When Alies Maybee’s abdominal pain became so severe she started weeping, her first instinct was to call her family doctor.
But when she called, all she heard was an automated voice message. It told her to go to the emergency room.
“It was a bit discouraging but the pain was so bad I just wanted to have some kind of relief,” said the 66-year-old Torontonian. “I don’t like to go to the emergency department unless I absolutely have to.”
Across Canada, nearly one in five patients who visited an emergency room did so for conditions that could have been treated by a family physician or at a clinic, according to a new report from the Canadian Institute for Health Information (CIHI).
Of the 7 million cases analyzed, 1.4 million could have been better treated at a family practice or clinic, the study found. There were about 17 million visits to emergency departments in Canada from April 2013 to March 2014, according to the institute.
“To me, the most important system issue is people’s access to family physicians,” said Dr. Howard Ovens, director of the Schwartz/Reisman Emergency Centre at Mount Sinai Hospital.
In the past two years, more patients have told Ovens they are on months-long waiting lists for family doctors, he said.
“I think they expect more from the healthcare system, and they recognize the emergency department as an entry point for many of these treatable, more acute conditions,” said Ovens.
Regardless, the bottom line is still that patients should come to the emergency room if they think they need to, he said.
Ovens said that in his three decades at Mount Sinai, there hasn’t been much change in the percentage of patients coming in with conditions that could have been treated elsewhere.
Sore throats, colds and the flu are among the top reasons for potentially avoidable visits, according to the report. Some people come into the emergency department to fill repeat prescriptions, said a CIHI representative.
Nearly half of all respondents in a CIHI study said they can’t get in to see their family doctor in a timely manner. Some experts recommend family doctors offer better availability on evenings and weekends.
To unclog emergency departments and improve patient care, Sholom Glouberman, president of Patients Canada, said more government resources should go toward community-based healthcare.
“Our extra-institutional services are crap in Canada,” he said. “The vicious cycle in Canada is that because we don’t have services in the community, people are forced into the emergency room.”
Funding for emergency rooms is then taken out of community services such as preventative healthcare programs and public health education, he said.
Glouberman said CIHI’s figures actually sound low; he expects that the proportion of emergency room patients who should be seeing a family doctor instead is more than one in five.
Infants and children under the age of 5 have the highest rate of preventable emergency room visits, according to the study.
The study looked at emergency room patients who did not need a hospital bed at hospitals in Ontario, Alberta, the Yukon, Saskatchewan, Nova Scotia and P.E.I., between April 2013 and March 2014.