More than one in five Canadians — an estimated 6.5 million people — do not have a family physician or nurse practitioner they see regularly, according to a national survey. That’s a dramatic increase since 2019 when Statistics Canada estimated only 4.5 million people did not have a regular health care provider.
The OurCare initiative, led by Tara Kiran at Unity Health Toronto, surveyed more than 9000 people across Canada last fall about their access to primary care and preferences for the future.
“One thing that was striking to me was just how much variation there is in access to a family doctor or nurse practitioners across the country,” Kiran said. “I live and work in Ontario, and I think there’s a big problem with access here, but Ontario fared the best with just 13% of people saying they didn’t have a primary care provider they see regularly.”
By contrast, more than double that number in British Columbia (27%), Atlantic Canada (31%), and Quebec (31%) said they lacked a primary care provider.
“The fact that almost a third of people [in some provinces] don’t have a family doctor or nurse practitioner is heartbreaking,” Kiran said.
Racialized people, those with lower incomes, and those in poor health were among those least likely to report having a regular primary care provider.
“People who most need access to primary care are struggling to find it,” said Ruth Lavergne, an associate professor in the department of family medicine at Dalhousie University in Halifax.
According to Kiran, these findings are in keeping with recent reports of worsening access during the COVID-19 pandemic.
One recent analysis of administrative data showed the number of Ontarians without a primary care provider rose from 1.8 million in March 2020 to 2.2 million in March 2022. Meanwhile, roughly 3% of family physicians in the province stopped working in the first six months of the pandemic — twice as many as in previous years.
People without a regular primary care provider told OurCare they sought treatment for nonurgent health issues at in-person and virtual walk-in clinics (50% and 27%, respectively) or emergency departments (24%) instead.
Some turned to other health professionals, including pharmacists (14%), chiropractors (5%), specialist physicians (3%), and naturopaths (3%).
Notably, more than one in five people without a regular primary care provider (21%) reported paying a fee the last time they sought care. This was most common in Quebec, where 37% reported paying such fees.
