The Current - The ‘Hunger Games’ of finding a family doctor

Episode Date: January 17, 2025

Jacqueline Simoes lined up for hours in the snow for the chance of registering with a new family doctor coming to Walkerton, Ont. earlier this week. But so did more than a thousand others.

Viking. Committed to exploring the world in comfort. Journey through the heart of Europe on a Viking longship with thoughtful service and cultural enrichment on board and on shore. Learn more at Viking.com. This is a CBC Podcast. Hello, I'm Matt Galloway and this is The Current Podcast. Walkerton is a small Ontario town of about 5,000 people northwest of Toronto. Earlier this week, more than a thousand of those people lined up in the freezing cold and snow for a chance at a family doctor. Only the first 500 were successful in landing a spot with the new doctor in town. One Ontario doctor lighted the process to the hunger games.

Jacqueline Simos was one of the people who stood in that line for hours. Jacqueline, good morning. Good morning. What was your first thought when you heard that a new doctor was going to open up a practice in your town? Excitement. I think a lot of, I think a lot of people in town and the surrounding area were very excited to know that we, to know that the team had procured

a doctor for walkerton, which is much overdue and very welcome. How did you hear about it? I actually heard about it. Our municipality posted it on Facebook of all places. And a lot of people actually only heard about it through social media. And so you found out and you thought,

I gotta get in line for this. Describe the scene when you went to register to get on this new doctor's patient list. So I had rounded the corner. I had anticipated to get there sooner than I did. I only arrived at 8.30, but we had a bit of a weather event the night before, so I think a bit of a weather event the night before. So I think a lot of people felt like I did and figured people wouldn't come from far and away with the road conditions the way they were.

I was genuinely surprised when I turned the corner. I had to park five blocks away and the lineup was just right from the Legion, around the parking lot, around the corner and down the adjacent street behind. How many people do you think were in line? When I got there, I'd probably be around already like the 800 mark. 800 mark? Yeah, at 830 in the morning. There were people that were already sitting there in lawn chairs that had been there since

like 5 a.m. As you said, there was since like 5 a.m. As you said, there was a bit of a weather event. I know that part of the province pretty well. There's a lot of snow and the temperature at this time of the year would be cold. What was it like out there? It was, we were thankful it wasn't windy. It was definitely snowing quite a bit

and it was about minus 10. So when you initially first started at the line, it wasn't too bad, but you're not moving around, you're slowly progressing forward. So after a while, it was the toes, the nose and the fingers were getting pretty frozen. How long were you waiting in line for until you got to the front of the line, when they opened the door and let you in? I, well, I actually never even got like made it

right up to the door. Uh, I was in line for approximately four hours. You said, you said you never made it to the door. What happened? So the first 500 people, they counted them out and they kind of segregated them off of the line. And then, and then we had, um, some ladies come out and take the information of the next 500 people onto the waiting list.

So I got waitlisted for the next doctor coming in April. And so the first 500 get a spot with this new doctor and then you're on the wait list for the next doctor that arrives. Yes, sir. Do you feel like it, like it was a success? Like it was worth it? It's a, it's a small glimmer of hope. I mean, it's, it's kind of, we're hoping it was a success? Like it was worth it? It's a small glimmer of hope. I mean, it's kind of, we're hoping it's a light at the end of a very long tunnel.

When our information went down, it was our names and phone numbers and they said they would call us when the new doctor arrives. And I remember asking that lady if that list was actually going to go somewhere, end up in the bin and we'd have to do this all over again. She assured me no, it was a list. So it's a small glimmer of hope, but that's all we can have, right? How long has it been since you had a family doctor? Just over eight years. Eight years? Eight years, yeah.

And so what does that mean for you for, for your medical care? If, if you need to see somebody, where do you go? Uh, so we have no choice in our region. There's about 45,000 people in South Bruce Gray area that have no family doctors. So we have nowhere else to go other than our local ERs because we don't have walk-in clinics here. Um, our South Bruce Gray health Center is responsible for four of the local hospitals here and two of them actually aren't open full-time. So if you're in those areas,

you will not receive health care unless you arrive on a weekday during business hours. This is the story of these emergency departments in some of those smaller communities that are closing, as you said, after business hours or on the weekend. Yes. And so if you're sick, I mean, you have to drive up to Owen Sound or something like that? Yeah. And even if you decide to go to a larger hospital like Owen Sound, which is an hour's drive away from Walkerton, they're so full of patients up there

that you wait for hours and hours that even the Owen Sound Hospital has issued wait time warnings. And you're in that waiting room for hours and hours. And you're probably in there with folks Even the Owen Sound Hospital has issued wait time warnings. And you're in that waiting room for hours and hours, and you're probably in there with folks who may or may not have like contagious respiratory illnesses that we know go around in the winter time. And that's your solution. If you want healthcare, you gotta sit and wait.

