‘It’s just a vicious circle:’ Sask. doctors sound off on staff shortages

A shortage of family physicians in the province is leading to longer waits at clinics and emergency rooms while also leaving plenty of people without access to a doctor. 

According to a Saskatchewan Health Authority website listing available doctors, no clinics in the Saskatoon area have accepted new patients since Sept. 12. 

With no ability to book an appointment, many doctors have noticed wait times more than double in recent months as more people are forced to go to a walk-in clinic or an emergency room instead. 

The system is in a crisis, said Dr. Andries Muller, the president of the Saskatchewan College of Family Physicians. 

"The poor patient out there who's never had a family doctor will now have an even harder time finding one because no one is taking new patients," he said. "It's just a vicious circle -- and to be honest, I think most of my colleagues would say that they don't see the light at the end of the tunnel."

Muller said a physician shortage is nothing new to Saskatchewan, but COVID-19 helped reveal the gaps in the system. Over the pandemic, many doctors retired or moved away from the province as many patients opted to stay home and put off regular check-ups. 

"Everyone is basically trying to catch up right now," he said. 

The result is far more demand than available doctors, and the whole healthcare system gets caught up in the backlog because family doctors are often the first point of contact for specialized care.

The issue became so bad at Legends Medical Clinic in Warman that staff decided to close the doors to the walk-in clinic on Tuesday for a minimum of two weeks due to "the physician shortage and continued verbal abuse."

Dr. Adam Ogieglo with Lakeside Medical Clinic understands that pressure all too well. He regularly spends his lunch hours or evening hours phoning patients. He has tried to double book patients to decrease wait times, but it’s still as bad as he's ever seen in his 11-year career. 

"Maybe once every six months you'd see a three hour wait in our clinic. That's routine, that's every day for the last few weeks," he said. 

The problems facing family physicians did not materialize overnight. With recruitment and retention lagging for many years, primary care doctors were left to deal with people with increasingly complex health concerns. 

Dr. Brady Bouchard, a family doctor in North Battleford and the president of the College of Family Physicians of Canada, said many students in their first year of medical school are told how unattractive the career path is. 

Family physicians are paid a fee for each patient they see, which Ogieglo says is outdated today, with complicated health needs using up more time.

"You're being penalized for providing good care to complex patients. That is one big flaw in our system," Ogieglo said. 

The overhead necessary to operate a clinic is another barrier. Rather than spending a majority of time helping patients, doctors are spending their time ordering medicine and filling out forms for insurance or workers compensation purposes. 

"It's just not an enjoyable job anymore," Bouchard said. "And in some provinces, and even in some parts of Saskatchewan, not only is it not enjoyable, but they can't really make a living doing it anymore, either."

The solution? Systemic reform, says Bouchard. 

One model picking up traction is team-based care, like that offered in Saskatoon’s community clinics, which experts say will serve more of the population and lead to huge cost savings. 

Rather than the family doctor serving as gatekeeper for the patient's every need, a variety of healthcare workers support the patient throughout the continuum of care. 

For example, if a diabetic is going to see Bouchard for a routine issue, diabetic educators, nurse practitioners and nurses could be used instead, which could also prevent further health complications later on in life. 

"You save ER visits, you save unnecessary surgeries for missed cancers, chemotherapy. The list goes on," he said. 

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