Sunday February 01, 2015
Is it time to re-think the role of doctors in the healthcare system?
Provincial health systems are struggling with doctor shortages and lack of access during off-hours -- not to mention the high cost. Proposed solutions vary from more doctors to fewer doctors, from higher paid doctors to salaried doctors. Is it time to re-think the role of doctors in the health-care system?
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Canadians love their health care system ...and for many it works very well, but it has become clear in recent years that as the needs of Canadians change, the system itself has not kept up. There is a growing consensus that something has to change. Canada has one of the most expensive systems in the world but it consistently performs near the bottom of the list of wealthy nations on a range of factors ...most troubling, waiting lists and access to care. Rising costs coupled with sub-standard performance: it presents a daunting challenge.
One aspect of the health system -- but obviously a key aspect -- is physicians. All the provinces are struggling with different ways to manage their doctors. Why? Because payments to doctors as a group are rising faster than some of the other costs such as hospitals and drugs. Individually, doctors' pay has not gone up but because there are more of them working, there are more of them to pay. But despite a dramatic increase in the number of doctors across the country, Canadians' access to GP's remains a significant problem ...especially in rural and remote areas. And when it comes to offering older people timely health care, a recent study puts Canada dead last, when compared with 10 other Western nations.
The provinces are making changes ...and there are more on the way. Ontario recently announced a cut to doctors' fees. Quebec is setting higher targets on the number of patients doctors must see. BC is hoping creating more nurse practioners will take the pressure off doctors. Some experts go further, suggesting putting doctors on salaries and assigning medical graduates to remote areas. Newfoundland hopes signing bonuses will attract doctors into rural areas.
We'd like to hear your views. What has your experience been with the health care system? Do you think that some or even many of your needs could be met without actually seeing a doctor?
Are you happy with the service you receive from your local health clinic and GP?
Do you have a family doctor? How long do you have to wait for an appointment?
What do you think of the idea of expanding the roles of nurses and nurse practioners?
Today we want to hear your experiences - the good and the bad.
Are there things that are working well? We'd like to hear about them as well.
Our question today: "Is it time to re-think the role of doctors in the healthcare system?"
I'm Rex Murphy ...on CBC Radio One ...and on Sirius XM, satellite radio channel 169 ...this is Cross Country Checkup.
Dr. Arthur Parsons
Retired physician from Halifax and author with Patrician Parsons of several books including "Healthcare Ethics" and "Patient Power"
Director, Centre for Health Services and Policy Research and Professor, School of Nursing at UBC
Dr. Ben Chan
Assistant Prof, University of Toronto & past CEO of two Health Quality Councils in Canada
- Canadian patients wait longest to see family doctors
- Health-care quality satisfies Canada's seniors, study finds
- Solution to doctor shortage may be more than money
- Ontario doctors reject province's contract offer
- Ontario NDP promises law to name physicians and amounts they bill
- Ontario to crack down on illegal medical billing
- Nfld offers signing bonuses to attract MDs to remote areas
- Ontario health workers strike could mean hospital backlogs
- Hospital emergency room wait is more than 28 hours for 10% of patients: report (Oct. 7, 2014)
- Digitally numb: Doctors are losing hands-on diagnosis skills by relying too much on technology
- Patients questioning doctors are changing the face of medicine – and physicians are embracing the shift
- Halifax doctor moving to Toronto, leaving up to 20,000 patients without physician
- Innovation, not dollars, the cure for Canada’s health-care system: pharma exec
- Value of big data in health care is measured not just in dollars, but in lives
- Infected and undocumented: Thousands of Canadians dying from hospital-acquired bugs
- The upside of no-frills Canadian health care, by Jonathan Kay
- Aligning health-care incentives in Ontario, by Howard Ovens
Globe and Mail
- Older Canadians’ timely access to health care ranked last by survey
- Doctors and provinces: End your Cold War over billing, by André Picard
- How much are Canadian doctors paid? by André Picard
- How do we control physician costs? by André Picard (Mar. 19, 2012)
- Are nurse practitioners the cure for B.C.'s family doctor shortage?
- Ontario slashes fees it pays to doctors following negotiations
- Wynne’s spin on Ontario doctors not supported by the facts, by Dr. Douglas Mark
- MDs’ gross income $307,000, report finds
- Why is it so hard for doctors to retire?
Canadian Institute for Health Information
- Infographic: Cost of doctors (pdf)
- Wait times for primary and specialist care longest in Canada, among 11 countries
Health Council of Canada
Organisation for Economic Co-operation and Development