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Young adults struggle to find steady family doctor

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Date: Thursday Aug. 12, 2010 1:13 PM ET

TORONTO — Melodie Cardin has spent years visiting different doctors to try to find relief from her recurrent tonsillitis.

It's not because she wanted a second or third opinion -- it's because she doesn't have a steady family doctor.

Cardin, 24, has been without a family doctor for nine years, ever since her family moved to Quebec from British Columbia.

She had access to a pool of doctors when she was a student at Carleton University in Ottawa but, like all others who graduate, was no longer allowed to see them once she stopped writing a tuition cheque.

Cardin, who still lives in Ottawa, and thousands of other young people in Canada spend years hopping from one walk-in clinic to another, describing their problems to the first available doctor. That doctor does not know their medical history, and doesn't have a full picture of their overall health.

Young people move to new cities more frequently, or simply outgrow their pediatrician and are left hanging because of a nationwide family doctor shortage, a spokeswoman for the Canadian Medical Association said.

Cardin said she thinks a stable family doctor would be more likely to get to the bottom of the cause of her tonsillitis, and not simply prescribe medication for each flare-up as if it were an isolated incident.

"They don't have any history, so it's very hard to put your ailments into a context," she said.

"I think it's one of those situations where having someone consistent makes all the difference."

The College of Family Physicians of Canada said people between the ages of 18 and 34 are least likely to have a family doctor, compared to people in other age groups.

A Harris-Decima poll conducted for the college last fall found that of 1,011 people polled, 22 per cent of respondents age 25 to 34 did not have a family doctor.

It's a big difference compared to baby boomers between the ages of 55 and 64. Only six per cent of that demographic is without a family physician.

Dr. Cal Gutkin, executive director of the college, said that aside from the doctor shortage, another explanation is that some, especially young men, think a walk-in clinic is enough because they see themselves as generally healthy and only go to a doctor when they are feeling sick.

He said people with that mentality miss out on a doctor's advice that can help them prevent diseases before it is too late.

"What walk-in clinics don't provide is someone who gets to know you and provides continuity of care over time for different kinds of problems," said Gutkin.

He said young people are particularly susceptible to diseases caused by poor nutrition or substance abuse. One example is the increasing incidence of diabetes among people in the age group.

Gutkin said emotional and mental health problems are likelier to appear in young people, and family doctors are especially important in helping pinpoint issues.

"Oftentimes stressed individuals in those age groups are trying to cope in their lives (and that) is a challenge for them, and it is a challenge that could be addressed much more successfully if they had a family physician who they know and trust and they can see over time," Gutkin said.

With the doctor shortage, which Gutkin said was caused by cuts in medical school spaces in the 1990s, sometimes even those who desperately want a doctor end up out of luck.

Noura Hassan has been looking for a family doctor for most of her life.

The 21-year-old McGill University medical student said her physician died in her hometown of Chicoutimi when she was a young girl, and she's been unable to find a new doctor since.

A few times she's called clinics that advertise they are accepting patients, only to be told she wasn't quick enough and the clinic was already full.

She goes to student walk-in clinics or family members who just happen to be doctors, but is predicting a huge problem once she graduates and no longer has access to those resources. She says she wants a family doctor to monitor her and her baby when she wants to start a family.

Hassan is thinking about specializing in obstetrics or gynecology, but admits she doesn't really know much about family medicine. She says it is time for a checkup on attitudes and curriculum at some Canadian medical schools, where some students see family medicine as a backup plan, and not a good first choice.

"In all honesty, I feel my medical school didn't expose me to family medicine early in my career-making progress, so I don't know what to expect from that career," she said.

"This is a problem that is so deep-rooted in the way physicians are being trained that it's going to take a lot to change that trend."

Gutkin said the majority of Canadian medical schools have started exposing students to family medicine earlier, some in the first year.

But while those medical students work their way through school, people like Cardin continue to wait.

She's since turned to homeopathy, at first simply because the clinic was accepting patients.

She said she's found relief from debilitating headaches after the naturopath had her tested for allergies and she cut certain foods from her diet.

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