More than 1.2 million Ontarians travel 30 kilometres or more to see family doctor: study

A doctor holds files in this undated stock photo.

Nearly 13 per cent of people attached to a family physician in the province live more than 30 kilometres away from their general practitioner, according to a new study released Monday.

The study, published in the Canadian Medical Association Journal, tracked Ontario residents and the distance they travelled to see their family doctor, along with the associated health outcomes for patients.

The study looked at nearly 10 million Ontarians in urban and suburban settings who were enrolled with a family doctor as of March 31, 2023.

It found that about one in 10 lived more than 30 kilometres from their family physician and were, unsurprisingly, more likely to visit emergency departments for nonurgent issues.

“These patients had higher odds of being male, being younger than 65 years, having lower socioeconomic status, and being newcomers to Ontario,” the study read.

“They also had higher odds of visiting an emergency department, not seeing any family physician, not having continuity of care with their family physician or team, and not being screened for breast, colon, or cervical cancer.”

The study notes that, over the past decade, access to primary care has declined across the country, a development that was partly accelerated by the COVID-19 pandemic.

“Anecdotally, and perhaps as a result of the worsening workforce shortages in primary care, patients continue to stay connected to their family physicians, even after moving, which is a particular concern in the context of the vast geographic distances in Canada,” the study read.

Lead author Dr. Archna Gupta, a family doctor at St. Michael’s hospital and a scientist at the hospital’s Upstream Lab, said she was surprised to see the number of Ontarians who lack close access to their primary care provider.

“The fact that we see more emergency department use is not surprising, that we see less cancer screening is not surprising, that we see less continuity of care is not surprising,” she noted.

“But the biggest thing for me was just how many people, 12.7 per cent of the population, or over 1.2 million Ontarians, live greater than 30 kilometers away from their family doctor or the primary care team.”

Gupta said her research validates what she was experiencing at her own practice, which was the impetus for the study.

She said after taking over a practice at the hospital in 2022, she discovered many of her patients lived a significant distance away from Toronto’s downtown core.

“I started asking patients, you know, ‘You moved during COVID, or in the last few years, why are you still staying attached to a doc in Toronto when you live in Ottawa, or Collingwood, or Niagara Falls,’” she said.

“For many of them, it was simply that they couldn’t find a doctor locally, so having a doctor far away was better than having no doctor at all.”

She said this research also shows the primary care crisis extends beyond just an inability to get a family doctor.

“This research really shows that even if someone has a formal attachment to a family doctor, they still may have access issues because they live so far away,” Gupta added.

“We only looked at urban and suburban populations in the study. That doesn’t even include individuals who live in remote settings.”

The provincial government is investing $2.1 billion in its Primary Care Action Plan, which aims to connect all Ontario residents with a family doctor or primary care team by 2029. Former federal liberal health minister Jane Philpott was tapped last year to lead the new primary care action team.

Gupta said with the introduction of the Primary Care Act of 2025, the province has an opportunity to “revolutionize primary care in Ontario” by removing barriers to access, including distance.

“One way of doing that is by looking at geographical attachment, so similar to the school board district. If a child moved from one area to another, they’re guaranteed access within the school,” Gupta said.

“So can we model that in primary care? Can we create primary care districts so that if one moves, there’s the opportunity to attach to a primary care locally.”