Environmental Scan - Government of Nova Scotia

Physician Resource PlanningAn Environmental ScanFigure 8 Estimated Net Difference Nationally between Annual Physician Need and SupplyOtherThis figure estimatesphysician need as the sumof annual turnover (e.g.,retirement) pluspopulation growth plusgender shift adjustment.Physician supply is basedon the expanded M.D.programs pluscontinuance of incomingIMGs, including CSAs.Since the 1990’s themedical education systemhas invested heavily inrenewing curriculum andteaching models (e.g.,CanMEDS, community-based learning, longitudinal clerkships) and expanding education and trainingcapacity to accommodate the dramatic growth in the number of UGME and PGME learners. Converselythere is little evidence of physician resource planning at the national or provincial levels to provideevidence-based direction and long term stability to the medical education system. Nova Scotia, bydeveloping a physician resource plan, is availing itself of the opportunity to provide provincial directionand greater stability to the Dalhousie Faculty of Medicine UGME and PGME programs. The absence ofnational and inter-provincial collaboration on physician resource planning is a challenge Nova Scotia willhave to manage proactively going forward.Physician Payment Systems - Nationally, in 2008-09, 27% of payments were non-fee-for-service with therange being 49% in Nova Scotia to 15% in Alberta. Nova Scotia is a national leader in advancing alternativepayment systems. Evidence supports the permanence, growth, and evolution of non-fee-for-servicepayment models. Alternative payment systems create a challenge for physician resource planning if anaccurate measurement of services delivered is not maintained. This is not to say the services should beidentical to fee-for-service; they do, however, need to be systematically defined, measured, and reported.Figure 9 Physicians by Province paid partially and mainly through alternate payment methods, 2008/09 (Source: CIHI)Figure 10 Population and (demand-based) Physician FTE Change, 2010 to 202219 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011