And if you don't, then you're in the same place you were where you started. This is, I mean, it's a personal question, and. And if you don't, then you're in the same place you were where you started. This is, I mean, this is a personal question and just say what you want to say, but how do you think not having a family doctor for eight years, there's a stress that's associated with that, but how do you think that may or may not have impacted your own personal health?

It's definitely stressful. It's a weight on you. Like not having a family doctor to me is scary. And I'm worried for all the people, myself included, who don't have a means of consistent care. We have no way to check up on our health unless we go into an ER department that's already overwhelmed with patients. And you get to a point after where you just avoid going unless it's very urgent.

And so I mean, there is a stress because you, like I could think to myself, I could be walking around in a stage of illness or conditions not being diagnosed. And in my case, what if eight years later I now get a doctor and I come to find out it's too late, I'm in a stage of something that cannot be treated. That to me is one of my biggest fears. So that's something that weighs on you all the time. How do you, just before I let you go, how do you feel about this whole situation? That you, like hundreds of other people had to line up in the freezing cold for hours on end

to not even get a doctor, but to wait, be on a wait list or the people behind you who were too far behind and they didn't even get on the wait list. How does that make you feel? It, it, it saddens me. It's, it saddens me, but at the same time it's frustrating and it kind of angers you. And I know a lot of people express their frustration in line about seeing on the

news, like all the money that's getting spent on programs, uh, and expansion of public services in urban areas. And it feels like the healthcare system has forgotten us, the hundreds of thousands of us out here in rural Ontario and it's angering in a way because we all pay taxes. So why is it that us in rural Ontario have to line up like cattle in minus 10 weather in hopes of just getting a family doctor? When do you think you'll have that first appointment? They say if everything goes well, uh, that she

will start up in April, but I mean, she's going to have 500 new patients too. So I, my mind is set that, uh, it'll probably somewhere, probably be somewhere around the fall when I finally get in to see anyone. And Mr. Galloway, I just, one thing I think is really important to highlight, and I would like to do that is, is the humanity of all the people who stood in that lineup

on Wednesday. People were so patient with each other and polite and would hold each other's places in line so they could step away to the washroom or get a warm beverage to warm up and shout out to the ladies who bought boxes of coffee and walked down the line offering a cup to everyone so they could warm themselves and people using their cars as warming stations for a break. And as much as it was sad to see that this is what health care has come to in rural parts of our province, it was also very uplifting to see our fellow neighbours looking out for one another. And we hope our governing officials could do the same and help us secure the

healthcare we so desperately need out here. There's some good news and some good people who are looking out for each other but in the meantime your story is a story that I think a lot of people across not just in Ontario but right across this country will see themselves in. Thanks for talking to us about this and I wish you the very best of luck. Thank you so much. I appreciate it. Jacqueline Simos is a resident of Walkerton, Ontario. And as you heard, waited in line for hours in that community to get waitlisted for a new family physician in that town.

Viking, committed to exploring the world in comfort, journey through the heart of Europe on a Viking longship with thoughtful service and cultural enrichment on board and on shore. Learn more at Viking.com. Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income? That's not a tight ball, 50%.

That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, Just Search for Money for Cups. Well, here with me in our Toronto studio is a family doctor, Dominic Novak, who's also president of the Ontario Medical Association. It represents the province as doctors.

Doctor, good morning to you. It's a pleasure to be here. You were the person, I said at the beginning of the conversation that somebody compared this to the Hunger Games. You were the person who made that comparison. Why did that analogy come to mind? It is the Hunger Games, right? So right now we have a situation where nearly one

in four people in this province can't find a family doctor. That's especially difficult in rural and Northern communities where by the way, life expectancy is two and a half years less in part because of lack of access to care and communities are pitted against one another in terms of recruitment for doctors and what we need is a plan from the

province rather than this hunger games that's pinning communities and people against one another for access to a family doctor. When people find out that you're a family doctor, I mean, I know doctors who they'll say this in a party and then somebody will inevitably say, do you have any spots available? Does that happen to you? Every day. And this happens to us as family doctors. I know every day, whether we're on our way somewhere or at an event. And I very often meet people who haven't had a family doctor for years.

