Access to General Practitioners in Metro Vancouver

We analyzed the relationship between general practitioners accepting new patients and the median incomes of municipalities within Metro Vancouver. We also addressed the potential impact population size of a municipality may have on the availability of general practitioners accepting new patients. 

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Though the maps show that there are less GPs in areas with lower population sizes, this does not necessarily mean there is an inequity of GP distribution. It makes sense that there are more GPs in areas with more people, as there would be a higher demand for them. Further research would have to be done to see if suburban areas (low population areas) have a higher demand for GPs compared to urban areas.

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Implications 

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Our results showed that there is a need for new family doctors with practices in Delta, the District of North Vancouver, and in the Township of Langley. A lack of doctors accepting new patients in one's home municipality will likely require individuals to travel out of their municipality in order to find a GP accepting patients. Walk-in clinics provide patients with primary care, but patients are less likely to make frequent visits. Since adherence to seeing a doctor seems to be associated with the subjective experiences a patient has when visiting a doctor, factors such as familiarity with the doctor may affect whether a patient would go for check ups at a doctor when they are further away to get to.  

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Currently British Columbia only has one medical school. This can severely restrain the province's capacity for replacing older doctors who are now retiring. The urgency for new family doctors is highlighted since young doctors are choosing to specialize rather than take on a general practice. This is due to perceptions that general practice would entail long work hours with low pay. Not only does this deter medical students from pursuing general practice, but may also discourage young family doctors from working long hours. The consequence of this may be that fewer patients will be served and in turn, discouraging patients from booking appointments to see a doctor due to long wait times. This presents a public health problem where primary care is no longer able to serve the population when as they need it.

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Limitations

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During our search for GPs accepting new patients, we found that some available GPs worked in the same office building. So when we geocoded the offices on to the map, some white dots were overlapping each other, under reporting the number of available GPs in the municipality. To address these overlapping points, we added a table to the map to list how many different GP there were in each municipality.

 

We also had problems geocoding the locations of the GP offices. when we ran the addresses through the website, around five addresses were not accurate. An address along Marine Drive, North Vancouver got geocoded into a place in Port Alice. To ensure we had the correct points we cross checked each point in our list to the geocoded results. For addresses that were geocoded incorrectly, we used Google Maps to search for the address of buildings or stores that were next to the GP office. 

 

Another limitation is that the list on the BC College of Physicians website may be out of date. This affects the accuracy of our data for making analysis and recommendations as the data may be over- or under-represented. To solve this problem, we could have called each office to inquire if they were accepting new patients, but that would have taken too much time for this project.

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We wanted to do our map based on dissemination areas of Metro Vancouver but as we were looking for data, we could not find median income information by DAs so we chose to do it by municipality instead.

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Challenges

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We attempted to generate a kernel density analysis but were unable to due to unknown reasons. Here, we hypothesized that the kernel analysis would have provided a visual on the distance that people would have to travel to reach a GP. This would have produced an estimate on access to GPs. 

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Alternative approaches 

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We had originally intended to use a Gravity Model to capture a more realistic account of the convenience of accessing GPs. The gravity model takes into account population density and supply and demand. It would have shown a more realistic account of potential access by assuming people would travel across artificial boundaries. In other words, the gravity model takes into account the possibility that people would travel across municipalities to get to a GP.

 

Other considerations include how we should have been more diligent when tracking our methods and progress as we were going along. It would have saved us time when writing this report so we wouldn't have to keep going back and forth. For the next project, we will know the benefits of keeping our procedures and files organized.

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