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Time to Think Canadian
(Doctor Shortage)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page HM4 in the October 25-26, 2008 issue of
The Mississauga News under the feature: Health, Wellness & Beauty, Medicine Matters.

In Haliburton, there are hundreds of “wanted” posters in an attempt to attract doctors to the area. That and the recent rhetoric about relaxing Canadian medical standards got me thinking about the health care crisis and the physician shortage. There is no greater shame than to be part of a country that just plainly refuses to train adequate numbers of doctors. It is as simple as that.  The doctor shortage was not created by doctors. It is the result of catastrophic political calculation. Canadian society, by way of government policy, simply chooses not to train enough physicians. We rank a dismal 27th in physician manpower among developed countries, while administrative positions ever expand.

It is now 17 years since Bob Rae's NDP convinced Ontario that they were over-doctored and proceeded to slash medical training spots. We have made only slight gains since that low, with five different governments at the helm. This snail's pace of political action has remaining doctors worried. Ontario’s doctors are greying as a group, and more often than not wind up being patients within our own system. Another rumor that keeps surfacing is that we are losing doctors to the United States. The number of Canadian doctors who go south is a mere trickle and not a major tidal wave, but the number of Canadians who get locked out of Canadian training, and go elsewhere is a tidal wave. We are losing many more doctors to burn-out and stress. New technologies and models of care are dangled like carrots for all to see, but select few to have. My colleagues are a dedicated group still brimming with Canadian pride.

I think it is time for governments at all levels to start thinking outside the box.  It requires a sense of pride in Canada, and a willingness to recognize that our greatest natural resource is our youth. Thousands of Canadian university graduates surpass the basic qualities, skills and intellect to complete medical training. I have sat on admissions committees and watched qualified Canadians repeatedly rejected for lack of training spots. Many Canadian-born students pursue their training abroad at their own expense. Few ever make it back. This brain drain should be very worrisome to the future of any young country. We don’t make it easy to come back with skills so badly needed here. Most don’t even try. This group is culturally sensitized to the needs of our society, a trait that no written test can measure but essential in the practice of medicine. What other country would simply give away a natural resource, complain about shortages and be incapable of recognizing and re-accepting that same resource in a more refined state? I wonder if we are applying this same rationale to our oil reserves?

Training a physician is an expensive proposition for any country, and more so for poverty stricken lands. Canada’s international reputation will suffer if we are seen as physician poachers. It suggests to the world that we lack resources. Just imagine our own outrage if another nation roamed our countryside enticing our existing physicians to relocate. You cannot just “hire” doctors anytime you like, as one federal candidate seems to think.

Short term solutions lie outside of the box. One solution is to arrange collaboration between government, universities and gifted students. Thousands of Canadians could be placed in subsidized positions within foreign recognized medical schools to quickly ease the shortage. We are a proud first world nation, with top notch universities crammed with gifted young people, world class researchers, and technological advances and yet we have a physician shortage?  The private sector is capable of processing that natural resource. Hundreds of Canadian students train in American medical schools at their own expense. Most settle there because returning to Canada is a difficult option.

We should not lower our standards. We need visionary leaders who can lead us out of this tragedy. The physician shortage started as a warning and turned into a crisis. A crisis left unaddressed transforms into a national shame and soon into a national outrage as we lose our pride. The future of any country is defined by its ability to recover from political errors. Fixing mistakes requires courage and provides little glory, and a big tip of the hat to the Ontario regulatory body, the College of Physicians and Surgeons of Ontario (CPSO), for taking the first step. We need government to follow suit!


Related resources:

Ontario Physician Shortage 2007 from Ontario Medical Association (OMA).

Canada's Doctor Shortage Worsening from McLean's Magazine.

Britain could solve Canada's doctor shortage by CTV.ca News Staff.

Curing Canada's doctor shortage from National Post.

Your View: How has Canada's doctor shortage affected your life? From CBC News. Roughly 4.1 million Canadians aged 12 or older are without a family doctor.

Canada's Physician Shortage: Effects, Projections, and Solutions from Fraser Institute.

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