A few months ago, I ran into someone who hadn't been able to find one in six years. They were bouncing around hospitals, emergency rooms, pharmacies, walk-in clinics, just trying to get some sort of care. And they ended up having a delayed serious breast cancer diagnosis in the emergency room. That speaks to what Dr. Mitchell Curry, who's this new doctor in Walkerton, might see when he starts work. Given the fact that many of these patients haven't had a family doctor, haven't seen a primary care provider in many, many years, what do you think that doctor's likely to run into?

A big challenge, right? Because we know that people who don't have a family doctor end up using the emergency room more often, end up getting to hospital more often, missing cancer screening and other preventive care. Uh, and if you don't have a family doctor, there are some studies that show that you might live shorter, right?

And, and cost the healthcare system more money. And as a family doctor myself, very challenging to take on patients who haven't had any care for a long time or diagnosing delayed cancers, other serious illnesses, and all of this preventable. If we had a system where everyone could have that foundation level of care, that I know we can get there. It'll take political will from the government to get there and implement

things that we would know work to get every single person in this province, a family doctor. Jacqueline talked about the fact, and this again, will be familiar to people across this country, um, that, that she would see in the news stories of investments being made in urban centres, but that she in a rural community felt as though they were being abandoned, that they were being forgotten. Why is it so difficult to get family doctors, to get access to family doctors or primary

care in rural communities? Mm hmm. And I think of the, the care in rural communities. Mm-hmm. And I think of the situation in rural communities that I've been visiting over the last several months as president at the OMA and all across Ontario and rural communities in the north, the healthcare systems might rely on six, seven handful of doctors and family doctors. Often they're the Swiss army knives of the healthcare system. They're caring for people in the office.

They're also doing emergency department visits, the same doctors delivering babies, doing end of life care. Does that make it less attractive to practice in a rural setting? I wouldn't say that, but it does put a lot of pressure on a handful of people. And let's say you have one or two retirements,

suddenly that seven goes down to five, one person moves away. Suddenly you have four and all of a sudden you have one or two retirements, suddenly that seven goes down to five, one person moves away, suddenly you have four, and all of a sudden you have a crisis in that community. And that's happening all across the province. But part of this is about people practicing in those communities. I mean, doctors can practice wherever they want, but the reality is that it's difficult.

You'll see these signs in small communities, attracting, you know, it will it, it will appear in the local newspaper, attracting local doctors, people offering incentives, um, they're treated like celebrities when they arrive because there is a need, but why is it so difficult to get doctors to practice in rural communities? Yeah.

And I'd highlight some of the success stories that we've had. So the Northern Ontario School of Medicine University, for example, they've really taken on this grow your own approach to doctors. And by the way, doctors who train in the North, who learn in the North, uh, and end up staying in the North and in rural communities. And that's, we need to see more of that and more supports for the, for doctors to be training, learning in the North and also for the, the educators, right? right? We know that we need to expand our family

physician workforce, but who's going to do that training? We need to support our teachers, including teachers in community settings, in northern settings, in rural settings. Do you need greater incentives to get people to stay in those communities, not just do a residency for a short period of time, but to, to set down roots and be there for a couple of years and provide

continuous care. You know what, I think of, it's less about incentives and more about a plan for the province. But that's part of the, is that not part of the plan? To get doctors to, in those smaller communities, and Wauketon is in Ontario, but in communities across this country, to get people to set down roots there, to hang their shingle in those smaller communities.

I'd say people want supports, right? And what support looks like is for example, to be able to be part of a team. We know that, that doctors who work in, in teams with nurses, pharmacists, social workers, other health professionals, it's more joyful work. And by the way, it's better patient care

for the people we're serving. And it makes it much more realistic when we work in teams, when the province builds out teams to connect every single person to family practice, when those practices are supported by teams. So that's the kind of solution that we need more of and rapid expansion of if we're gonna get to our goal where every single person has a family doctor.

