Canada’s healthcare system is on the brink of transformation as experts and policymakers navigate the challenges of an aging population and a growing shortage of family doctors. Steven Lewis, an adjunct professor of health policy at Simon Fraser University, has highlighted that “organized medicine is at a fork in the road in this conversation.” Lewis’s 45 years as a health policy analyst and researcher in Saskatchewan show no one better understands the province’s pioneering role in advancing universal medicare healthcare. As Canada faces unprecedented pressure on their publicly funded and administered healthcare system, the need for fast, flexible and collaborative solutions is vital.
Our Canada Health Act has been remarkably successful, surviving 40 years without amendment. It provides all Canadian residents universal, comprehensive coverage for medically necessary hospital and physician services—meaning Canadians don’t pay out-of-pocket or hold private insurance for these services. This neighborhood framework is quickly becoming a relic, as Lewis noted, “as relic as corded rotary phones.” The Act misses the mark by omitting cornerstones of supportive services as rehabilitation, occupational therapy, etc. This huge oversight creates dangerous gaps in the system that urgently need to be filled. Almost one in five Canadians is now 65 years or older. To add salt to that wound, nearly 6.5 million Canadians can’t find a family doctor.
The Need for Change
Under the Canada Health Act Services Policy, provincial or territorial health care plans are required to cover services that are considered medically necessary. This goes for care provided by physicians, as well as other “physician-equivalent” practitioners like nurse practitioners. This policy change is scheduled to go into effect on April 1, 2026. Nova Scotia recently committed to providing public funding for therapy as a treatment option for patients with mood and anxiety disorders. This program is a huge leap for them to be the first province with universal mental health care.
Steven Lewis underscores the irony in the current situation: “So, the irony is that governments provide insurance for these other services that governments deny to large swaths of the population.” This unprecedented and increasing demand means we need nothing short of a revolution in how we provide care. This amendment is even more imperative in light of today’s shortage of family doctors to fill the gaps.
Embracing Multi-Disciplinary Teams
Dr. Dominik Nowak emphasizes the importance of comprehensive medical training: “When I think of physician-equivalent, it’s someone who has gone to medical school, has done the years of training, the thousands of hours of expertise and experience that it takes to tell a sore throat from a peritonsillar abscess or a regular headache from a serious health emergency like temporal arteritis.” The real challenge is making sure that patients are diagnosed correctly and specifically treated, something that is only possible with years of training and experience.
Perhaps the answer is providing care in a more effective, team-based model. Dr. Nowak promotes the creation of multi-disciplinary teams in family practice as the way to effectively scale access to doctors. He asserts, “The way we scale access to a doctor is by building out (multi-disciplinary) teams in family practice,” rather than “siloing out health professionals and expanding the scope of health professionals by themselves.”
Dr. Alykhan Abdulla supports this approach, stating, “You can set up the model anyway you want.” The key is ensuring that patients receive oversight, comprehensive care, and are connected with the right healthcare professional at the right time.
The Potential Impact
The team model allows deeper collaboration among the team in a richly publicly funded environment. It convenes a family physician or nurse practitioner, and this model has the support of both Steven Lewis and Dr. Abdulla. By taking advantage of the skills of multiple healthcare professionals in this model, we could significantly shorten wait times and improve patient outcomes. Dr. Abdulla points out that skilled professionals can make a significant difference: “You just want to make sure that people get oversight, and they get comprehensive care, and they end up with the right person at the right time.”
Overcoming the healthcare problems we’re all facing today starts with a change in approach. As Lewis notes, “a whole lot of people do not actually benefit a lot if they only see a doctor.” By fully utilizing all healthcare providers within team-based models, Canadians would be able to access more timely, effective care.
