CBC — It's taking longer for patients with an urgent condition to see a doctor, a new survey suggests.

The Canadian Medical Association, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada released their findings on the opinions of doctors, medical residents and medical students on Monday.

In spite of improvements in some areas, doctors are finding it harder to meet the changing health-care needs of the growing number of Canadians living with chronic and complex medical conditions, the survey suggested.

About 58 per cent of family physicians and general practitioners say they're accepting new patients, with 18 per cent saying they have no restrictions and 41 per cent saying they accept some.

People in Quebec might have the easiest time. In that province, 66 per cent of practices are fully or partially open. Alberta had the lowest proportion of practices willing to accept new patients at 52 per cent.

For those who do have a family doctor, they may be waiting longer to see one.

When physicians were last surveyed in 2007, 65 per cent of family doctors saw urgent care patients within one day, compared with 61 per cent in 2010.

For specialists, the urgent care wait rose from 32 per cent four years ago to 37 per cent last year.
Work changes for doctors

Almost half, 47 per cent, of patients with an urgent condition can be seen by a doctor within a day, with the highest rates in Saskatchewan at 59 per cent and the lowest in P.E.I. at 40 per cent.

The doctors surveyed pointed to increasingly complex patient caseloads (72 per cent), chronic conditions (63 per cent), increasing administrative work and paperwork (61 per cent), aging population (59 per cent) and increasing patient expectations (58 per cent) as reasons for greater demands on their time.

On average, a physician's work week was 51.4 hours in 2010, compared with 51.7 hours in 2007. The amount of time spent on direct patient care is decreasing and indirect patient care, such as completing charts and making phone calls, is on the rise.

The size of family practices seems to be shrinking. Younger doctors under the age of 35 had an average practice size of 1,160 compared with 1,900 patients for family doctors aged 55 to 64. The national average is about 1,700 patients.

"We have seen a shift towards smaller practice size," said Dr. Robert Boulay, president of the College of Family Physicians of Canada, who practises family medicine in Miramichi, N.B.

"And I think that has to do once again with that our practices are becoming populated more and more with people with multiple chronic conditions. It's taking us more time per patient and more visits per year to be able to serve that patient population."

Solo practices are also becoming less common. About 27 per cent had a solo practice in 2010 compared with 32 per cent in 2004.
Wired health care

At the same time, doctors are increasingly using electronic media and technology. About 39 per cent of respondents have electronic records, up 13 per cent since 2007.

More than half of family doctors, 55 per cent, and 44 per cent of specialists said they refer patients to websites to get information on diseases, treatments and patient support.

The survey also looked at how physicians are paid, professional development such as reading peer-reviewed journals, and time spent in on-call duties.

In 2009, Canada had about 68,000 active physicians working in the country, according to the Canadian Institute for Health Information. Just less than 18,000 physicians and medical students completed the 2010 survey.

The response rate raised questions for Dr. Mike Dillon, a family doctor who runs a clinic in Winnipeg. He wondered whether the survey paints an accurate picture.

"They don't really make a distinction between whether you have access to care in general versus what we see as more important, such as having ongoing relationships, especially in family medicine, with a primary care provider through the life cycle," said Dillon.