When I was in family practice years ago in Peterborough, Ontario, the city and surrounding communities were well served with both family physicians and specialists. Hospital beds were nearly always accessible and waiting times for surgical procedures were not an issue. Time was set aside in the office each day for patients with issues that were considered urgent and, otherwise, appointments were given ‒ usually within a week. There were enough family doctors that the five doctors in our clinic always accepted new patients and never had a “closed” practice.
Medical information or advice was readily available from the family doctor or specialist. All family doctors had an answering service, thereby making the doctor on call available in the case of urgent problems on nights and weekends. Many family doctors even had evening office hours. Occasionally, a patient in the office would present an article from an issue of Reader’s Digest or similar publication related to their symptoms, diagnosis or treatment, asking questions regarding their particular situation.
Those days are gone. For many in both Canada and many other countries, access to such care is significantly reduced or delayed. Nurse practitioners and physician assistants are often the first attendants for medical problems and care. Waiting times for physician appointments and specialist care are often delayed and surgical procedure wait times are excessive. Hospital beds have not kept up with need. A recent report by OurCare survey ‒ led by Dr. Tara Kiran at Unity Health Toronto in partnership with the Canadian Medical Association ‒ showed that 5.9 million adults in Canada do not have a family doctor, nurse practitioner or primary care team whom they see regularly.
Where in the past, the majority of patients with medical issues were seen in a timely manner in the doctor’s office, the current excessive delays have prompted a surge in visits to the emergency room of the nearest hospital. This has increased the burden on available medical personnel and beds resulting in excessively long wait times, especially for non-urgent problems and sometimes to the detriment of the patient’s condition.
Because of both these changes and the advancement of technology allowing easy procurement of current information relating to symptoms, diagnoses and treatment protocols, most persons now have ready access to relevant information. There are a number of Artificial Intelligence (AI) platforms now available on the internet, the most common being ChatGPT. The websites can provide detailed information regarding the possible conditions which relate to one’s symptoms and when medical attention might be urgently indicated. If a diagnosis has already been made by one’s doctor, all of the information related to current appropriate investigation and treatment is listed, allowing the patient to more effectively benefit from future followup physician visits. Information including potential side-effects from any prescribed drug is also readily available.
A recent survey in Europe by the 2026 Edelman Trust Barometer found that 35% of people now use an AI platform for health questions, with 78% of those looking for treatment suggestions and 74% using AI to get a second opinion of a diagnosis. The increasing difficulty in getting timely care for many, including the millions in Canada without a family doctor, may cause access to such information and care to be critically delayed, often resulting in one turning to the internet for medical information. An example recently related to me by a former patient was that for three or four weeks she had been experiencing headaches and shooting pains in the right temple area. She had rarely had any headaches in the past and there was no relief provided by over-the-counter pain medication. She phoned her family doctor’s office and was given the first available appointment in three weeks. She turned to the internet, accessed her AI portal and listed her symptoms. When she found that her symptoms closely matched those of a condition she had never heard of known as temporal arteritis and that urgent attention was indicated, she promptly attended the hospital emergency department where she received confirmation of her suspicion and the urgent treatment she required.
In addition to the use of AI sources for medical assistance on the internet, there are many advertisements for telephone appointments with physicians. Such telephone encounters were initiated during the Covid pandemic and were partially covered by some provincial insurance plans, temporarily. Since that time, numerous such services are still available, but are uninsured under provincial benefits; charges are directed to the patient.
Even physicians are now using AI in their practices to assist in recording details of office examinations, as well as helping to make decisions regarding investigation choices, possible diagnoses and treatment protocols. Doctors in Canada have for a long time complained that paperwork and administrative duties take up too much of their time. Now, physicians are using software programs to listen to patient discussions, automatically transcribe information from those discussions and produce clinical information from the encounter, as well as their examination findings for their records. Using this and other software in their practices allows for more direct care of patients and less time spent on paperwork. In hospitals, resident physicians and specialists are increasingly using AI in assisting with possible diagnosis of a set of symptoms and signs, an appropriate list of investigations to confirm the condition and treatment protocols once the diagnosis has been made.
Using AI platforms for both patients and physicians must always be done in conjunction with traditional tools, wise judgment and trained health-care professionals. Internet platforms may misdirect an individual seeking medical information and advice and should only be used as a supplement to ‘hands on’ attention for medical care. When a diagnosis has been confirmed by your physician, having a thorough knowledge of your medical condition ‒ including appropriate investigation and treatments ‒ allows you to be well educated about the condition and the possible side-effects from treatment, making your subsequent medical encounters more useful.
In spite of the deficiencies that have resulted in reduced access to timely medical care, improvements in many areas have gradually been seen. The development of medical teams ‒ including nurses, dietitians, social workers, physiotherapists and other health-care professionals ‒ has increased the access to primary health care. Medical schools have increased their enrolment and many restrictions on foreign medical graduate entries have been lifted. More hospitals and hospital beds are being funded.
There is also the promise that AI platforms will prove to be a useful asset to both patients and medical personnel in improving access to both medical information and care.