1 in 3 People in Quebec Do Not Have a Primary Care Clinician
Author: Canadian Medical Association Journal
Published: 2024/05/21 - Updated: 2026/02/14
Publication Details: Peer-Reviewed, Survey, Analysis
Category Topic: Canada - Related Publications
Contents: Synopsis - Introduction - Main - Insights, Updates
Synopsis: The information on the OurCare initiative in Canada is significant because it represents a potential shift in the country's approach to long-term care for seniors and people with disabilities. This community-based, non-profit model aims to address the shortcomings of the current system by prioritizing quality care, fair wages for workers, and affordable options for families. By proposing an alternative to both government-run and for-profit facilities, OurCare seeks to improve the overall standard of care while potentially reducing costs and increasing accessibility for those in need of long-term care services - Disabled World (DW).
- Definition: OurCare
OurCare was an 18-month pan-Canadian initiative, led by Dr. Tara Kiran and researchers at the MAP Centre for Urban Health Solutions at St. Michael's Hospital (Unity Health Toronto) and the University of Toronto, that set out to build a patient-centered vision for primary care by going directly to the public. Through a large-scale survey of more than 9,200 people conducted in both English and French, along with broader community engagement, the project documented how Canadians actually experience primary care - who has access, who doesn't, and what people value most in their relationship with the healthcare system. Its findings, published in the Canadian Medical Association Journal, revealed stark regional disparities in access and helped quantify the gap between Canada's universal healthcare ideals and the day-to-day reality faced by millions of people without a regular family doctor or nurse practitioner.
Introduction
More than 1 in 5 adults in Canada did not have access to primary care, with large regional gaps in access, found new research in the Canadian Medical Association Journal (CMAJ).
"Translated to the population of Canada, our survey estimates that more than 6.5 million adults across the country don't have access to a family doctor or nurse practitioner they can see regularly," says Dr. Tara Kiran, a family physician and researcher at the MAP Centre for Urban Health Solutions at St. Michael's Hospital, Unity Health Toronto and the University of Toronto. "And even those lucky enough to have a family doctor are struggling to get timely care for urgent concerns or care on evenings and weekends."
Main Content
As part of an 18-month, across-Canada initiative to develop a vision with patients and the public for primary care called OurCare, researchers conducted a survey to understand people's values and experiences with primary care. They analyzed data from more than 9200 people via survey, with 73% of surveys in English and 27% in French to provide a national overview.
"What is most surprising is the provincial variation in access to primary care," says Dr. Kiran. "Primary care is the front door to the health care system - the first point of access for acute concerns, managing chronic disease, preventing illness, and helping people access other supports. It is simply unconscionable that in some parts of the country, this door is now closed for almost one-third of the population."
In Quebec and the Atlantic provinces, almost 1 in 3 people reported they did not have a primary care clinician, even after the authors adjusted for differences in age, gender, education, and other demographic characteristics of survey respondents.
People in Ontario were most likely to report having a primary care clinician. Men, people younger than 65 years, and those with poor health were less likely to have a primary care clinician.
People with primary care clinicians also reported challenges in accessing care, as most practices did not offer appointments outside of usual weekday 9-5 hours, and more than half of respondents said they could not get an urgent appointment within 3 days of attempting to book. Many turn to walk-in clinics, which do not provide continuity of care, something that patients indicated was important.
The research team notes that 90% of survey respondents would be comfortable with getting care from another member of a primary care health team, suggested internationally as one solution to address the primary care crisis. Yet less than 15% of respondents reported that their primary care clinician worked with a social worker or pharmacist or dietitian. There was substantial provincial variation, with the odds of working with any health professional lower for people living outside Ontario and Quebec.
"The crisis in access to primary care is in stark contrast to the values that people in Canada hold dear - that everyone should have access to health care regardless of where they live and who they are," says Dr. Kiran.
Insights, Analysis, and Developments
Editorial Note: The OurCare findings lay bare a troubling paradox at the heart of Canadian healthcare: a system built on the promise of universal access is quietly failing millions of people at the most basic point of entry. That nearly a third of Quebecers and Atlantic Canadians lack a regular primary care clinician isn't just a staffing problem - it's a structural one, and it falls hardest on those already navigating barriers to care, including people with disabilities and chronic conditions who depend on continuity and timely access more than most. The willingness of 90% of respondents to see other team-based health professionals suggests the public is already ahead of the policy conversation. What remains to be seen is whether provincial governments will treat these numbers as the emergency they plainly are, or continue to let primary care erode while emergency departments and walk-in clinics absorb the fallout - Disabled World (DW).Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Canadian Medical Association Journal and published on 2024/05/21, this content may have been edited for style, clarity, or brevity.