By J. Edward Les, March 10, 2026
When it comes to Canada, the doctor is not in
Fully 18 per cent of Canadians – more than 7 million people – don’t have a family doctor, according to the latest Angus Reid survey. But even if you do have a family doctor, that doesn’t mean you have access to care when you need it: another 31 per cent of those surveyed – folks who do have family doctors –indicated that it’s difficult to get an appointment within a week. Most urgent medical concerns can’t wait a week, of course.
And so, it’s no wonder that record numbers of Canadians beat a path every day to impossibly overburdened walk-in clinics, urgent care centres, and emergency departments. Uncontrolled mass immigration to this country in the past ten years and an aging population certainly haven’t helped.
Add in the fact that emergency departments have become warehouses for people who are too sick to go home, but who can’t move to inpatient wards because there aren’t enough staffed beds (and because many of those inpatient beds are occupied by patients waiting in the queue for a woefully inadequate supply of long-term care spaces), and it’s not difficult to see how disasters like the case of 44-year-old Prashant Sreekumar can unfold; Sreekumar waited for eight hours with crushing chest pain in the waiting room of Edmonton’s Grey Nuns Community Hospital before collapsing and dying.
It’s become popular in my province of Alberta for fed-up citizens and healthcare providers to point fingers at Premier Danielle Smith’s United Conservative Party government for the Sreekumar tragedy and for the general awful state of healthcare affairs. But the fact is that the same conditions exist across the country, in every province and territory, irrespective of which stripe of government is in charge.
Look only to Alberta’s west, where British Columbia’s NDP has been in charge for almost nine years: hospital emergency rooms repeatedly close their doors in the face of staffing shortages (as many as 250 such closures in 2025 alone); similar shortages shut down inpatient pediatrics in Kelowna for six weeks last year; and the mass resignation of all seven Kamloops OB/GYN physicians from in-hospital care last fall in the face of impossible conditions left that region without meaningful specialist care.
And conditions in the rest of the country aren’t any better. We’re short of doctors, nurses, ancillary providers, hospitals, diagnostic equipment – pretty much everything (except for bureaucrats – we’ve got plenty of those).
And we’re short of common sense. Because if we had any, we wouldn’t subscribe to the insanity of doing the same things repeatedly while expecting different results.
The unvarnished truth is that our “cherished” Canadian healthcare system is on life support; and without urgent and meaningful intervention, it threatens to collapse entirely. It’s surely no accident that Canada is about to euthanize its 100,000th citizen through its euphemistically named Medical Assistance in Dying (MAiD) program; that’s more than the other 10 countries in which euthanasia is legal, combined. Those are wartime casualty numbers (42,000 Canadians were killed in the Second World War); but MAiD subscribers are being killed by doctors, not by enemy combatants on the battlefield. It’s certainly cheaper and easier to kill people than to supply appropriate support and care to those who are suffering.
Our system is in dire need of resuscitation. It’s doable, but it’ll take willpower, innovation, collaboration, the judicious application of funds, and an openness to upending the status quo.
Here are some suggestions:
First, double (at least) training spaces for doctors (and for nurses, sonographers and other ancillary healthcare workers). The best time to have done that was ten or fifteen years ago; but the next best time is now. And we need to look downstream and get to work creating more postgraduate training slots. Last year only 17 per cent of applicants to medical school gained admission; plenty of the other 83 per cent were perfectly well-qualified to begin training as doctors but were denied the opportunity to do so because there was no room. Many would-be doctors are being driven elsewhere to train, and many will never return. We need to fix that, now.
Second, immigration: we’ve finally begun to put some constraints on the untrammelled immigration of the Justin Trudeau years, but we also need to reform the Interim Federal Health Program, which provides better health benefits to non-citizen immigrants than to Canadian citizens: they enjoy free healthcare access plus 70 per cent coverage of vision, dental, and medication costs, at a cost of a billion dollars per year. That money should be reallocated toward improving the healthcare system for everyone.
Third, fund patients, not hospitals. Money shouldn’t be awarded lump-sum to hospitals in a way that frames each additional patient as a cost, but should instead follow each patient such that each additional patient represents revenue for hospitals, with those hospitals incentivized to compete for patient “business.”
