A new national report finds that 4.5 million Canadians who are middle aged and older have had trouble accessing specialist care — a problem that could only get worse as the country’s population ages.
The Statistics Canada findings published Wednesday break down who is experiencing roadblocks with the system and the toll it’s taking on their health. Experts say wait times for specialized care continue to get worse across the country, as the health-care system struggles to manage an aging population of people with complex conditions while dealing with a lack of family doctors, specialists and proper tools to prioritize patients.
“One of the biggest reasons why people can’t get access to specialist care is they don’t even have a primary care provider,” said Dr. Samir Sinha, a geriatrician and clinician scientist at Sinai Health and Toronto’s University Health Network. He was not part of the Statistics Canada report.
The report, which used 2024 survey data, is representative of 17.2 million Canadians aged 45 years and older. It found that 6.6 million people used specialist care, most commonly for a skin condition, urological or gynecological issue or an orthopedic condition.
A majority of those referred to specialists, 4.5 million people, couldn’t easily book an appointment or waited months for the visit.
Meanwhile, 2.9 million people had unmet health-care needs, meaning they didn’t have treatment for a new physical or mental condition or couldn’t access proper injury care.
Millions waiting in B.C.
The situation is dire in British Columbia, which had the highest percentage of middle aged (35.9 per cent) and older (29.2 per cent) Canadians who struggled getting specialist care, according to Statistics Canada.
B.C. neurologist Dr. Robert Carruthers says the province has 1.2 million people waiting for a specialist — a number that’s only been growing. He says just last year, the province saw a 10 per cent increase in those needing special care.
“Our population has grown rapidly by about a million over the last decade and our system just hasn’t kept up with it,” said Carruthers, who is also the president of Consultant Specialist B.C., which advocates for access to specialist care in the province.
He said many specialists are starting to close their waitlists to non-urgent referrals.
Family doctor Birinder Narang in B.C. points to a variety of causes, including not having enough specialists and outdated systems.
For example, he said when he has to fax over a referral, “there’s a chance it won’t get there.” He said that according to estimates by the Provincial Health Services Authority, the B.C. agency responsible for improving the health-care system, 10 per cent of referrals fail because of the technology, while 33 per cent fail because they didn’t go to the right specialist or weren’t filled out with the proper form.
“So we’re talking about millions of transaction referrals in the system that are uncertain,” he said.
One way to fix this problem is to digitize the process, which he says has already started.
The latest Statistics Can data found that after B.C., people living in Quebec and Newfoundland and Labrador were more likely to have a hard time accessing care.
About one-third waited three months or less
According to the report, 31 per cent of people 45 to 64 years old and 30.9 per cent of people 65 and older, waited less than three months between their referral and first consultation with a specialist.
But that’s not the case for everyone — about seven per cent of middle-aged adults and five per cent of older adults waited one year or more. Pat Fulton, in Calgary, is one of them.
The 72-year-old says she’s been told it could take between 20 to 24 months for her to see a specialist after finding out that both of her hips are riddled with arthritis.
“Two years is a long time just for the consultation,” she said.
“When you have a sore hip, you compensate using your other muscles, so your back can get sore, your knees can get sore.”
She’s been waiting since May and says she’s considered paying partly out of pocket to get care at a private clinic.
Stress, poor health affect waiting patients
Without timely access to care, experts agreed that patient health is at risk of getting worse. The Statistics Canada report found that the wait time mostly caused worry, anxiety or stress.
But for others it led to worsening pain, issues with daily activities and deteriorated their overall health.
Sinha in Toronto has seen firsthand the impact that delays have on patients. He said he had an older patient who had advanced psoriatic arthritis, which involves pain and inflammation around the joints.
“This is actually a very highly treatable condition, but by the time we got her the referral to a rheumatologist in the hospital they basically said she needed to be started on treatment 10 years ago,” he said.
The patient not having a family doctor and a long wait time for the referral were partly to blame, says Sinha.
One of the biggest challenges for health-care providers, says Sinha, is there’s no way to easily know what the wait times are.
“It’s hard for anybody … to actually know what the waits are and how to get people equitably to see the right person in the right amount of time,” he said.
In some countries, Sinha says health-care providers can review specialist availability through a central, digitized system — something he thinks could be helpful in Canada.
Quebec’s medical specialists signed a new deal with the province last April. But has that agreement stopped their departure from Quebec? Quebec has 44 practicing cardiac surgeons, and according to Dr. Louis Perrault, president of the Association of Cardiovascular and Thoracic Surgeons of Quebec, that number is lower than it should be — and its affecting the surgery backlog.
