It took me about two years to get diagnosed with Crohn's disease. That's two years of stomach cramps and unfortunate bathroom habits, and two years of waiting for test results and appointments with specialists. All of these procedures took longer than they needed to and were more complicated, because I didn't have a family doctor to act as a go-between and collect the information I needed.
But because I live in the Maritimes—where finding a family doctor is akin to winning the lottery off a ticket bought by your monkey butler—I had no choice.
I haven't had a primary care physician since I moved to the east coast in 2012. Over the last few years, I've lived in New Brunswick, Prince Edward Island, and now Nova Scotia. In each new city, I call around to doctor's offices, asking if they're accepting patients. When I first moved to Fredericton, three offices hung up on me with a brusque "no," while one literally laughed at me. About half of the places I called referred me to the patient waiting list.
Patient Connect NB is a provincially-run waiting list for patients; Nova Scotia and PEI have similar set-ups. When you call seeking a family doctor, you're asked some basic questions, and then that's it. You're not contacted again until a doctor is free to take you. In the years I lived in New Brunswick, no one ever called me back.
Here's how I (finally) got my Crohn's diagnosis: I got up at 5:30 in the morning to get to the only open walk-in clinic in the city. I got there at 6, and waited in line until the doors opened at 7:30. After a few more hours of waiting, the beleaguered clinic prescribed me antibiotics for a stomach virus. I took them for a month with no changes, so I went back to the clinic and through the whole procedure again. This time the doctor said I should get a scope (camera in the tush) so a specialist could see what was going on. I was told the specialist would call me to arrange it.
I waited another six months to hear from the specialist, and then a month before I could get the scope. Now, I take pills every day and needles every week, but I don't have anyone I can see regularly if something goes wrong.
I'm actually lucky. Because of my busted gut, I'm guaranteed a visit with a specialist at least once a year. But some people, like Alora Hazel, don't even have that.
"It would likely take a situation in which I'm super unwell to take steps in seeking medical help. That situation hasn't happened yet, and I'm hoping it never will," Hazel said. The 24-year-old is from Windsor, Nova Scotia, and moved to Halifax last fall. She lost her doctor three years ago when she aged out of her family health plan, and hasn't had one since. She's been on the wait list in Nova Scotia for the past year and a half.
"I know of quite a few people who don't have a doctor as well. Lots of peers I went to school with for sure, often in the same boat as me," said Hazel. She says she's found a clinic that provides yearly pap smears, but other then that, she's out of luck.
This situation is frighteningly common. The New Brunswick Medical Society estimates about 50,000 people are on the wait list in that province; the government of Nova Scotia has been criticised for not even releasing the number of people on their waiting list. This isn't just a Maritime problem either. Statistics Canada estimates that 4.5 million Canadians go without a family doctor (and the majority of those people are between 20 and 34), but it does seem harder to find one out east. Prince Edward Island has the lowest provincial rate of doctors per capita, and in 2015, three Atlantic provinces lost doctors who moved west.
It's also worth noting that things are markedly better in bigger cities. Across the country, fewer than ten percent of doctors practice in rural areas, but nearly 20 percent of Canadians live there. It's also harder to keep doctors in provinces with smaller centres. In Nova Scotia, 39 per cent of medical school graduates stay in the province, compared to 85 percent of the grads in Quebec.
Haoyang Lui was on the patient list in New Brunswick for five years, and went without a doctor for seven. He's had to rely on the emergency room too often. A few years ago, Lui contracted H1N1, and went to the emergency room with a scorching fever. He waited for eight hours before seeing a doctor, who told him to go home and drink more water.
"I thought I was very fortunate, because the guy who sat right beside me…was holding his own finger," Lui recalled.
A month ago, Lui learned of a doctor opening a practice in Fredericton, and called immediately. But he was wary about taking his name off of the provincial wait list.
"I was like omg, I have to make sure I am a patient," Lui said. "This is my first time doing it. I was waiting for the clear sign for saying 'yes, we will take you as a patient.'"
As luck would have it, I met with my new gastroenterologist while writing this article. I've been waiting to see her for about 10 months, which she tells me isn't uncommon. With thousands of patients, Dr. Jaclyn Flemming has been practicing in the Halifax area for about two years, and says even in that short time, things have gotten worse.
"I have probably seen about 20 local GPs retire or change roles, just in the (Halifax area), and no one's replacing them," Flemming said. While there are doctor shortages across Canada, "It's particularly bad here, and it's particularly bad with primary care."
And there's one guess as to why.
"It all comes down to money," Flemming explained. It's costly to run a family practice, and family doctors aren't compensated as well as specialists, so in Flemming's experience, they move on to other areas where they can make a better living. That leaves fewer doctors behind to pick up the slack—they get burnt out, and the cycle continues.
There certainly isn't an easy fix. Rural areas are hurting more than urban ones, plus the Atlantic populations are aging faster than the rest of Canada. And the provincial governments are certainly trying to lure doctors to the east coast shores. But for Flemming, they're just not offering up enough cash—or giving doctors tax breaks. Nova Scotia has one of the highest tax rates in the country for the top income brackets.
"I don't see any other solution other than some kind of incentive program for people to practice and stay in (the Maritimes.)"
I moved to Halifax last summer, and I'm hoping that being in a bigger city will help my chances of finding a doctor. But for now, there's nothing I can do but wait.
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Lead image via Pexels.