Many go through the angst of a face-to-face interview with a physician taking patients, or fill out questionnaires.

Some even withhold medical information from prospective doctors, in case they are refused.

These are the realities that patients searching for a family doctor still face five years into a shortage that the Ontario Medical Association says is only getting worse.

Doctors, too, cope with problems, including overwhelming patient loads.

As they approach retirement, some doctors are scaling back duties in favour of more balanced lives. Others are returning to Canada from abroad as their twilight years approach, to spend more time with families still based here.

The average age of an Ontario family doctor is 49.5. And nearly a third of family physicians are female, meaning many doctors are also working fewer hours in order to raise families.

“For a while yet, we’re going to have to face declining numbers,” says Dr. Jeffrey Turnbull, president of the College of Physicians and Surgeons of Ontario. “You’ve got a long time where the problem is going to get worse before you see significant increase in the number of physicians.”

All these forces have an impact on how patients get daily, basic care, and how doctors make do. Sometimes, a solution creates a brand-new problem.

A number of physicians, for example, have opted out of taking hospital privileges over the last few years.

To make time to see more patients in the office, many have abandoned the traditional role of attending to their own patients in hospital when the patients go for surgery or other care.

This, in turn, has created what hospitals call “orphan patients,” people admitted and initially cared for by surgeons or other specialists, but who still need an attending physician for in-patient care. Now, a new breed of doctor called a “hospitalist” looks after them.

In Oakville, nine hospitalists now see between 175 and 195 patients a day. In Milton, one hospitalist attends to a daily patient list of up to 25. In Ontario, one million adults and 130,000 children don’t have a family doctor. The OMA says the province needs 1,000 general practitioners now.

About 200,000 patients without a doctor live in the Milton to Niagara area covered by Metroland West Media Group’s investigation into family care.