Fourth, fix family medicine. For too long family medicine has been treated as a dumping ground within the system; and for too long family doctors have been buried by mountains of unpaid administrative work. It’s no wonder that so many of our top talents in medicine choose disciplines other than family practice, or that so many of our family doctors are burned out, or that so many of them opt out of providing the cradle-to-grave care we so desperately need. Family doctors are the quarterbacks of our system and should be valued and enabled as such.
Fifth, leverage virtual care. Whenever possible, a patient’s first contact with healthcare providers should be via virtual connection with a physician provider. During COVID-19, I and some colleagues launched a pediatric urgent care platform called Virtual Kids that allowed worried parents to connect directly with a pediatric emergency physician via videoconference; we attended to some 3,000 patients during the time in which we were up and running; and in more than 90 per cent of cases those visits began and ended in patients’ “living rooms.” No packing sick kids into car seats in the dead of winter and at all hours of the night, no spending hours in the ED swapping germs while waiting for care. Just expert advice delivered by videoconference, by seasoned doctors who knew what they were doing. That same model applied to more complex adult patients wouldn’t achieve a similar 90 per cent decant from emergent care; but initial virtual assessment by an MD would undoubtedly relieve some of the pressure on urgent care centres and emergency departments.
Sixth, incentivize well-equipped, state-of-the-art regional medical centres. Hospitals should be for inpatients, for emergency and trauma care, and for surgical procedures. Everything else should be migrated away from that hugely expensive setting to regional centres that house a collaborative mix of providers under one roof: family doctors, specialists, radiologists, nurse practitioners, pharmacists, physiotherapists, dieticians, social workers, and so on. A city the size of Calgary might have six such centres, for instance, pulling patients away from hospitals. And they can be built and operated under a private/public partnership model, with careful tracking of quality of care and economic metrics.
Seventh, optimize surgical capacity. There’s been focus in some jurisdictions – including Alberta – on contracting out procedures to privately run surgical facilities. Such facilities have their place, but we have state-of-the-art operating theatres that go dark every afternoon by 4 p.m. We should work to build out staffing so that those ORs can stay open until 11 p.m. each day, rather than rushing to build outside-of-hospital surgical suites at great expense.
Eighth, slash red tape. Canada has more healthcare bureaucrats per capita than other developed countries, but fewer staffed beds and less equipment per capita. We need to flip those metrics. Don’t get me wrong: all the efficiencies in the world won’t compensate for inadequate numbers of healthcare personnel and inadequate infrastructure. But top-heavy bureaucracy, in which folks get paid to meet, strangles innovation instead of fostering it.
Ninth, build new hospitals where we need them, and modernize the ones that we have. But let’s not get caught up in comparing staffed beds-per capita numbers from thirty years ago to the present-day. That’s comparing apples to oranges. Minimally invasive laparoscopic surgery, for example, allows patients to go home much earlier post-operatively than in the past; and women used to spend days in hospital post-partum, but now they mostly go home the next day. And it’s not just hospitals we need: the construction of long-term care centres to allow patients to move out of hospital beds is key to relieving emergency department gridlock.
Tenth, let’s learn from jurisdictions like the Netherlands and elsewhere that intelligently join public and private delivery of healthcare services. For too long we’ve been stymied by cries of “American-style healthcare!!” every time anyone proposes to inject private sector efficiencies into our system. Stop it, already: it’s childish and ill-informed. A good chunk of our system is already privately funded (drugs, vision care, most dental care, private MRIs); we should apply ourselves to learning how we can optimize private sector involvement without compromising universal healthcare coverage.
There are complexities to each of the ten items I’ve described; and it’s by no means an exhaustive list. Yet it’s a starting point for discussion and for meaningful action. We have to do something, because the status quo is leaving patients without the care they deserve, and in some cases killing them. As US President Ronald Reagan liked to say, with a smile on his face:
“Status quo, you know, is Latin for ‘the mess we’re in.’”
Our healthcare system is certainly a mess. But it’s nothing to smile about.
It’s high time we started cleaning it up.
About the author
Dr. J. Edward Les is a pediatric emergency physician in Calgary, clinical assistant professor at the Cumming School of Medicine, and author of Cloudy with a Risk of Children.
