By Jenny Weichenthal
After 27 years of practicing medicine and working to become an established doctor, Dr. N. B. Matuk says she’s now in need of new patients to keep her family medicine practice operating.
She arrives at her office, which has been at 180 Metcalfe Street for her entire 27-year career, each morning at 7:30 a.m. and doesn’t leave until 5:30 p.m. By the end of the day she says she’s discouraged by the small number of patients she has seen.
“Sometimes we have only 16 or 17 patients a day,” Matuk says. “That is not enough to keep us going.”
With bills to pay and the upkeep of the office, Matuk says 25-30 patients a day would be ideal. But she often goes for hours without seeing patients. Instead of booking appointments, the receptionist often just tells patients to come anytime and they will be able to fit them in.
Matuk says she sees the same trend happening with other doctors and blames part of the patient loss on the rising number of walk-in medical clinics in the area.
“My older patients are still very loyal to me,” she says. “It’s the younger people who prefer walk-in clinics.”
Matuk sees many of her patients drifting away to these clinics for faster medical care, though many often return. She says her patients tell her the wait at a clinic is longer than it would be to come to see her in the first place.
Dr. Sheila Rothstein, a physician at the walk-in clinic at the Family Medical Centre on Elgin St., says the doctors at the clinic are seeing as many patients as they can in a day, which is typically about 90. She says even those with family physicians love to go to walk-in clinics because they “are too lazy to make appointments to see a doctor.”
“People want instant care,” Rothstein says. “It’s like McDonald’s. It’s 7-Eleven medicine.”
Before working at the walk-in clinic, Rothstein says she experienced the same decline of patients in her private practice in Winnipeg that Matuk says she began seeing once clinics started opening.
“People don’t even want family doctors anymore,” she says.
She says more and more doctors are also opting to practice at walk-in clinics partly because building a practice takes time, but also because the patients are easier to care for.
Rothstein says it’s family doctors who have to deal with the serious illnesses and the seniors who require time and effort.
Martin Scullion, director of operations for the 33 Family Medical Centres across Canada, says the number of patients seen in private medical practices depends on the style of the doctor and the type of patients they have.
He says it’s possible for doctors in private practices and walk-in clinics to make the same amount of money depending on the number and type of patients they see.
Except for the one or two per cent of doctors he estimates to be on salary at Community Health Centres, all doctors are paid by OHIP on a fee-per-service basis.
But given that many people who go to clinics may have otherwise gone to the emergency room instead of making an appointment with a doctor, he says it’s cost-effective for patients who are not seriously ill to get medical care at a clinic. This is because the operating costs for a clinic are much lower than for a hospital emergency room, he says.
While some doctors feel the appeal of walk-in clinics is taking patients away from family doctors other area doctors are still so busy they are not taking on new patients.
Dr. J.W. Maloley, an area family doctor, says his practice is too large to take new patients unless it’s an emergency or the patient is referred to him by a hospital.
He says this is a common challenge facing doctors in Centretown because there is a large senior population. These patients require more time with the doctor, and so they’re unable to see as many patients as doctors in walk-in clinics.
Bonnie Thompson, a receptionist for a family doctor in Centretown, says her office gets many calls from people who are having difficulty finding a family doctor.
But even though she says this is a major problem for residents, their practice is also too busy to accept new patients.
At the Centretown Community Health Centre, where there is a walk-in clinic as well as doctors who see patients with an appointment, Dr. Josée Labrosse says both areas of medical service are very busy.
While the walk-in clinic has brought patients she says they wouldn’t have seen before, such as homeless people, the regular appointments for physicians are booked up quickly. “We would like to see many more patients than we are able to accommodate,” Labrosse says.
She says beginning in March 1998 they were unable to take new patients for a year because they were just too busy.
They have since tried to cut back on the length of appointments to see more patients.
“It’s still an issue because the waiting times have started to creep up for regular patients,” Labrosse says.
Given that some physicians say their practices are not busy enough, and others say they are swamped with patients, just how difficult is it for people living in Centretown to find a physician?
In a survey of twenty family doctors conducted in Centretown over the last two weeks, Centretown News found most physicians are not taking on new patients right now.
Nine of those surveyed say they are currently accepting new patients.
Seven say they are too busy right now and the other four are also not taking new patients but say they would make exceptions for family members of current patients.
A few of those who say they are taking new patients said it could take up to a month before they get an appointment.
Kevin Barclay, executive director of the District Health Council that advises the provincial minister of health, says whether or not there are too many or not enough physicians cannot be easily answered for small communities like Centretown.
Barclay says when you examine the ratio of physicians to population there are actually more doctors than should be needed in the Ottawa area.
While he says there is no evidence of a shortage of doctors in the Ottawa area, he cannot say if they are practicing in the right place at the right time.