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BEYOND THE PLACE: There is a shortage of support for doctors in Canada



This article, written by Rebecca Renkas, University of Toronto, originally appeared in The Conversation and was republished here with permission:

The complaints are ubiquitous – "my doctor has retired"; "my doctor is on maternity leave;" "The clinic is not accepting new patients."

Medicare, a pillar of pride for most Canadians, does not seem universal to those struggling, sometimes waiting for years, to access a GP.

It may seem like a supply and demand problem – there are not enough doctors to meet patients' needs. However, recent statistics show that Canada has more doctors per capita than ever before – and that the flow of doctors in the system is outpacing population growth.

The results of this analysis, released in September by the Canadian Institute for Health Information (CIHI), are disconcerting as Canada remains the lowest among developed countries for providing timely access to reliable primary care.

To understand this problem, we need to look more closely at how the doctor's workforce has changed and what the implications are.

Doctors offer better care

The CIHI report reveals that today's average physician profile is quite different from what it was 50 years ago. The overall proportion of female doctors increased to 42% in 2018 from 11% in 1978. Women make up 47% of family doctors.

Almost 60% of family doctors in Canada under 40 are now women. This means that over time, family medicine will become an increasingly female-dominated practice.

About half of the students in my medical school class were women. At the beginning of my training, I saw this as a reassuring sign of progress. Working as a family doctor, I began to see signs that we might not have gotten as far as I expected.

More women in medicine should be considered good. There is a growing body of evidence showing that they tend to practice with a better style for their patients. Compared to male doctors, women spend more time with their patients, are more likely to adhere to the guidelines, offer more follow-up care, and are more careful in their prescribing practices. They are also more likely to solve mental health problems and establish collaborative partnerships with their patients.

In turn, female patients have fewer hospitalizations and emergency appointments than male doctors; This difference is even greater for patients with complex medical problems. Medical patients are more likely to be up to date on preventive screening, such as mammograms, and are more satisfied with their care.

The problem is that our healthcare system has not changed with the style of practice of its medical workforce, and the consequences are beginning to appear.

A gender pay gap

In Canada, most doctors are paid by the government based on a service fee schedule that lists each service provided by a doctor. This means that a doctor attending more patients in less time earns more than one attending fewer patients, taking more time with each visit. This partly explains why doctors earn less than men, regardless of the quality of care provided.

The government-physician fee agreement was imposed with the introduction of Medicare in the 1960s, when most doctors were men whose life and career paths were very different from today's doctors.

The gender pay gap is just one of the ways in which the medical system is against female doctors. They must also balance their careers with the family in ways different from men's; They need to deal with pregnancy and pregnancy in a workplace without a formal maternity or paid leave policy.

Female doctors are more likely to have a full-time spouse than men, and they take on a greater proportion of household and parenting tasks.

To that, add a boy club work culture that is rife with gender-based discrimination, abuse, and harassment that has little hope of change without the representation of female voices in medical leadership.

Burnout, depression and suicide

In 2018, the Canadian Medical Association released the results of its National Physician Health Survey, which showed that doctors were 23% more likely to suffer burnout, 32% more likely to be depressed and 31% more likely to have suicidal thoughts than they did. Yours. Male colleagues.

These results may help explain why doctors are more likely to reconsider their career plans. Recent University of Michigan research published in JAMA Open Network, shows that within six years of completion of residency training, nearly 75% of female doctors reported reducing their working hours or considering working part-time.

We have no shortage of doctors in Canada. We lack support for our doctors.

Rebecca Renkas, GP and Global Journalism Fellow at Dalla Lana College of Public Health, University of Toronto, University of Toronto

This article has been republished from The Conversation under a Creative Commons license. Read the original article.


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