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opinion: digital solutions can transform hormone healthcare access in canada

providers must embrace a more holistic and patient-centered approach to hormone health care, and telehealth can help.

by hira siddiqui, hormonal health advocate, co-founder and coo of science and humans

jul 22 2024
read time 5 minute read
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access to care isn't easy for everyone, but telehealth can bridge those gaps to provide more equitable and patient-centred care. getty images

about 22 per cent of the canadian adult population does not currently have a family doctor, and the government anticipates a shortage of 78,000 doctors by 2031 and 117,600 nurses by 2030.

this general state of canada’s healthcare workforce is consistently at the forefront of headlines, and although it is a significant cause for concern, these headlines conceal a true crisis the country faces in accessing hormone healthcare.
in urban centres like toronto and vancouver, patients are likely to have easier access to specialized hormone health services but still face significant wait times. on average, it will take 14.6 months for a patient to receive a referral from a general practitioner and 13.1 additional months to receive treatment.
in rural and remote areas where healthcare infrastructure is significantly underdeveloped in comparison, patients have no choice but to travel long distances and accept the additional financial burden and delays in treatment associated with receiving adequate care.
a portion of the population most significantly impacted by a lack of trained hormone health specialists are women facing menopause and experiencing debilitating symptoms that challenge each aspect of their day-to-day lives.

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doctors who have received specialized training in menopause are few and far between. this results in even longer waiting lists to receive a consultation from a specialist, and a lack of widespread expertise means many general physicians find it challenging to preemptively discuss menopausal symptoms with their patients. canadian women can struggle to find primary care providers with enough expertise to both understand and feel comfortable prescribing menopausal hormone therapy (mht) as their quality of life is affected.

impact on patient outcomes

the disparities in access to hormone health care significantly impact patient outcomes. prolonged wait times can lead to the progression of untreated conditions that require more intensive and costly treatments.
common health concerns facing both men and women are thyroid disorders (hyper- or hypothyroidism) that can cause heart disease and compromise bone health, while adrenal disorders can cause chronic fatigue, muscle weakness, and metabolic disturbances.
hypogonadism – significantly low testosterone levels in men – can lead to infertility, osteoporosis, cardiovascular disease, and metabolic syndrome, while unmanaged menopause for women can lead to osteoporosis, cardiovascular disease, and severe mood disorders.

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importantly, compromised hormone health at any level can exacerbate depression, anxiety, and other mental health conditions. the negative impact on canadians’ ability to work, manage relationships, and attend to their day-to-day lives becomes immeasurable.
in rural and remote areas specifically, the longer wait times and travel burdens can discourage patients from seeking necessary care, further exacerbating health inequities. this is particularly concerning for vulnerable populations, such as older adults and those with limited mobility or financial resources. for these individuals, the barriers to accessing timely hormone health care can become insurmountable.

telehealth: a solution for equitable care

one promising approach to addressing the hormone health care crisis is the integration of telehealth services into the healthcare system, which allows practitioners to provide care over digital platforms. by leveraging technology, providers can offer virtual consultations, remote monitoring, and timely follow-ups at the patient’s convenience, ensuring they receive the care they need without unnecessary delays.
telehealth can streamline the referral process, improve access to specialized care, and alleviate the burden of travel for patients in remote areas by allowing general practitioners to collaborate more effectively with specialists and provide comprehensive care plans tailored to individual patient needs. this approach improves patient outcomes and enhances the efficiency of the system by reducing the strain on overburdened clinics and hospitals.

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by expanding the integration and reach of telehealth in canada, many barriers to adequate care are removed, enabling the healthcare system to become significantly more equitable.

breaking the stigma and focusing on prevention

in addition to improving access to care, it is essential to address the social stigma surrounding hormone health. symptoms caused by menopause are often overlooked or diminished by both the general population and general practitioners, leading to underdiagnosis and undertreatment. by raising awareness and promoting education around hormone health, more individuals will be encouraged to seek consultation, while more practitioners will be encouraged to seek specialized training.
a shift towards preventative health measures, including routine hormone testing, check-ups, and early intervention, can help mitigate the progression of hormone-related conditions. this proactive approach improves patient health outcomes and reduces the long-term costs associated with chronic disease management. educating both patients and practitioners about the importance of hormone health will help canadians feel empowered to seek care rather than accept their reduced quality of life.

policy and systemic changes

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to effectively address the crisis in specialized hormone healthcare access, systemic changes are needed at both the policy and practice levels. there has been remarkable success in integrating primary care and mental health services with the digital health space, leading to improved patient outcomes and compliance. leveraging successful case studies, policymakers and practitioners need to advocate for digital specialty care services to expand to include hormone health. at the same time, insurance companies, brokers, and stakeholders in the payer market must make the change to integrate critical hormone care services into their policies and coverage plans.
these steps forward will significantly enhance clinical outcomes by increasing continuity of care, ease of accessibility, and significantly reducing the financial burden on patients.
as a result, canadians will see a reduction in workplace absenteeism, boosted productivity, and enhanced quality of life by improving cognitive function, bone health, and muscle strength. for women in particular, these improvements can lead to a significant reduction in employee turnover and disability claims as roughly one-quarter of the 19-million-canadian workforce are women over the age of 40, with 10 per cent of these women being forced out of the workplace because their menopause symptoms are debilitating.

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in addition to the expanded integration and use of telehealth, healthcare systems should more widely promote a base level of training in specialized hormone care while providing incentives for medical professionals to work in rural and underserved areas to improve accessibility and equity for all canadians.
by working together, providers and policymakers can create a more inclusive and efficient system that values effective hormone health care. the ripple effect of benefits will be felt not only across the working population but within each micro community of affected individuals.

the way forward

providers must embrace a more holistic and patient-centred approach to hormone healthcare. this includes integrating telehealth services into routine care, increasing the workforce’s specialized training—particularly concerning menopause—promoting preventative measures, and addressing the stigma associated with hormone-related conditions.
access to hormone healthcare in canada is fraught with challenges, especially for those in rural and remote areas. the disparities in service availability and prolonged wait times significantly impact patient outcomes and quality of life. by embracing telehealth solutions and fostering collaboration between providers, gaps in care are bridged, and canadians receive timely, equitable, and effective hormone healthcare.

policymakers, healthcare professionals, and the public must advocate for these changes to create a more inclusive and efficient system that prioritizes patient well-being and access to care. only through concerted efforts and innovative solutions can we hope to address the hidden crisis of hormone healthcare in canada and ensure that every patient receives the care they deserve.

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