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Health If a specialist was required, a personal phone call was made to the specialist in cases where the family doctor felt that there was some urgency, and the response was usually immediate referral. In others, a written request for consultation resulted in a consultation within two to three weeks. Medicine has evolved over the past 60 years to a point at which the average life expectancy for Canadians has increased from age 71 to age 82. For those who have reached their 60s and are in good health, the life expectancy is beyond that. Much of this progress has been due to the advances in public health measures, including availability of numerous vaccines to prevent illnesses such as polio, measles, German measles, whooping cough, mumps, flu and shingles. The advances in laboratory testing, pharmacotherapy, imaging technology such as CAT scan, MRI and PET scan, and medical and surgical treatments have played a major role. In spite of these documented increases in the average life expectancy, the perception of the quality of care at the primary level has deteriorated for many. In Canada, statistics from Stats Canada reveal that there are now 4.5 million Canadians without a family doctor. For those individuals and families, their only access to primary medical care is through nurse practitioners, walk-in clinics or emergency rooms. While this may serve urgent needs satisfactorily, long-term preventive health measures, continuity of care, routine monitoring of chronic conditions, annual health assessments, updates on immunization and other benefits of long-term, single-source family doctor care are lacking. Patients are scrambling to get on waiting lists for a family doctor and trying every other way of signing up. Family doctors are setting limits on the number of patients for whom they want to be responsible and doctors are working fewer hours than decades ago, including the many female practitioners − most of whom have children to care for which necessarily limits their hours of practice. In Canada, two-thirds of family physicians under the age of 35 are female and more than half of all graduating physicians are female. Payment models available to family doctors have probably changed some services which we used to expect. For many years, the majority of family physicians were paid on a “fee for service” basis, i.e. they were paid according to a negotiated fee schedule listing every medical and surgical service, including family doctor office visits. Many payment models now provided by provincial governments pay a “capitation fee” per month for overall care of individuals, regardless of whether or not services are rendered. Extra payments are made for certain procedures, such as assistance at surgical operations. In some provinces, limits are placed on the available opportunities for family doctors to establish practices under these models. Some critics believe that the capitation payment method reduces the incentive to see patients regularly, while others believe that the fee-for-service method stimulates overuse of services. In response to the shortages, many communities are offering financial and other incentives in an attempt to woo physicians to their communities, but the shortage in available candidates just perpetuates the challenges of attracting new family doctors. But why are there too few family doctors, when statistics show that we are now training more physicians per capita than ever before? About half of graduating doctors become family physicians, the other half become specialists, GET OUT THERE FAMILY TIME The Closest accommodations to Bryce Canyon | rubysinn.com/CSASpring22 Take your time and enjoy the journey by coming to Ruby’s Inn at the gateway to Utah’s Bryce Canyon National Park. Life’s too short to just reach your destination, so reward yourself and come experience life Ruby’s way! • Hotel and Campground • Closest Accommodations to Bryce Canyon National Park • Just off Highway 89 for a perfect side trip • Midway point for Western US desintations CSANews | SPRING 2022 | 35

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