more excellent graduating MDs rather than disparaging the practise.
 

Miette

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I agree. The way it is "promoted" now leads to a lot of people reserving it for their "backup choice." Now that's not to say that these people will be bad doctors per se, but it probably means they will be less passionate about their work, and may have personalities less suited to family medicine, which requires great interpersonal skills.
 

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