Provinces lure physicians from one another

Provinces and territories are continuing to compete for physicians in the absence of a national or provincially coordinated recruitment plan, says the Health Council of Canada.

In the 5-year period, 1999–2003, Newfoundland and Labrador, Quebec and Saskatchewan lost the greatest number of physicians, at 269, 263 and 263 respectively. British Columbia, Ontario and Alberta attracted the largest number of physicians, at 466, 345 and 241 respectively (see Fig. 1).

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Fig. 1: Number of physicians gained or lost (Canada, 1999–2003). Source: Canadian Institute for Health Information

The report, Modernizing the Management of Health Human Resources in Canada, sets 2–5 year targets for human resource planning for governments, professional associations, regulatory bodies, employers, unions and educators. It also recommends that initiatives be “properly resourced” and based on population health needs integrated across jurisdictions.

“The Council's emphasis is not on seeing this as a physician supply problem, but on seeing this as an organization of care problem,” says Michael Decter, chair of the Council.

If a hospital loses a physician to another province, at least the organization can conduct a search to replace the doctor, Decter says. It's a much tougher problem in the community, where losing a family physician can mean the service disappears.

Creating strong organizations, such as group practices, at the primary care level means that, if a physician leaves, the organization can still look after patients and can recruit, says Decter.

Evidence suggests that the team approach to health also produces better health outcomes for patients, particularly those with chronic conditions such as diabetes, Decter says.

The Ontario Medical Association recently issued its own recommendations concerning physician shortages. They include increasing medical school enrolment; offering incentives to retain physicians and rural doctors; temporarily increasing the number of fully qualified international medical graduates; and eliminating physician billing caps and regulations mandating forced retirement.