We also need more people to be family physicians. Why is it that people don't want to do what you're doing? Yeah, and I'm a family doctor. We also need more people to be family physicians. Why is it that people don't want to do what you're doing? Yeah, and I'm a family doctor myself, but I'm also a teacher of medical students and residents. So you would know then that many of those doctors to be are not going into family practice, they're going into other specialties. That's right, and in part,

that's because of the enormous, crushing administrative burden that doctors face. Family doctors, one of the reasons why many people can't find a family doctor is that we're doing 19 hours weekly of unnecessary navigation of the sheer bureaucracy of our healthcare system. That means chasing down referrals, uh, getting

consult notes, just navigating the paperwork and the bureaucracy and red tape of healthcare. Let's get that off the plates of doctors and let's get us focusing on the care, medical students, residents, family doctors sign up to do patient care, not paperwork. And our students are seeing that and they're choosing other things outside of family practice

because of that. I know that you represent family doctors, but is the answer here, not just family doctors, but primary care, that there are nurse practitioners that could fill many of the roles and provide much of the care that people like Jacqueline are looking for. That we need to stop talking about family doctors

with great respect to the great family doctors, including my own, um, and talk about, about primary care. I'd say we need to start talking about teams and, and ambitious expansion of teams. We know that on one hand, there's enormous training and experience and expertise that goes into being a doctor and people deserve a family doctor.

And at the same time, the only way we could get to a future where everyone is connected to primary care or family practice is by building out teams. And that means doctors, nurses, pharmacists, social workers, all sorts of health professionals working together. What is preventing us from doing that now? It's the political will right now.

So right now we have teams in some parts of Ontario and teams that are working very well. And we need teams for everybody in this province and supporting every family practice in Ontario to get to a place where everyone's connected. Dr. Jane Philpott, a former federal health minister is now leading a team for the Ontario government

that is aimed at getting every person in that province, primary care by 2029. She's talked on this program about the idea of a home health model, which is like a young person in a community is attached to a school. You are attached to a primary care provider in your community. This works in the UK, it works in the Netherlands,

it works in Scandinavia. Will it work here? I'd say, you know, let's, let's see what the plan is from Dr. Philpott's team. It's, it's an ambitious announcement from the government here, but we, we want to see a 90 day plan, some milestones, and it to see a 90 day plan, some milestones and it can't be five years from now.

It has to be action that starts right away because like we see in Walkerton and many other places in this country, people are suffering. They're in pain. They're waiting for a family doctor. They can't get the care they need and we need action now, not several years from now. What is your advice? Just finally, we just have a minute and a half left. Let me ask you two questions.

One is, what is your advice to people like Jacqueline, people across this country? Six and a half million Canadians don't have a family doctor or primary care. What is your advice to them? I'd say it matters that you have a family doctor, that you have a connection to primary care. When people have that relationship,

I know from my own practice, but then also the evidence shows us that they use the emergency department less often, they end up in hospital less often, they end up getting cancer screening and other preventions, they live longer if they have a family doctor. And by the way, at a lower cost to the healthcare system, so it makes our system more sustainable.

But they can't get one, the six and a half million Canadians can't get one. So if they're standing in line in the freezing cold, what should they do? My invitation to everyone who can't find a family doctor is one, search for one and try to find one, but then two, your provincial elected officials are responsible

for healthcare. If you can't find a family doctor, let them know, tell them your story, tell them how long you've been waiting, tell them your experiences about healthcare. They need to know, we need to make this an election issue. Do you think just finally on that, that it

could be an election issue? There are a lot of things that people look at as a ballot box question, and yet healthcare is one of those very intimate intersections that we have with government. Um, and if it's not happening, you're going to be like Jacqueline, you're going to be angry. Is there the possibility to make this an

election issue? We're at a tipping point right now in our healthcare system where far too many people are going without the care they need, nearly one in four without a family doctor. For example, in Ontario, I'd say if we don't do it now, it's only going to get worse, right? It's only going to get more challenging for

people to get that care. Dr. Novak, thank you very much. It's my pleasure. Dr. Dominic Novak is a family physician, also president of the Ontario Medical Association. Your thoughts on this as a patient or as a healthcare provider.

What are your experiences in trying to find primary care or practice in a rural community and how do we solve this problem? You can email us at thecurrent at cbc.ca.