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www.oakvillebeaver.com The Oakville Beaver Weekend, Saturday November 24, 2007 - 29 Searching for a doc? Stand in line By David Lea OAKVILLE BEAVER STAFF I s there a doctor in the house? This is a question more and more people in Oakville may soon start asking as their family physicians retire or move out of the area. DOC+OR IN THE HOUSE? Although the College of Physicians and Surgeons of Ontario stated in a 2006 report that it had licensed a record 2,961 physicians to practice in the province, it also reported that the number of family doctors accepting new patients continued to plummet with the 2006 statistic falling to only 9.6 percent. Oakville has not proven immune to this trend with the Doctor Search portion of the CPSO website showing only nine Oakville physicians accepting new patients and of these only five physicians confirmed this data. The others said the website was out of date. Stella Mousseau and her husband Bernie, who have resided in Oakville for around 14 years, became victims of this doctor shortage for four years when their existing family doctor retired in 2003. "This guy didn't have anyone to refer his patients to," said Stella. "So, that left us kind of out on a limb." A bout of pneumonia a year later sent Bernie to the emergency room at OakvilleTrafalgar Memorial Hospital (OTMH) after which he was advised to have his family doctor follow up on his condition. However, the Mousseaus soon found out that getting a family doctor in Oakville to take you on as patient is not so easy. "Bernie went in there and he was given this questionnaire that had all kinds of questions about how much money you've got and things that had nothing to do with your health," said Stella. "Then the doctor talked to him for a while and Bernie is the kind of guy who talks too much sometimes when he's nervous. So, I guess the doctor decided he couldn't deal with him and wouldn't even give him a checkup." The Mousseaus tried finding other doctors, but every time a friend or relative would tell them of a doctor who was accepting patients they would make the trip only to find that he or she was not. A period of concern followed where Stella and Bernie were reluctant to continue shopping for a family doctor fearing they would fail the interview process. "If I only knew what it is they were looking for. When we got an interview with a new doctor we were scared of what to tell her. Things like, we didn't have children," said Stella. "Maybe they don't like people without children. There's stuff you're holding back because you're scared they're going to get rid of you if they find out. They need to know these things, but you're scared to death to tell them because you don't want to be rejected." The alternative, a walk-in clinic, where Stella would eventually go to deal with a kidney stone, was effective, but still lacked the familiarity and the regular check-ups that come with a family doctor. "You should be having mammograms and blood tests done every year, but you don't because you can't find a doctor," she said. IS THERE A LIESA KORTMANN / OAKVILLE BEAVER FIRST LINE OF DEFENSE: Without a family doctor, some people miss regular routine checkups that could diagnose a problem before it becomes serious and requires intensive medical attention. After four years without a doctor Stella and "Physicians aren't obligated to take anyone Bernie started shopping around for one again on." eventually finding one accepting patients. The reasons for this important power being Stella says this happened not a moment too left in the hands of the family physicians are soon. many as some doctors choose to focus their "There's certain conditions we have that practice on a particular area of medicine and as probably should have been diagnosed a lot such may have to turn away patients presentsooner. Just high cholesterol and it's not super ing conditions they have no experience in serious, but we've been working on it ever treating. since," said Stella. Other doctors may have a large number of "It's scary because until you have a doctor high maintenance patients and therefore may tell you, you don't really think about it." be reluctant to take on more patients with With so few doctors accepting patients it chronic health problems who they know will may seem unthinkable that a family doctor require more time than they have. could reject a potential patient based on a simThe same day one of these doctors rejects a ple personality conflict, however this is the high maintenance patient they may accept a doctor's right. young healthy patient because they know that "Whether or not a physician accepts a new person will not be in that often. patient is up to them," said Kathryn Clarke, "I really believe that doctors have the right Senior Communications Coordinator with the to select patients just as patients have the right Ontario College of Physicians and Surgeons. to select doctors," said Dr. Ted Jacobson of Oakville. "I'm not saying there are loads of them out there, but there are drug seekers and there are all sorts of people out there that you may not particularly want as your patients." Jacobson is also a firm believer in the right of doctors to decide when and if they are accepting new patients. "It's wrong for a doctor to take on lots of new patients when he or she is already full because then you just make it more difficult for people to get in to see you," he said. Clarke had a similar view noting that different family doctors have different time constraints and therefore must be able to decide for themselves how many patients they can take on. "It's at their discretion because it depends what else they are doing in their professional life," she said. "You can have a physician who is raising children and only wants to work four days a week, not five, or you can have a physician who is also teaching and can only devote three days to their practice rather than five." Working on research projects or dividing their time between family medicine and shifts in the local emergency room are other factors that could limit a doctor's ability to take on patients. "It's up to the professional to decide what is an appropriate number of patients to have within his or her practice so that they can be providing good care," said Clarke. While the College of Physicians and Surgeons of Ontario (CPS)) respects the family doctor's right to choose who and how many patients they serve, that does not stop them from issuing some friendly advice from time to time. In the November/December 2005 issue of Dialogue, the CPSO's magazine, the college printed an article entitled Initial Patient Interviews in which family physicians are encouraged not to fill their practice with patients who have few, if any, health problems. The article notes to do so may not only result in legal action against the physician, but may serve to weaken the health care system. "Physicians should be aware that refusing patients based on factors such as age and disability without a valid reason could violate the Ontario Human Rights Code's prohibition on discrimination," the article reads. "Furthermore, if a significant number of physicians were to start accepting only healthy, young, low-maintenance patients, the very people who are most in need of medical care would find their access to care systemically cut off." In another portion of the article the CPSO announced its disturbance at becoming aware of patient intake surveys, which asks questions the CPSO says, `have little or no apparent relevance to health care or practice management issues, and appear prejudicial.' These questions included: Does the prospective patient have a criminal record? Has the patient ever lodged a complaint with the CPSO? Has the patient ever been involved in a WSIB (Workplace Safety and Insurance Board) claim? "Screening patients based on their responses to such questions, and for other similar reasons (e.g., questions related to ethnicity or income level), could unjustifiably exclude large groups of people from care," states the article. "This could provoke human rights complaints, and may cause the public to perceive physicians in a negative light."