Family doctor says change is needed to address shortage in Saskatoon

Families looking for a physician in Saskatoon are out of luck, as there are currently no clinics in the city accepting new patients.

Clicking on the link on the Saskatchewan Health Authority website that is supposed to provide a list of clinics in Saskatoon which are accepting new patients brings people to a one-page document that recommends every Canadian have a family doctor before saying: “Currently, there are no clinics accepting new patients.”

Dr. Andries Muller, a family physician and president of the Saskatchewan College of Family Physicians, said the lack of family physician services in Saskatoon is the result of a perfect storm of issues.

“There was always a shortage of family doctors, but now with the pandemic and everything else that’s happened, many people were burned out and they just couldn’t work anymore,” he said.

Some doctors retiring and others moving to other provinces has left many people without a family physician of their own in Saskatoon. Making the issue worse, many more physicians have scaled down their practices to work fewer hours each week.

Having fewer available doctors in the province couples with what Muller called an increased demand on family physicians. During the pandemic, he said many patients weren’t going to see their family doctors, and that has led to some people getting more sick, to the point where they need care now more urgently than they did before.

“There’s just not enough doctors to go around to deal with that backlog of family physician patients,” Muller said.

Vicki Mowat, Saskatchewan NDP MLA and health critic, said the province lost 82 family doctors between 2018 and 2021, with a continued “exodus” in 2022.

Mowat said some clinics have been shuttered, and there are “alarming” reports of physician burnout.

Without family doctors taking on new patients, families turn to walk-in clinics, where workloads and wait times are increasing. Muller said there aren’t enough doctors at walk-in clinics, or in emergency rooms, where families are forced to turn when they aren’t able to be seen in a clinic.

“You know just as well as I do that there’s a crisis in the emergency rooms,” Muller said. “They’re overwhelmed. The hospitals are full.”
The doctor called it a ripple effect without any good short-term solutions.

“We need a real plan for how to provide primary care to the people of the province,” said Mowat.

Mowat said the issue of not being able to access a family physician is scary for families, but nothing especially new. She said she’s been hearing concerns for years about the difficulty of finding a family doctor in Saskatoon, but the issue has only worsened since the COVID-19 pandemic.

The problem isn’t just limited to the city, Mowat said. According to Mowat, more than 200,000 people in the province don’t currently have a primary care provider.

“It’s clear that our health system is in crisis. It seems that everyone saw this coming except for the Sask. Party,” she said.

“It’s completely unacceptable that there are no family doctors accepting new patients in Saskatoon, and it’s no fault of the family doctors who are doing their best to support very high patient loads.”

Muller said the system is under pressure because it is without a good primary care component. In a system where primary care is robust, Muller said patients are cared for at the clinic level and kept out of hospitals — leading to lower costs for health care systems.

The solution is one that will take years to implement, Muller said, and must emphasize a team-based care approach to maximize physicians’ time while still seeing to the needs of each patient.

One model suggested by the Saskatchewan College of Family Physicians is a system where each patient is assigned to a home clinic, where they can see their family physician when needed. However, when their needs can be met by another member of the clinic’s team, that team member will help address a patient’s concerns and issues when seeing a doctor might not be necessary.

“That frees up time for the family physician to take on more patients,” Muller said, calling it an “ideal solution.”

He said the college has been working with the Saskatchewan Medical Association to lobby the government to implement this model, and Muller said it appears as though the province’s health minister, Paul Merriman, has been assessing it favourably.

Merriman himself seemed to reference that model on Wednesday when asked about the family physician shortage in Saskatoon by reporters. He said the solution isn’t simply hiring more doctors, but needs to enhance the roles of other positions like pharmacists, nurses, and nurse practitioners so they can all work together to meet the needs of patients.

The health minister said Saskatchewan is always looking for more doctors, especially for rural areas of the province.

Mowat, however, said a faster solution is needed — one that allows for recruiting, training, and retaining staff to provide proper care for Saskatchewan’s growing population.

“Without access to primary care, our hospitals continue to be overwhelmed, our emergency rooms continue to be overwhelmed, and those stressed and stretched health care workers can’t provide the quality of care that they’ve been trained to provide, that they want so desperately to provide,” Mowat said.

In the meantime, Muller said the best thing to do is work to relieve some of the pressure on doctors by helping with their administration duties and using other team members to help lighten the workload when appropriate. Muller said the clinic where he works tries to implement a bit of a team-based care model, which gives him a bit more time.

Muller encouraged the public to put pressure on the government by lobbying their MLAs, though he noted that politicians in the province are already very well aware of the issue.

Merriman said walk-in clinics are still a valid option for families who need to be seen by a doctor, though they will often require a longer wait. In Saskatoon, he noted that patients can check online for a wait time estimate at each clinic.

Merriman also noted the 811 health line as a resource people can use if they need care, but are unsure of where to turn.