|
|
New Canadian Institute for Health Information (CIHI) report sheds light on
physician shortage perception
June 5, 2002
Ottawa, ONTARIO – Over the past decade, perceptions about the supply of
physicians in Canada have taken a 180 degree turn. Many Canadians now report
difficulties finding family doctors, and stories of waiting lists for specialist
services are common. Yet, just 10 years ago, medical school positions were cut,
physicians were encouraged to retire and doctors from other countries were
discouraged from coming to Canada.
How did this perception change so quickly? This report, entitled "From
Perceived Surplus to Perceived Shortage: What Happened to Canada’s Physician
Workforce in the 1990s?", analyzes what happened to Canada's supply of
doctors over the past decade. "It offers us some important lessons for how
we should manage our physician supply in the future," says Dr. Ben Chan,
author of the study.
5% DROP IN PHYSICIAN SUPPLY
According to Dr. Chan’s calculations, physician supply peaked in 1993 and
has since dropped 5%, to the same level as in 1987. Dr. Chan’s estimates
account for the fact that the population is aging, the elderly use health care
services more intensely and a growing number of physicians are females who, on
average, work fewer hours than their male colleagues.
HOW DID THIS HAPPEN?
To identify the causes of this drop, this study examined the inflows to and
outflows from Canada's physician workforce before and after 1993. The results
show that:
- The biggest factor behind Canada's drop in physician supply was an
increase in the amount of time doctors spend in postgraduate training. This
accounted for 25% of the estimated decline in physician supply. After 1993,
doctors wanting to do family practice needed two years of extra training
after graduation instead of one. Also after 1993, there were many more
specialists being trained compared to family physicians, and specialists
spend more time in training;
- 22% of the decline was due to fewer foreign doctors entering Canada;
- 17% was due to more physicians retiring, and
- Only 11% was due to medical school enrolment cuts. This is surprising,
because these cuts are frequently cited as the main cause of Canada's
perceived physician shortage. The full impact of these cuts, however, will
be felt in the coming years.
WHAT IT MEANS FOR PATIENTS AND DOCTORS
a. Fewer family doctors
The proportion of Canadian graduates starting practice as a general or family
practitioner (GP/FP) dropped sharply, from a high of 80% in 1992 to 45% in 2000.
GP/FPs comprised 53% of the physician workforce in 1993, compared to 51% in
2000. The relative drop in GP/FP numbers may help explain why some patients
report difficulties finding a family doctor.
b. Fewer young physicians in the system
There are fewer young physicians in the system now, largely because their
inflow into the system has been delayed due to increased training time. It is
the young physicians, however, who are more likely to perform obstetrics, work
in emergency departments, and provide locum relief for physicians who need a
break.
c. More work for physicians
Physician workload has increased by 7 to 8.6% (depending on specialty) over
the past decade, perhaps to compensate for the decrease in physician supply. A
large proportion of doctors now report that they want more time for themselves
or their families.
"A variety of different policies may have contributed to current
perceptions and realities. When analyzing what happened in the 1990s, one should
consider not only those policies aimed directly at managing the physician
supply, but also policies on training, physician remuneration and expenditure
control which may have had unintended consequences for the supply of
doctors," concludes Dr. Chan.
Next: Reports 
 Top
 Back to News & Events
|
|
|
In this release:
