Canada's doctors are coming home-reverses 30 yr trend

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Canada's doctors are coming home

New numbers reverse 30-year trend

Aug. 24, 2005. 05:50 PM toronto star

 

FROM CANADIAN PRESS

 

For the first time in 30 years, more doctors are returning to Canada than leaving the country for so-called greener pastures in the United States or overseas, a comprehensive report on Canada's physician supply shows.

The report by the Canadian Institute for Health Information (CIHI), released today, shows that 317 physicians returned to Canada last year and 262 left.

 

The net surplus is the first since the institute began collecting this data in 1969, and is "a continuation in the trend we have seen since the mid-1990s of a decreasing number of doctors leaving Canada for opportunities in other countries," said Steve Slade, co-author of the report.

 

"That's not happened once on record with our database, and it's a first, a historical year for Canada," he said from Ottawa.

 

The number of doctors who left Canada stood at 420 in 2000; and in 1994, a whopping 771 physicians crossed the border south or left the country's shores.

 

Meanwhile, a 24 per cent rise in the number of doctors returning home in 2004, compared with five years earlier, gave Canada's physician workforce the net gain.

 

CIHI also found that the number of doctors across the country had risen by five per cent between 2000 and 2004 - to 60,612 from 57,803.

 

But that increase has not made it easier for Canadians to find a family physician or get access to a specialist, said Slade, noting that growth in the country's population kept pace during that period, leaving the number of doctors per 100,000 residents relatively stable.

 

"I guess we're somewhat relieved to see there's a net increase in physicians coming into Canada, although it doesn't really help us in overall numbers," said Dr. Ruth Collins-Nakai, president of the Canadian Medical Association. "We are more or less treading water in terms of our overall physician supply."

 

Collins-Nakai said the return of some physicians may be related to Canada luring back doctors to head or staff high-profile research institutes at universities across the country.

 

She said hundreds more medical school entry positions are needed - and professors to replace those retiring to teach them - if Canada is to even approach self-sufficiency in achieving a physician workforce large enough to serve all Canadians in a timely fashion.

 

"In order to accomplish that, the medical schools, which are currently bursting at their seams, are going to need increased resources," the cardiologist said from Edmonton.

 

Complicating efforts to ramp up the number of doctors to meet an aging population's growing demand for both family practitioners and specialists is the concurrent greying of health-care services.

 

Baldly put, Canada's doctors are getting older. In 2000-2004, the average age of physicians increased by one year, to 49 from 48. During the same period, the proportion of physicians under age 40 dropped by 13 per cent.

 

"That's like our window into the future, where we see a decrease in the number of really quite recent graduates in Canada," said Slade.

 

The report also shows that the doctor supply is made up increasingly of women: in 2004, females accounted for almost one-third of physicians, a 10 per cent increase since 2000. Among doctors 40 and under, women made up nearly half in 2004.

 

But with more female doctors working shorter hours, access to care is not improving for patients, but declining, experts says.

 

Making matters worse for patients is the expected retirement of more than six per cent of physicians in the next two years, said Collins-Nakai. "And we expect up to one-third of all physicians to be decreasing hours of work.

 

"Many physicians over the past half or (full) decade have been doing excessive hours of work to provide access to patients," she said. "And we know we've got increased burnout levels among physicians."