Promising quantities, disappointing distribution. Investigating the presence of French-speaking physicians in Ontario's rural Francophone communities

Abstract

Previous studies have suggested that there may be a lack of French language healthcare services in the province of Ontario. The purpose of this study was to determine if physicians in Ontario who expressed a proficiency in providing services in the French language are located in 'Francophone communities'. Responses from 10,968 Ontario-based family physicians (FPs) certified by the College of Family Physicians of Canada and uncertified general practitioners (GPs) who responded to the 2007 College of Physicians and Surgeons of Ontario Annual Membership Renewal Survey were analysed and compared to the 2006 census of the population of Ontario. Main outcome measures were the number of FP/GPs categorized by their language of competency to conduct medical practice and the number of people categorized by their first official language spoken. The physician-to-population ratio was then compared for different groups of communities in Ontario categorized by the degree of francophonie of the community: strong French communities, with a Francophone population ≥25%; moderate French communities, with a Francophone population of 10-24%; and weak/no French communities, with a Francophone population <10%. There are 5.6 French speaking FP/GPs for every 1000 Francophones in communities with a French population less than 10%. This ratio is considerably greater than what was found in moderate French communities (3.4 FP/GPs) and strong French (1.3 FP/GPs). Overall the lowest ratios were found in rural strong French communities both in southern and northern Ontario (0.8 FP/GPs and 0.9 FP/GPs respectively). The ratio for all of Ontario was 0.7-1.3. As the number of Francophones increases in a community, the availability of French-speaking FP/GPs actually decreases, particularly in rural northern Ontario. Furthermore, there is a paradoxical relationship between the potentially high number of FP/GPs in the province with French-language capabilities and the perceived deficiencies in the availability of French language medical services.