In the past 4 years, the number of PEI residents without a family doctor has TRIPLED. This group now constitutes 21% of the population of the province, up from less than 8% four years ago.

PERIODIC SHOCK

One of the curious things about Canadian society – and not in a positive way – is that certain beliefs are so entrenched in popular lore that no amount of evidence suffices to dislodge these beliefs. One of the areas afflicted by this pernicious stubbornness is healthcare; despite credible, indeed irrefutable, evidence rolling in periodically from various parts of the country, we cannot rid ourselves of the patently untenable claim that Canada has ‘the best healthcare system in the world’. As a corollary to this, any suggestion to improve the state of our healthcare system (other than pumping yet more money into it) invites scaremongering of ‘privatization’ which is, by definition, supposed to be the very embodiment of evil. In the meantime, the decades-long process of further deterioration of our healthcare system continues unabated.

Having written many articles in the past 30 months on the many lacunae in our healthcare system, it was nevertheless an unpleasant surprise for me to see recently a news report by CBC saying that the number of residents of Prince Edward Island who do not have a family doctor has nearly tripled in the past four years. This what the chart looks like:

A couple of quick points. (1) the sharp downward movement in 2020: According to the CBC report, Health P.E.I. says the change was the result of a list cleanup, where it removed people no longer looking for a doctor” (emphasis added), and (2) I am sure that you noticed that in the government-speak of PEI (and possibly elsewhere in Canada), the term of choice is ‘patient registry’ rather than ‘waiting list’. The latter term has a negative vibe, because it shows unavailability of the service that people need (in this case, healthcare).

As to why exactly people were ‘no longer looking for a doctor’ is not explained in the CBC article. Maybe they passed away, having been deprived of the healthcare that they may have needed. Or maybe they moved to somewhere else in Canada and therefore were likely on another province’s ‘patient registry’. Or maybe, just maybe, they actually got assigned to a doctor – in which case one wonders why their removal from the ‘patient registry’ had to happen via the instrumentality of a ‘list cleanup’; the optics for administrative efficiency are not great in that case. I suppose the luckiest ones went abroad, hence why they were ‘no longer looking for a doctor’ in PEI.

CRUNCH & MUNCH

Let us now dive into the nitty-gritty of the issue. According to CBC, in January 2020, there were 16,012 PEI’ers on the ‘patient registry’. By May 2020, the ‘list cleanup’ reduced that number to 12,511. By March 04, 2020, that number had increased to 36,970. This means that in the period between May 2020 and March 2024, or in 3 years and 9 months, the number of people in P.E.I. without a family doctor nearly tripled. Out of the 24,459 additional people on the ‘patient registry’, 969 individuals were added to the list since January, i.e., within a span of less than two months. Of these, 299 were added since ‘mid-February’, according to the CBC report. It appears that the demographic of ‘people without doctors’ is increasing at the rate of 150 individuals per week on average.

In addition, as CBC reported on April 30, a Summerside clinic had closed down, leaving its 2,500 patients without a family doctor. On the other hand, according to Health P.E.I., it was in the process of assigning 400 Islanders to doctors. As a net result of these two, the ‘people without doctors’ category would grow by over 2,000. Add in the 150/week rate of increase in the demographic, and we are easily looking at its size growing to 40,000 by the end of May. As CBC notes, during the election campaign in the spring of 2023, when the current government of Premier King promised to eliminate the ‘patient registry’ (which stood at 28,546 at the time) in 24 months. Instead, in the 12 months since then, it will have grown by well over 11,000, or more than 40%.

Let us remember that in the language of healthcare reporting, ‘family doctor’ is interchangeably also called ‘primary healthcare provider’. It is well known that people who lack access to a primary healthcare provider tend to develop more complex health issues that require more resources to tackle, while their quality of life also suffers. To compound the challenge, waiting time for specialist treatment in P.E.I., as reported by Statista, was over 55 weeks as of December 2023 – but this was including 27+ weeks of wait time from the referral by the G.P. to actually seeing the specialist. Clearly, people who do not have a family doctor (G.P.) would find it even more difficult to receive specialist treatment because they don’t have a G.P. to refer them to a specialist – the need for which would often have been caused by their lack of access to a family doctor. A report by CTV News on December 08, 2023, echoes the same data.

POPULATION-LEVEL ANALYSIS

According to the website of the government of P.E.I., as of January 01, 2024, the population of the island-province was 176,162. This number would have changed a little bit by March 04, 2024 (a period of 65 days), however, it would be safe to assert that in percentage terms, just a touch under 21% of P.E.I. residents lack access to a primary healthcare provider. Apart from the raw number of ‘people without doctors’, the percentage has also seen a steep rise in the past 4 years. Let us look at how the province’s population has grown, via this chart from the same website of P.E.I. government:

According to Statistics Canada, the population of P.E.I. was 157,494 at the end of Q1, 2020 and 158,401 at the end of Q2, 2020. Therefore, we can confidently take the population as of May 2020 at 158,000. As mentioned above, at that point in time, there were 12,511 ‘people without doctors’ in P.E.I. after the ‘list cleanup’. This yields a percentage value of 7.92%. It is clear that between May 2020 and March 2024, the percentage of people in P.E.I. who do not have a ‘primary healthcare provider’ has risen from 7.92% to 20.99%. This represents a worsening of the availability of family doctors in P.E.I. by 165% in one year.

HEALTH & DEMOCRACY

The question is whether any political pressure exists in P.E.I. to ameliorate this dire situation, and if it does, if there are enough resources at the disposal of the province’s government to bring about positive changes. As someone completely unfamiliar with that province, I am not in a position to formulate any answers to these questions. But it concerns me greatly that in a G7 country:

  • The crisis in healthcare has become so deeply entrenched that we have to resort to euphemisms like ‘patient registry’ in place of ‘waiting list’,
  • That ‘patient registry’ grows by a mind-numbing 40% in a year,
  • Nearly one in four residents in a province do not have access to basic healthcare.
  • Which makes their health issues graver, requiring specialist treatment,
  • But receiving that specialist treatment involves a wait time of almost 13 months,
  • Which period could be (or would be, even) longer for ‘people without doctors’.

I am not much for doing outrage, but if I were inclined in that direction, I would say that the outrage is that there is no outrage over this abysmal situation in one of our provinces.

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(Image Credit: Wikimedia Commons, Author ‘Skeezix1000’; the image is at this link. Used without modification under Creative Commons Licence)