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WHAT'S NEW
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Rx for the doctor shortage
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Five million Canadians are "orphan patients" -- unable to find a family physician to take care of them. If you've been stranded by our country's acute doctor shortage, here's how to ensure you get the best care you can -- under the circumstances.
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By Patricia Robertson
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What exactly does a doctor shortage mean?
Although the doctors interviewed for this story agreed that patients need a family doctor, five million Canadians are without one. These "orphan patients" now depend on walk-in clinics or emergency wards for their primary care. In Ontario 10 per cent of the population is without a family doctor and therefore may not be getting regular checkups and important preventive screening tests such as Pap smears and blood tests. Orphan patients also miss out, says a 2004 study by the Canadian Health Services Research Foundation, on important disease prevention advice and getting connected with specialists when needed. A family physician also becomes your key coordinator within the medical system if you are ever admitted to hospital.
"We are operating at 80 per cent self-sufficiency in training doctors," says Dr. Albert Schumacher, a former president of the Canadian Medical Association. Canada has 20 per cent fewer doctors than countries in Western Europe and is training too few to make up the gap. Yet according to Canadian Family Physician's 2004 National Physician Survey, 18 per cent of family practices in Canada are completely closed to new patients, and many more are partially closed. Only 20 per cent are completely open to new patients.
And the doctor shortage is not just felt by individuals without a general practitioner to care for them. Even those with family doctors are affected as they face longer wait times to see their physician, who may face burnout from juggling a heavier workload.
Causes of the doctor shortage
So why aren't there enough doctors in Canada? At the root of the shortage are some complex variables. The first is an aging physician population. In British Columbia, 40 per cent of practising physicians are over 50. But if an elder physician retires, there isn't a new doctor to assume the practice. Funding cutbacks to medical schools mean fewer doctors are graduating. A 10 per cent reduction in medical school enrollment that was imposed across the country in 1993 to cut costs is one reason why we have fewer physicians per capita in Canada than almost any other industrialized country right now, says Dr. Peter Barrett, also a former president of the Canadian Medical Association.
Then when they do graduate, 19 Canadian-trained doctors migrate to the United States for every American doctor who comes here. And foreign doctors who immigrate to Canada must requalify to practise here and then complete a residency program. The number of candidates exceeds the number of spots, creating a backlog.
A growing group of family doctors, many of whom are women, manage family responsibilities and their practices, meaning that they are choosing to work fewer hours a week. This means they see fewer patients, says Dr. Michael Golbey, president of the B.C. Medical Association.
There is also the issue of money. In Canada in 2002, the average family doctor earned $190,928 while a nonsurgical medical specialist earned $229,795. Since medical students graduate with an average of $150,000 in student loans, it makes economic sense for many of them to pursue specialties that can pay considerably more than family practice, says Golbey.
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