79 per cent of N.B. residents have access to permanent primary care provider: survey

In 2023 only 79 per cent of New Brunswickers had access to a permanent primary care provider, a decrease of 14 per cent since 2017.

It’s one of the many findings in the New Brunswick Health Council’s latest update on the state of access to primary care in the province. Primary care is a sector facing many challenges globally, according to the article, in terms of accessibility, continuity, and coordination of services.

“When it comes to primary care, we should be aiming for a model that ensure 100 per cent of citizens have access to a primary care provider,” says New Brunswick Health Council CEO Stéphane Robichaud.

When compared to other developed countries, the national percentage of Canadians with a regular doctor is 86 per cent while the Commonwealth Fund (which includes countries like Australia, the United States, and the United Kingdom) boast an average of 93 per cent.

Even citizens with a regular health-care provider face challenges in finding appointments. Only 26 per cent of Canadians claim they were able to get a same or next day appointment with their doctor or nurse practitioner the last time they required care.

Focusing on New Brunswick, the article also includes findings from the 2023 edition of the Primary Care Survey undertaken by the organization. The data was collected from 5,010 New Brunswick residents aged 18 and over from October 2023 to January 2024.

There was a 14 per cent decline of New Brunswickers with a primary care provider over the past six years. Some areas of the province have felt the impact more than others, with only 67.8 per cent of residents in the Fredericton River Valley area claiming to have a primary care provider in 2023. In 2020, 92.8 per cent of survey respondents from that area claimed to have a doctor.

Part of the reason for this decline in recent years is due to a number of physician recently retiring, leaving many without a primary care provider. New Brunswick population increases have also made if more difficult to find a doctor.

Robichaud also says part of the issue is there is no sole organization overseeing the different primary care options in the province.

“There isn’t a clear authority responsible for primary care,” he says.” So if we are talking about extra-mural, for example Medavie manages extra-mural. If we are talking about hospitalizations or acute care, the (regional health authorities) manages hospitals. We need to get to a point where there is clear authority as to who is responsible for the planning and management of primary care as that is going to be an important part to ensuring a coordinated approach.”

In 2020, 51 per cent of New Brunswick residents claimed they were able to get an appointment with their family doctor within five days. The provincial average for 2023 dropped nearly 20 percentage points to around 32 per cent.

Sixty-nine per cent of respondents with a primary care provider also reported using other health-care services because their provider wasn’t available.

New Brunswick Medical Society president Dr. Paula Keating admits she wasn’t surprised by any of the articles findings.

She says the current system in place clearly is not working, and changes need to be made in New Brunswick’s health sector to solve the issues.

“We need to look at new ways to practice,” says Keating. “We have been advocating for more resources for primary health-care teams in order to allow patients more access and being served by the right provider for the appropriate care needs that patients have.”

Outside of Ontario, New Brunswick spends the least amount of dollars on their health-care, averaging $8,413 per person in 2023.

Robichaud says New Brunswick at one point was among the provinces spending the most on health care. He would like to see an increase in spending, but notes more money isn’t the ultimate solution.

“We cannot lose sight, though, that increased spending has to be accompanied with reorganization of current resources,” says Robichaud. “We can’t just add, in fact, compared to perhaps 15-20 years ago where perhaps you could have tried to spend your way to better care, today everybody is competing for resources.”

Robichaud says it isn’t possible to set a hard timeline to resolve these issues; rather improvements will have to be made as issues arise.

“We are going to have to change how we are working along the way, and we need to do a better job at identifying those with high needs in our population,” Robichaud says. “We have one New Brunswickers in four that has three or more chronic conditions. Even if they have a primary care provider, if they are in the group of people where it takes six or seven weeks to get an appointment, they are not getting the continuing of care that they need and end up having to go to the emergency room or after hours clinic.”

Dr. Keating notes the medical society has reached out to the government on ways to improve primary health care.

“We have been advocating for change for some time,” Dr. Keating says. “And we submitted a proposal to the government in November of 2023 outlining some possible solutions for this crisis that’s upon us and we are still waiting on action.”

“Physicians as we have heard and primary care providers are burning out,” she continues. “It’s tough to be a community family physician these days. The increasing complexity of patients, and this is where a team based care model may help to improve access.”

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