Dr. Danyaal Raza (Photo: John Major)
The family doctor shortage is one of the most pressing issues in Canadian health care. Data from OurCare led by Unity Health Toronto researchers and the largest pan-Canadian conversation about the future of primary care, showed the number of people across Canada without consistent access to a family doctor or nurse practitioner has risen from 4.5 million in 2019 to more than 6.5 million in 2023.
Dr. Danyaal Raza, a family physician at St. Michael’s Hospital, was recently appointed to a new role as the inaugural Primary Care & Health Policy Scholar at St. Michael’s Hospital’s Department of Family and Community Medicine. He’s a dedicated community family doctor with St. Michael’s Academic Family Health Team’s Sumac Creek Health Centre, and a passionate researcher and writer who focuses on health system reform and the effects of the commercial determinants of health.
We sat down with Dr. Raza to learn more about the work he will be doing to help address the primary care crisis.
What is the significance of this new appointment?
This is a new position, not just for our hospital network. No other hospital or family health team that has a dedicated scholar who is focused exclusively on both on primary care and knowledge translation [the process of shifting research into more practical use].
I think we’re at the point now where everyone across the country understands that the primary care system is in crisis. There are millions of people across the country who don’t have access to a primary care provider, a family doctor or a nurse practitioner, and it’s really time for some big, big changes. We know that if you want a high functioning health-care system, you have to have primary care at the cornerstone.
Especially in our department, we are lucky to have some amazing research generated by national and international health policy and health services research experts like Drs. Rick Glazier, Tara Kiran, Andrew Pinto and Archna Gupta. I think the challenge that all of us have, my research colleagues included, is taking this really high quality research and translating into policies that result in more people getting the care they need.
What are you hoping to accomplish in your first year?
We’re at a fork in the road, and the choices we make today will define primary care, I would argue, for the next 10 or 20 years – potentially even longer. These are crucial decisions and we need to choose wisely. I’m hoping to lift-up the choices that we want to make, and highlight changes we might want to avoid.
For example, we’re seeing an encroachment of investor ownership into primary care, including corporate ownership and even private equity investment firms. This financialization of primary care complicates what the bottom line is. Is it patients? Is it shareholders? Is it profit?I’ll be highlighting what the robust and growing body of evidence says on that question, and how we can apply it to the current crisis.
What primary care solutions and challenges would you like to focus on?
We have solutions proven in other countries with high quality primary care systems that work not only for patients, but the health care professionals who work in them. For example, scaling up team-based care and thinking about primary care like we think about a school board system. Closer to home, we should reforming care in a way that matches what Canadians want in their primary care system. Lucky us, we even have that articulated through the OurCare project, for care that’s not-for-profit, technologically integrated, and socially accountable.
Virtual care is also part of the solution. The COVID-19 pandemic accelerated is adoption, and now I use it as a routine part of my practice. It’s made care more convenient for patients, and it’s allowed me to do more with the time that I have.
One of the negative consequences of this this rapid acceleration, has been the rise of for-profit, walk-in style, virtual care clinics that don’t necessarily provide the highest quality of care, while also charging patients privately for care that you might otherwise reasonably expect would be covered by Medicare.
How long will you be in this role?
Up to four years. The longer term goal is to not just have one person doing this knowledge translation and policy work, but to institutionalize the role, build a team and to allow the work to continue beyond whatever window of funding that exists today.
By: Adam Miller
What impact do you believe the commercial determinants of health have on the primary care system, and how can we address these influences?
Archyde News Interview: Tackling Canada’s Family Doctor Crisis with Dr.Danyaal Raza
By Archys, News Editor, Archyde
Canada’s health care system is facing a critical challenge: a growing shortage of family doctors and nurse practitioners. According to recent data from OurCare, a pan-Canadian initiative led by Unity Health Toronto researchers, the number of Canadians without consistent access to primary care has surged from 4.5 million in 2019 to over 6.5 million in 2023.To delve deeper into this pressing issue, we sat down with Dr. Danyaal Raza, a family physician at St. Michael’s Hospital and the newly appointed Inaugural Primary Care & Health Policy scholar at St. Michael’s Department of Family and Community Medicine.
Archyde: Dr. Raza,thank you for joining us.Your new role is unique – can you explain its significance?
Dr. Raza: Thank you for having me.This role is groundbreaking because it’s the first of its kind in Canada. As the Primary Care & Health Policy scholar, my focus is twofold: advancing primary care research and translating that knowledge into actionable policies. Primary care is the backbone of a well-functioning health system, and this position allows me to bridge the gap between research and real-world solutions.
Archyde: The family doctor shortage has worsened considerably in recent years. What are the key factors driving this crisis?
Dr. Raza: There are several interconnected factors. First,we’re seeing an aging population,which increases the demand for care. Second, many family doctors are nearing retirement, and we’re not training enough new physicians to replace them. Third, the workload and administrative burdens in primary care can be overwhelming, leading to burnout among existing providers. there’s a geographic mismatch – many doctors are concentrated in urban areas, leaving rural and remote communities underserved.
Archyde: What solutions do you propose to address these challenges?
dr. Raza: We need a multi-pronged approach. First, we must expand medical school spots and residency programs specifically for family medicine. Second, we need to incentivize doctors to work in underserved areas through better funding, support systems, and work-life balance initiatives. Third, we should leverage team-based care models, where family doctors work alongside nurse practitioners, pharmacists, and social workers to share the workload and provide more thorough care. Lastly, we need to invest in technology, like telemedicine, to improve access, especially in remote areas.
Archyde: You’ve mentioned the importance of knowledge translation. How does your work contribute to this?
Dr. Raza: Knowledge translation is about turning research into practice. For example, my work focuses on health system reform and the commercial determinants of health – how industries like tobacco, alcohol, and fast food impact health outcomes. By studying these issues and advocating for evidence-based policies, we can create a system that not onyl treats illness but also prevents it.
Archyde: What role can the public play in addressing this crisis?
Dr. Raza: The public’s voice is crucial. Canadians need to advocate for better primary care by engaging with policymakers, participating in initiatives like OurCare, and supporting local health care providers. We also need to shift our mindset from viewing health care as a service we access only when we’re sick to seeing it as a continuous partnership with providers to maintain health and well-being.
Archyde: what message would you like to leave with our readers?
Dr. Raza: The family doctor shortage is a complex issue, but it’s not insurmountable. With collective effort – from policymakers, health care providers, and the public – we can build a system where every Canadian has access to the primary care they deserve. This is about more than just fixing a problem; it’s about ensuring a healthier future for all of us.
Dr. Danyaal Raza’s work exemplifies the dedication and innovation needed to address Canada’s health care challenges. As the Primary Care & Health Policy Scholar, he is poised to make a significant impact on the future of primary care in Canada. Stay tuned to Archyde for more updates on this critical issue.
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End of Interview
