As Canada’s aging population reaches unprecedented levels, there is growing evidence they will need more geriatric care. But a gap is widening between the services needed and what is available to Canadians.
Figures from Environics Analytics, a marketing and analytical services company, reveal the country’s senior population is projected to surpass 11 million by 2043. The data shows how the senior population as the fastest-growing age group in the country, and this surge in the number of Canadians aged 65 and older will further strain the country’s beleaguered health-care sector.
Geriatrician Shortage
Finding family doctors is already a struggle for many Canadians. To use one province as an example, 2.5 million of the Ontario’s residents don’t have access to a family doctor, according to the Ontario College of Family Physicians. A recent report from the C. D. Howe Institute estimated that filling today’s shortage would take 10 years.
Amina Jabbar, staff geriatrician at Trillium Health Partners in Toronto, estimates there are close to 300 geriatricians in the country, a paltry number compared to the specialists needed for Canada’s aging population. She adds that even if a family doctor can refer a patient to see a geriatrician, the wait list can be as long as 18 months.
“The more rural of an area you live in, the more difficult it will be to access a geriatrician,” she says, noting how a similar pattern exists for finding family doctors.
What’s to blame for this shortage? A paper from the National Institute of Ageing writes that geriatricians were traditionally some of the lowest paid specialists, until recently. “In addition, the lack of focus on geriatric medicine in medical school curricula as well as the insufficient number of residency training programs are also barriers,” the report says.
Costs can also play a role. A C.D. Howe report found that access to medical care is a key challenge for low-income seniors, noting how 15 per cent of seniors in Canada are not visiting a dentist and eight percent are not receiving the home care they need because they can’t afford it.
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When to Seek Geriatric Care
If accessing geriatric care specialists is such an obstacle, can’t family doctors provide the medical attention these seniors need? Not so fast, says Jabbar. “These doctors are so overburdened, and their breadth is so wide, and they have 15 minutes for each patient. So if a senior patient is coming to them with congestive failure, dementia, COPD, and another condition, these issues are complex, as are the interactions of various medications they may be ingesting, and so that’s where a geriatrician comes in.”
It goes without saying that older Canadians have more complicated conditions compared to younger patients, and physicians with a more generalist background may struggle to advise seniors, says Lisa McCarthy, a Toronto pharmacist and a professor of clinical pharmacy research at the University of Toronto.
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She is hopeful that some seniors can access care via virtual services, but the “compensation structure laid out for physicians, who get a much lower fee for telehealth appointments than they do for in-person visits, will continue to be a challenge going forward.”
Looking across Canada, Jabbar is optimistic Ontario and B.C. will be close to meeting the needs for senior patients, but she is less bullish on geriatric care specialists available in provinces such as Nova Scotia. “The East Coast has always had a tough time to retain physicians,” she adds.
If the waitlist for a geriatrician in your province is too long and you are able and willing to travel—and your budget allows it—clinics outside of your province may offer geriatric care, but you will have to pay out of pocket. Alternatively, if it’s not possible to find a geriatrician, look for a family doctor that has specific training in geriatric care. Of consideration for individuals with significant health challenges may also be retirement or long-term care homes that have a geriatrician on staff.
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