Doctors Today and Tomorrow - British Columbia Medical Association

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emain unchanged (Buske, 2010d). However, when these crude ratios are adjusted for the demographic shifts of the populations, the projections are less optimistic: head counts per population would increase at a lower rate and FTEs per population would more or less remain constant. Nevertheless, supply issues such as the uneven regional distribution of physicians, particularly in rural settings, and the under-representation of physicians in certain specialties, are likely to remain problematic in coming years. Supply Factors Several factors and trends can affect the supply of, and demand for, physicians. Some of these are described below. Physician demographics In 2009, the average age of the BC physician workforce was 49.6 (Canadian Institute for Health Information, 2010). In 2010, 42% of all BC physicians were 55 years old or older (see Figure 5), and certain specialties had a majority in this age group, including dermatology (57%), clinical immunology/allergy (56%), internal medicine (52%), and general/clinical pathology (51%) (Buske, 2010a). Figure 5: Percentage of Physicians 55 years and older, BC, 2010 45% 42% 39% GP/FP Specialist All MDs Source: Canadian Medical Association Masterfile, 2010 The number of female physicians in the workforce has been steadily increasing over time. Between 1979 and 2009, the percentage of female physicians in the BC workforce has increased from 11.9% to 32.9% (Canadian Institute for Health Information, 2010). Traditionally, there have been more female GPs than female specialists, and this trend continued in 2009, with 37.3% of family medicine physicians and 27.5% of specialist physicians being female. Parental responsibilities have a significant impact on the average number of hours worked per week, especially among female physicians. In 2007, for example, Canadian female physicians with children younger than five years old worked on average 12.9 hours less per week than their male counterparts, excluding call. This gap narrows for female physicians with children over 10 years old, with females working 5.9 hours less than males. When there are no children dependants, female physicians work similar hours to male physicians (females working 1.3 hours less per week than males) (College of Family Physicians of Canada, Canadian Medical Association, & Royal College of Physicians and Surgeons of Canada, 2007). 16 Doctors Today and Tomorrow – The Current Workforce: Measuring supply and demand
Physician migration Gaining physicians through international migration can occur in two ways: either physicians who were previously in Canada return after working abroad, or internationally-trained physicians immigrate to Canada. Conversely, Canada can lose physicians through emigration. Over the last three decades, overall net immigration was highest between 2000 and 2009; during this period BC had a net gain of 978 physicians, largely due to the significant increase in the number of new IMGs compared with the previous two decades (Canadian Institute for Health Information, 2010). Physicians can also be lost or gained through interjurisdictional migration. Physician interjurisdictional migration data shows that BC, Prince Edward Island, Ontario, and Alberta gained more physicians than they lost in all three past decades, while Newfoundland and Labrador, Nova Scotia, Quebec, Manitoba, Saskatchewan, and the Northwest Territories lost more physicians than they gained (Canadian Institute for Health Information, 2010). Between 2005 and 2009, net gains in BC ranged from a low of 26 physicians in 2007 to a high of 117 physicians in 2005. In 2009, BC gained 93 physicians through interjurisdictional migration. Changes in workload Physicians are engaged in a variety of tasks throughout their work week, including patient care, teaching, research, administration, and continuing professional development. Over the past 20 years, a decline in self-reported hours of direct patient care (excluding call) has been observed for both sexes and across all age groups except for those over 65 years of age in BC (see Figure 7) (Buske, 2010b). The changes in age distribution appears to also have an effect on the supply of physician services: Watson and colleagues found declines between 1993 and 2003 in average service volumes provided by successive cohorts of younger physicians, but increases among older physicians (Watson, Slade, Buske, & Tepper, 2006). Figure 6: Average Weekly Direct Patient Care Hours (excluding call), BC, 1986 & 2007 50 45 40 35 Hours 30 25 20 15
Page 1: Doctors Today and Tomorrow Planning
Page 4 and 5: The BCMA Council on Health Economic
Page 7 and 8: Executive Summary Yogi Berra said i
Page 9 and 10: Recommendation 6 The Faculty of Med
Page 11 and 12: I. The Physician Workforce: Plannin
Page 13 and 14: Forecasting Physician Supply Foreca
Page 15 and 16: Key Considerations No perfect metho
Page 17 and 18: Figure 3: Quota Overview - Universi
Page 19 and 20: number of re entrants exiting BC po
Page 21: III. The Current Workforce: Measuri
Page 25 and 26: Demand Factors The aging population
Page 27 and 28: their financial situation, and thei
Page 29 and 30: 2. The potential impact of an aging
Page 31 and 32: • Evaluating health authorities
Page 33 and 34: Recommendation 5 The Medical Human
Page 35 and 36: Comprehensive and flexible recruitm
Page 37 and 38: Conclusion The challenges facing ph
Page 39 and 40: National Physician Survey. College
Page 41 and 42: Notes
Page 44: www.bcma.org

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