Dear reader,
The ballparks of Cactus League baseball are spread out across the Arizona desert, and Uber is the most efficient way to get around. I was there last March with two friends, and our conversations with those drivers made it apparent that, aside from Drake and politeness, Canada is best known for its “free” health care. “Must be nice,” I heard more than once. I’d nod and change the subject, unwilling to burst their shimmering bubble.
The truth would have taken too long to explain. But here’s how I would have started: in Toronto, a city of three million people, 516,000 of us are without a primary care doctor. That’s one in six, an outrageous statistic that would have Tommy Douglas spinning in his grave.
When our medical system works, it goes something like this. You’re a woman nearing 40, and you notice an odd pain in your chest. You call your doctor’s office, book an appointment—a couple of days later, tops—and are soon in front of your doctor, whom you trust and who knows your medical history and the prescriptions you take. You explain your symptoms, and they refer you for a mammogram. If it’s worrisome, you get booked for a biopsy and sent to see a breast cancer specialist. From symptom to treatment plan in a few weeks.
That’s the gold standard. An even better option is preventative health care, which means you have regular check-ups where you’re screened for risk factors as you age: diabetes blood work at 40, breast and colon cancer at 50, and so on. You catch problems before they start. Let’s call that the platinum standard.
Unfortunately, Nadine McKenzie experienced neither standard. A mother of two living in Ajax, she’d been waiting six years for a family doctor by the time she noticed an unusual pain in her right breast in 2022. She then spent three maddening, desperate weeks trying to see a walk-in doctor. Fed up, she went to the ER and waited. Eventually, the doctor on call assessed her, and a cancer specialist later delivered the devastating news: she had Stage 4 breast cancer that had already spread to her lungs.
After undergoing 13 rounds of chemotherapy plus immunotherapy, McKenzie is now considered stable, but her long-term prognosis isn’t good. As she says in our cover story, “Dying for a Doctor”: “[My doctors] say there’s only a 26 per cent chance I will still be alive in five years, but they’re not God.”
It’s easy to pin the blame on family doctors. If there were more of them, these systemic problems wouldn’t exist. Maybe. But the provincial brain trust has made family medicine so unattractive that prospective doctors tend to run, not walk, away. Operating your own clinic requires the skill set of a small business owner, which medical grads simply don’t have. And contrary to the popular stereotype of doctors raking in money, a fee-for-service family doctor gets paid just $37.95 per patient, no matter the complexity. To make the finances work, these grads, already mired in student debt, are compelled to keep overhead low and work around the clock. The rate of burnout naturally soars.
As our feature demonstrates in painful detail, doctors and patients are bound together in frustration. If there’s a silver lining, it’s that Canada, as I learned in Arizona, is still known for its world-class universal health care system. It’s not too late for us to once again live up to that reputation.
