For Kamloops family doctor Servaas Swart, the writing was on the wall 10 years ago, foreshadowing today’s family doctor shortage. Dr. Swart says that in 2013, a growing population, aging physicians, and career shifts from general family medicine all pointed to a worsening doctor shortage. At the time, 34 per cent of the population in the Kamloops-Thompson Region did not have a family doctor. Today, that gap is more than 40 per cent, even though we have more family physicians in the region than we did a decade ago.
Back then, the province asked its physicians when they planned to retire, and a lot of baby boomers said they intended to retire around 2018 to 2022.
“We knew then that we were heading for trouble,” Dr. Swart says. “You need to recruit people to make up for the population growth, and you also have to make up for those people who are going to retire. I think the urgency was there 10 years ago, and the urgency increased as time went on. That’s what we’ve seen right across Canada.”
Meanwhile, family medicine continues to see massive changes in the ways that physicians practice.
“Most of those physicians back then had huge practices that they built up over 35 years,” Dr. Swart says. “They were the old generation of truly full-scope medical practices. They did maternity care, after-hours call, and inpatient care. Physicians have become more specialized. Now, they’re doing just office-based family care, or just doing inpatient hospital care, or just maternity care. In a sense, you need more people to do the same work as one physician previously did.”
Dr. Swart says other factors contribute to strains on the health care system, such as patients’ expectations.
“Previously, the patient came to you and said, ‘My knee hurts, what do I do?’ Now, that patient can go on the Internet, read up on their condition, and say, ‘Well, my knee hurts, and I need physiotherapy, I need medicine, maybe an MRI, and I need to see an orthopedic specialist.’ Expectations are way higher and strain the system, but it’s a fine line to refuse to send a patient for all those things.”
An aging patient population also brings more complexity to primary health care.
“If I look at my own practice, those baby boomers were younger and healthier 10 years ago. They’re now 60- and 70-year-olds, so the complexity of diseases has evolved, it’s a naturally occurring phenomenon,” Dr. Swart says. “They get more medical conditions and that leads to an increased burden on the system. Remember, baby boomers are a big generation, so a lot of them are going into this complexity.
“So, all these things now happen suddenly. But now we’re faced with difficulty recruiting people, and it’s not just here, it’s from Halifax to Ucluelet that people are having difficulty recruiting people. So, we are in competition with all those other places to recruit physicians.”
Dr. Swart says the public’s concerns are important, and he encourages people to speak out.
“The more we hear the public voice, the better it enables the politicians who represent us and the physicians who represent us to carry the message forward,” Dr. Swart says. “In all my time being a family physician, this is the most support I’ve ever seen from my patients. People are grateful for having a family physician.”
