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Do You Have a Regular Doctor?

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18 March 2014

In 2011-2012, approximately fifteen percent of Canadians did not have a regular doctor. And while the number of practicing doctors per capita throughout Canada has steadily increased over the past decade, over the same period there has been nearly no improvement in the proportion of Canadians with access to a regular physician. According to Canadian Community Health Survey data from the years 2002 to 2012, the percentage of Canadians indicating that they do not have a regular doctor has fluctuated between a low of 14.0% (in 2002-03) and a high of 15.3% (in 2007-08).

Cross-Provincial Differences

There is a noticeable geographic component to the distribution of Canadians without doctors. In 2011-12, the proportion of residents in each of the prairie provinces (Manitoba, Alberta and Saskatchewan) without a regular doctor was higher than the Canadian average, and each of the Atlantic provinces (Newfoundland and Labrador, PEI, Nova Scotia and New Brunswick) exhibited a proportion of residents without a regular doctor lower than the national average.

It is, however, the province of Quebec and the northern territories that yield the most striking results, as residents of these regions were more likely than those in any other province to not have a regular doctor (25.1% in Quebec and 53.7% in the territories). Interestingly, residents of Quebec were also more likely than those in all other provinces to indicate that doctors in their area were not taking new patients (30.4%), and residents of the territories were most likely to indicate that doctors were unavailable in their area (56.6%).

Reasons for Not Having a Regular Doctor

Although 46.4% of those without regular doctors, in 2011-12, reported that they have not attempted to contact a physician, a slightly higher proportion (47.7%) indicated that they either could not find a doctor willing to take new patients, that no doctors were available in their area, or that their previous doctor had left the area or retired. While not having tried to contact a doctor was the most common reason identified for not having a regular doctor in eight provinces, those without a regular doctor in Prince Edward Island were more likely to be without a doctor because their previous doctor had left or retired (48.6%), and in New Brunswick – the province with the lowest rate of residents without doctors – both an equal proportion (31.0%) indicated that their doctor had left or retired as did not having tried to contact a doctor.

Demographic Trends

While there are pronounced differences across provinces and territories in the proportion of residents without regular doctors, there are also marked differences within demographic categories such as age, sex and income. Those between the ages of 18 and 29 are more than twice as likely to not have a regular doctor than all other age groups combined (27.0% compared to 12.3%). Men are over 70% more likely than women to be without a regular doctor – with 19.1% of men reporting not having a doctor, compared to only 11.1% of women. And men without regular doctors are also much less likely to have tried to contact one when compared to women.1 Additionally, the probability of having a regular doctor increases with household income. Among those with an annual household incomes of $20,000 or less, 20.8% reported not having a regular medical doctor, while the same is true of only 13.4% of those with a household income of $80,000 or more.

Doctor Consultations and Self-Perceived Health

Only slightly more than half of those without a regular doctor indicated that they had consulted a medical doctor in the previous year (54.7%), compared to 84.2% of those with a regular doctor. The mean number of doctor consultations in the previous year among those without a regular doctor (1.8) was less than half that of those with a regular doctor (4.1).

Yet, despite the fact that those without a regular doctor are much less likely to have consulted a doctor, there is relatively little difference in how both groups assess their own health. In providing a self-perceived health assessment along a five-point scale, where 1 represents “Excellent” and 5 “Very Poor”, the mean response among those without a regular doctor was 2.22, while the mean among those with a regular doctor was 2.35.2 Thus, on average, those without a regular doctor actually feel slightly healthier than those with a regular doctor. Interestingly, this holds true across all age groups, except among those below the age of 30. While those without a regular doctor across all other age groups, on average, rate their health better than those with a regular doctor, those aged 29 or younger and without a regular doctor rated their health slightly poorer (2.12 among those with a doctor, compared to 2.15 among those without).

While the supply of available physicians certainly is an important factor in determining whether many Canadians have access to a regular doctor, nearly half of those without a regular doctor have not tried to find one. Though it is certainly possible that, in many cases, those without a doctor have been dissuaded from trying to find one because they expected none would be available, the fact that Canadians without a regular doctor, on average, tend to rate their health slightly better than those with a doctor, seems to indicate that many without a doctor have simply not felt the need to seek regular medical care – or, rather, that worsening health may, in many instances, prove the incentive for finding a regular doctor.

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1 52.8% of men without a regular doctor report not having tried to contact one, while only 35.7% of women identify this as the reason they do not have a regular doctor.
2 There was, however, some variation between those respondents identifying different reasons for not having a regular doctor. Among those without a doctor, those that had not tried to contact a doctor felt the healthiest (2.10), while those whose doctor had left or retired or without doctors available in their area rated their health the poorest (2.34).

Unless otherwise noted, all data contained herein is drawn from the Canadian Community Health Survey (CCHS) 2000/01-2011/12. The CCHS is a joint effort of Health Canada, the Public Health Agency of Canada, Statistics Canada, and the Canadian Institute for Health Information (CIHI).