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Canada's MD shortage to worsen: Fraser report

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Canada AM: Nadeem Esmail, The Fraser Institute
A senior fellow with the Fraser Institute discusses the factors behind the shortage and says Canada has engineered a shortage due to cut backs in funding for physician training in the country.

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Blood pressure A woman is screened for radiation exposure at an evacuation center at Fukushima, northeastern Japan, on Thursday, March 17, 2011.

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Date: Thu. Mar. 17 2011 9:43 AM ET

Canada's doctor shortage is bad and is only going to get worse, concludes a new report from the B.C.-based think tank The Fraser Institute.

The report finds that Canada has 2.3 doctors for every 1,000 people -- a ratio that ranks our country 26th out of 28 developed nations with publicly funded health care. That compares to the average ratio of 3 doctors per 1,000.

The doctor shortage will only get worse, the report says, because of what the authors call "restricted physician training."

Nadeem Esmail, a Fraser Institute senior fellow and the report's author, says while Canada once enjoyed a healthy physician-to-population ratio, that's all changed because of poorly conceived government policies that have restricted admissions to Canadian medical schools.

"We've engineered a physician shortage," Esmail told CTV's Canada AM from Calgary.

"In the early 1990s, governments were concerned about a looming physician surplus so they cut back government-funded physician training in this contry, which brought us now to the physician-to-population ratio we now have that ranks us well behind other developed nations," he said.

The result has been a doctor shortage that is only going to worsen as older physicians retire.

The report looked at recent medical school enrolment and graduation rates and calculates that Canada will require between 2,200 and 2,300 new physicians each year from now through 2020.

That figure would be just enough to maintain the current physician-to-population ratio, not to improve the ratio. Nor does that estimate account for the increasing number of doctors currently practising who will retire between now and 2020.

"In fact, in 2010, 38 per cent of Canada's physician workforce was aged 55 or older and the projections we've made don't even account for that increase in retirement that we're likely to see over the next 10 years," Esmail said.

Esmail believes it was a mistake for the government to try to control the number of doctors graduating in Canada.

He cites an Organisation for Economic Co-operation and Development (OECD) study that found that countries that have allowed the markets to determine how many physicians should be trained tend to fewer problems physician-to-population ratio.

In countries such as Switzerland and Germany, physician training has been left to the marketplace, he says. So prospective students decided whether they wanted to go into medical school based on their prospects for finding a job later, and medical school decided whether they wanted to take them. Those countries are now having fewer problems keeping up with an aging population.

Esmail's report says that even if Canada's policies were reversed now, it wouldn't have an effect for at least another decade.

The report concludes that government-imposed limitations on the number of physicians being trained in Canada has been a policy choice that has not served the best interests of Canadians.

As well, capable students who have hoped to become doctors have been unable to access medical training in this country and have been either forced to seek training elsewhere or to change their career plans.

Esmail's report, "Canada's Physician Supply" appears in the latest issue of Fraser Forum, the Institute's bi-monthly magazine.

Comments are now closed for this story

Joanne
said
0 0

I know of a student doctor from Thunder Bay studying in New York who wanted terribly to come home and do his residency. He was basically told there wasn't much of a chance of him getting anything so he accepted a position in the States. This is quite unfortunate because his family is here and he would have been quite happy to set up practice here and help alleviate some of the physician shortfall we have in this area.


O.L. from Ontario
said
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This shortage is now so extreme, it will not be solved with marginal changes like adding a few extra spots in medical schools; and the medical establishment may not have all the answers. The system has also been over-rewarding specialists and under-rewarding family doctors, and has been influenced by the pharmaceutical industry far too much. There are other health care professionals who can quickly step in to help fill the void. For instance, naturopaths are very capable of providing primary health care, and are preferred by many Canadians because of their emphasis on healthy lifestyle, their alternatives to pharmaceuticals, and their ability to treat chronic conditions such as arthritis more successfully than the traditional "take this pill" approach. Reducing the over-use of antibiotics may be an added side benefit. Muscle, joint, back chronic issues can be very well assessed by reputable chiropractors and treated by chiropractors and physical therapists. Perhaps the medical establishment should get over themselves a little and let some of the burden pass to those who are able to carry it.


Barb
said
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Or perhaps this is the government's long-term plan to force private health care and remove health care costs from their budget? This is a Canada-wide problem. Is the writing on the wall?


Maria Rodriguez
said
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Hello. In my opinion is that by the way of not training enough doctors in Canada, the government has gained headway to control the health expense. When we can not be taken care of the government does not have to pay. It doctor would be available we would be looked after and would cost money for the government. Moreover, they really do not care how long we will live. Money is their only concerns .


MikeInBC
said
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And why is it that a dermatologist that came to Canada from another country who would treat any dermatological issue when he needed to build up his patient inventory (and bank account) will now no longer treat skin cancer issues because he can make more money doing cosmetic surgery?


Carl
said
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How can we have a shortage of doctors when the federal government is transferring more money than ever to the provinces for both health care and post-secondary education? What is happening to all that money? Obviously, it is being mismanaged. More free-market incentives are needed in the medical sector.


kd in ab (med student)
said
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This is a product of our garbage communist healthcare system where the government sets the rate of pay for a procedure. To ensure the practicing physicians have enough procedures to perform, so that they can make enough money to make it worth going through the 12 years of training and school, they keep the competition down. Another reason why going south is more attractive other than the higher pay, fewer hours, better equipment, better drugs, and lack of government control.


B.J.
said
0 0

The Doctor shortage is pathetic. Why has the Feds.and Prov. governmnets allowed this to happen. This should have been dealt with when the shortage started. No doubt there are Drs working in other jobs but because of beaurocratic red tape Canadians are subjected to no Dr. Why does it take so long for a Dr from another country to become licensed in Canada.. The Doctor status should be on going to ensure that this doesnt happen. Whats the College doing. No doubt nothing, so wait 'til the horse leaves the barn they Panic. So pathetic. Well if I was a Dr I'd be south.


Roger, Alberta
said
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The college of physicians don't help matters either making togher requirements for doctors to come here from other countries. As far as I am concerned the college of physicians are an arrogant bunch of goofs who accountable to no one. This isn't just the goverment's fault.


cc in to
said
0 0

Doctor shortage? Why then was there an article in the Globe and Mail about how there are Orthopaedic Surgeons fully trained in Canada using Canadian tax dollars that are unable to find a job? With the wait lists the way they are why do we have fully trained surgeons (via Canadian tax dollars) that are unemployed in Canada or moving to the US due to lack of jobs in Canada?


yoman, med. hat ab
said
0 0

Absolutely absurd. Why would the government want to restrict the amount of doctors graduating? This is just coming to light now after how many years of doctor shortages? Yikes. Harder and harder to be a proud canadian.


Ryan
said
0 0

Would be nice if the Government would extend more financial assistance to those students who want to study a speciality in medicine not offered in Canada at an accreditated medical school (US and/or Australia). I'm interested in rural and tropical medicine so applied to a medical school in Australia. I was accepted, but can not go because I need a $200 000 medical student loan from a bank...which I cannot get because I need a co signer and, well, my family nor anyone we know is rich enough to co sign for that amount. Government loans are not enough.


scott nova scotia
said
0 0

I know people waiting on lists for years to find a family doctor. The government should fund their education on the basis that they sign a contract to practice in Canada and not just major cities. If they wish to leave Canada they just have to buy out the contract which will put more money back to funding the next doctors education. They pay a fortune in student loans and leave for better paying jobs south.It keeps Canada from getting the so called "brain drain".


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