Orphan patient

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In health care, an orphan patient is a patient who has been "lost" within the system or has no primary provider overseeing their care.

Usually, the primary provider is a general practitioner who takes care of some of the basic health needs and then refers to a specialist for complicated medical problems. Thus, orphan patients are sometimes referred to as "no-family-doctor" patients. The view from insiders and health care providers is that orphan patients tend to receive inferior care compared to those who have a "gatekeeper" coordinating the medicine.

The Wordspy entry for this phrase is as follows [1]:

Contributing factors[edit]

There are multiple factors that are contributing to the orphan patient problem in North America. Some of them include:

  • problems maintaining a supply of qualified health practitioners
  • providing access to them where and when they are needed most
  • a growing population of patients
  • an aging population of patients
  • a sicker population of patients (particularly with diabetes and obesity being rampant in North America)
  • a more "medicalized" population of patients (expectations for medical care are higher than ever, and we have more defined diseases to treat)
  • increasing complexity of treatments for the diseases we have always known about (standard-of-care treatment for heart attack is much more labour-intensive now than it was even a decade ago)

The orphan patient problem has only been recognized in the media recently.

Older medical references mention the term 'orphan patient' using a different definition, specifically patients with an orphan disease. For example, New England Journal of Medicine mentioned patients with orphan diseases as orphan patients in 1988:

N Engl J Med. 1988 Mar 10;318(10):646. The orphan patient. Shelley WB, Shelley ED. Publication Types: Letter PMID 3344016


Solutions to the orphan patient problem are complex, as expected due to its multifactorial origins. It is not possible to decrease the population. It is not easy to increase the number of physicians and other health care providers available, as the time to train them tends to be long. Some of the temporary solutions have involved changing the way that health care is provided by: