Doctor shortage in N.L. is leaving patients with a lack of choice
Newfoundland and Labrador is bearing the burden of a family doctor shortage, and the repercussions are weighing heavily on those who cannot access a physician of their own.
According to the Newfoundland and Labrador Medical Association, there are currently 605 family physicians practicing in the province, many of which are coming close to the age of retirement. They estimate that 100-150 additional family physicians are needed to meet the needs of the province’s population.
Those fortunate enough to have a family doctor at all are often limited in their choices.
Gemma Johnson of St. John’s says she had to settle.
“I had no other choice but to go with a male doctor, which I’m kind of uncomfortable with,” said Johnson. “There are just some things, it seems, a female is more suited to deal with.”
Johnson is one of many people in the province seeking care from a female physician with little success. She says it’s a tiresome search, but one she is not doing alone.
Of the 605 family physicians in the province, 207 of them are women, according to the most recent research from March 2018.
From mental health concerns to reproductive health, Johnson says her family doctor has left her unsatisfied. She opened up to her doctor about her history with sexual assault and harassment – and he wasn’t sure how to respond. She says if she had access to a female physician, things might be different – and she might be receiving care more suited to her needs.
Having a gender preference for one’s physician is common among women, especially in relation to sexual health. Shannon Driscoll, client services coordinator of Planned Parenthood in St. John’s, says these preferences should not go ignored.
“Most people are more comfortable with a female doctor with sexual health-related things,” said Driscoll.
All doctors working at Planned Parenthood’s clinic are female. Driscoll says that’s one reason the clinic sees so many patients daily.
Driscoll says Planned Parenthood will likely maintain its practice of having only female doctors on staff.
The province has a relatively balanced male-to-female ratio among doctors, and more female doctors are being recruited than in the past.
According to Canadian Medical Education Statistics from 2017, 66.3% of those enrolled in medicine at Memorial University are women.
Despite these upward trends, says Driscoll, it is evident the needs of many patients seeking exclusively female physicians are not being met. For those people, Planned Parenthood might be the only clinic where female doctors, or any doctors, are made accessible to them.
“Based on the amount of people that come here, the access is clearly pretty limited elsewhere,” said Driscoll. “Some people will go to the walk-in clinic for everything else and come here for anything related to sexual health – or anything they can stretch to be related to sexual health because they have no access to anyone else.”
Driscoll says she has noticed female doctors in the province prioritizing pre-natal patients, postnatal patients, and for those trained in hormone therapy, transgender patients.
She attributes the lack of female physicians accepting newcomers to them often being tied to patient groups with a greater need for their services.
The associate executive director of the Newfoundland and Labrador Medical Association (NLMA), Lynn Barter, says the doctor shortage is a multifactorial issue that has ties to compensation, the high cost of overhead and style of practice.
“Recruitment and retention of physicians is an ongoing issue in the province,” said Barter. “While the number of physicians has increased overall, there are still gaps in services within regions of the province, in particular in family medicine.”
More physicians are being trained at Memorial University than ever before. Barter says more recently, there has been a trend in specializations, and family practice is not as attractive as it once was.
Barter says there are resources for people who seek primarily female care within the province, like Eastern Health’s female-based clinics and the refugee health care program that caters to cultural sensitivities for new Canadians.
“It is concerning that so many people in our province do not have a family doctor, regardless of gender,” said Barter.
Driscoll says it is common for male family doctors to refer their patients to Planned Parenthood for STI screening, breast exams and Pap tests. She says these family physicians should be well trained to do these procedures themselves.
She notes that this is a both patient and doctor problem. Some patients aren’t comfortable with their family doctor performing sexual health-related procedures, and some doctors aren’t taking initiative and offering to perform them either.
She says this may relate to societal shame around sex.
That societal shame is also why some people refuse to receive their testing at clinics like Planned Parenthood.
”I think a lot of it is a misconception in what we actually do, and what services we provide,” said Driscoll.
Johnson says that’s why she fears to make appointments at outside clinics like Planned Parenthood.
“It’s almost like there’s a stigma attached to the place,” said Johnson.
Barter says access to good primary care is critical to an individual’s overall health. It also ensures smaller clinics, walk-ins and emergency rooms are not always over-crowded.
She has hope that the increased number of seats for medical students at Memorial University, and team work within the medical community, will lead to a more reliable system.
There are currently 80 seats available every year for new students in MUN’s Faculty of Medicine.
“The NLMA would like to see more collaborative care models where family physicians, nurses and other providers work as a team to provide primary care to their patients,” said Barter.