From the Canadian Medical Association

View PDF

Dr. Brian Day
President
Canadian Medical Association

As you sit in the waiting room reading this, you may not realize it but you’ve already overcome one of the biggest barriers to receiving health care in Canada. Just being here means that you or your loved one has made an appointment with a physician.

Not so long ago, getting that appointment was a given. If you got sick, you went to see a physician, visited an emergency room or were admitted to a hospital for care. Today, as many as five million Canadians lack a family physician, emergency rooms are overcrowded, and many hospitals are closing beds and cancelling surgeries because they are desperately short of nurses and other health-care professionals. This means that many people seeking care cannot get the timely access to the health services they need to get better or stay well.

The Canadian Medical Association considers this shortage of physicians and other health-care professionals to be the single most important problem facing our health-care system.

For doctors, this dilemma can be traced to the early 1990s. At that time, governments decided to pare down the number of students entering Canadian medical schools by 10% in an attempt to limit the growth in the number of practising physicians. Decision makers were trying to control rapidly rising health-care costs, and they reasoned that cutting the number of doctors might solve the problem. However, this decision was made at the same time that a number of other factors came into play.    

• Many doctors who had come to Canada after the Second World War started to reach retirement age, and in some areas of medicine they constituted almost half of all practising physicians.
• A minimum of two years of pre-licensure postgraduate training was implemented as a national standard, eliminating the one-year rotating internship that had released more doctors to provide primary care sooner.
• Doctors began working fewer hours in order to have an acceptable work-life balance.
• As the population aged, it started to require more — and more complex — medical care.
• Many doctors migrated to the United States and other countries.

All of this resulted in Canada’s now having a ratio of physicians to population that is one of the worst in the developed world: 2.2 per 1,000 population.

As we entered the 21st century, and at the urging of groups such as the CMA, policy-makers started taking steps to address the shortage. Since 2000, the number of medical-school places has increased at Canadian universities. Programs have been developed to make it easier for properly qualified graduates of medical schools from other countries to practise here. Fewer doctors are retiring or moving to other countries.

But the problem remains very serious. Young doctors are still choosing to work fewer hours than their older colleagues, the population continues to age, and baby boomers are demanding more care.

The CMA continues to press governments to keep the shortage of health-care professionals at the top of their agendas. Addressing this will help Canada become self-sufficient in the number of health-care professionals it produces — now and in the future.