Measure of linguistic access to family doctors
Research team
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PIL. Bjerre (U Ottawa)
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Co-IC. Bélanger (U Ottawa), P. Timony (Laurentian U), A. Gauthier (Laurentian U), A. Désilets (Société Santé en français), A. Bélizaire (Health Ontario East), G. Laferrière (Ministry of Health), J. Fitzsimon (U Ottawa), C. Peixoto (U Ottawa), L. Godfrey (Institut du Savoir Montfort).
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PartnersInstitut du Savoir Montfort, Department of Family Medicine, U Ottawa
Funding agency
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INSPIRE-PHC ($25,000)Period: 2024-2025
Summary
Context/Objectives—Providing care in the patient’s preferred language improves clinical outcomes and satisfaction. However, the ratio of French-speaking physicians to the French-speaking population, often used to estimate access, does not take into account the fact that French-speaking physicians also treat non-French speakers, placing French speakers in a competitive situation. We propose a new method to more fairly assess access to language-based care between groups.
Methodology – Using public data on the population (2021 Statistics Canada census) and family physicians (College of Physicians and Surgeons of Ontario, January 2024), we first calculated crude ratios of physicians per 1,000 people by language group. These ratios were then adjusted to account for competition between groups, considering the proportion of Francophone physicians serving the entire population. Finally, we estimated the probability of receiving care in the patient’s language, incorporating the size of medical groups, non-concordant care, and patients without access to care.
Results: At the provincial level, the gross ratio was 2.42 French-speaking physicians per 1,000 French speakers, but it fell to 0.09 after adjustment. Assuming that 84% of Ontarians have a family physician, an English speaker has a 100% chance of receiving care in their language, compared to only 11.4% for a French speaker. Anglophones are thus 8.8 times more likely to receive care in their language.
Conclusion: Traditional indicators overestimate Francophones’ access to French-language care. Our approach reveals a marked inequity and offers a more accurate tool for health resource planning, applicable to other minority language groups.