More doctors in Hamilton but city still below national average: report

Hamilton enjoys one of the fastest growing doctor populations in the province, but the number of doctors per 100,000 population is still below national average, the latest figures show.

How doctors are paid is also changing as alternative payments increase

The latest figures show that Hamilton enjoys one of the fastest growing doctor populations in the province, but the number of doctors per capita is still below national average. (Adrian Wyld/Canadian Press)

Hamilton has one of the fastest growing doctor populations in the province, but is still under served compared to the national average, the latest figures show.

The number of family doctors working in the Hamilton Niagara Haldimand Brant region jumped from 1054 in 2008 to 1299 in 2012, says a report by the Canadian Institute for Health Information (CIHI). The 23.2-per-cent increase is slightly higher than the provincial average of 21.7 per cent and significantly higher than the national average of 13.2 per cent.

However, the region has 91 doctors per 100,000 people, below the provincial average of 100 and national average of 109.

The number of specialists working in the region reflects similar trends. There were 1503 specialists in 2014, a 17-per-cent increase compared to 2008 that outpaces the provincial and national average. 105 specialists are available in the region per 100,000 people, above the provincial average of 102 but slightly below the national average of 106.

Ontario's Health Minister Deb Matthews said the province is moving towards team-based models of care that maximizes the ability of nurses, nurse practitioners and others to provide primary care.

The per capita number of doctors "becomes a little bit less meaningful than it would have in the old days when you had a family doctor or nothing at all," said Matthews.

CIHI's annual reports on physician supply and payments for both general practitioners and specialists were released Thursday.

More med school grads

Nation-wide, Canada had a record 75,142 doctors last year and they earned $328,000 gross on average.

"The year 2012 saw the highest level of physicians per capita ever recorded in Canada," the authors of the reports said.

What's more, the six-year trend of growth in the number of doctors outpacing population growth is expected to continue since data from medical schools indicate more students are graduating with MD degrees.

Between 2008 and 2012, the number of female physicians increased by nearly 24 per cent, while the number of male doctors increased by 10 per cent. In all provinces, women represented a larger proportion of family doctors than specialists.

Since 2008, the number of doctors working in rural areas increased five times faster than the rural population, with almost 6,400 physicians in 2012.

But the numbers alone don't present the full picture. It's important to ask not just how many doctors are needed, but where are they most needed and in what specialties, said Geoff Ballinger, CIHI's manager of physician information.

 In 2011-12, clinical payments to doctors' offices also increased nine per cent over the previous year to more than $22 billion, the institute reported. In the two previous years, the increases were 6.1 per cent and 7.9 per cent, respectively.

Alternative payments rise

How doctors are paid is also changing.

Fee-for-service payments that reimburse doctors for each clinical service they provide continued to be the majority, at 71 per cent, last year. The average cost per service paid was $56.99.

Out of the gross amount, doctors pay for taxes, rent, salaries and equipment.

Alternative clinical payments, such as paying by hour or by the number of patients in a doctor's practice, rose to 29 per cent, up from 11 per cent of total payments a decade ago.

"Now they're being paid in ways that encourages them to see perhaps fewer patients but spend more time with patients, which is particularly important for older patients or patients with chronic disease," Ballinger said in an interview.


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