Growing our own

Issue: BCMJ, vol. 50, No. 4, May 2008, Page 180 Editorials

A number of years ago I wrote an editorial about the early indicators of physician shortages in this country, the additional specter of a graying/unhappy physician demographic, and the seeming lack of attention both of these red flags seemed to be generating in our legislators and educational institutions.

This was not a prescient revelation on my part, as most of us graying physicians were acutely aware of our shrinking professional resources with the progressively longer wait times for just about everything and the ac­celerated exit strategies that many of our close colleagues were excitedly describing during our very brief (and getting briefer) hospital interactions. 

Since that time the situation has not only become more professionally problematic, it has finally become a politically important item—at least here in BC where the current government has increased the size of the medical school and very appropriately agreed to fund three satellite faculties in addition to the Point Grey Campus facility. The combined UBC medical school will eventually graduate two-thirds of the doctors this province requires yearly just to keep up with our replacement needs as our top-heavy physician demographic retires, moves into nonclinical work, or dies. 

So, where will the rest of our docs come from? Historically, the rest of the country has supplied BC with large numbers of physicians who would rather carry an umbrella than wield a snow shovel. However, the rest of the country suffers from exactly the same problem as BC and these climate-challenged regions are already drying up as rich sources of Canadian-trained physicians. 

In fact, virtually all of these venues are suffering through the ex­tensive damage caused by the feds recommending to all of Canada’s training institutions to reduce their training positions in response to the Barrer, Stoddart report released in December 1991 (Toward Integrated Medical Resource Policies for Canada) and the accompanying endorsement of BC’s very own medical economist, Robert Evans. The rest of the Western world also finds itself doctor-deficient, and Irish doctors, British doctors, and South African doctors are no longer arriving in droves to fill the vacancies in the more rural areas because they are needed in their own countries and are being given lots of inducements to stay at home. 

There are a few non-licensed, internationally trained phy­sicians out there who could be added to our numbers fairly quickly, but they represent a mere drop in the bucket when we look at Canada’s current and long-term physician supply needs. 

The obvious answer—and one that we physicians have been suggesting for years—is that Canada must become self-sufficient and as quickly as possible develop the political will to commit substantial resources to the training of adequate numbers of physicians to meet our needs. 

This is a huge undertaking and not something for the faint of heart, but it is absolutely necessary that it gets done quickly. A political project of this size will cost an enormous amount of tax dollars and will require many years of planning and even more years of intelligent implementation.  As we all know, “politically fast” is generally the antithesis of political velocity in Ottawa, but this problem is too big and too immediate to allow it to languish on some committee table or wait for yet another Royal Commission. This problem needs to be addressed now.

Dr Brian Day has begun this process with a plea for all of us to get behind the CMA’s lobbying group in Ottawa in their efforts to convince our federal legislators to see the political necessity for this project to be moved forward and become a national program with an all-party endorsement. I would like to encourage all of you to send the postcards that Dr Day sent your way, call your MP, write a letter to your local newspaper—get involved, let people know how bad it really is. 

I find myself worrying that at a time when I need a family doctor, unless something changes quickly, she will have already been happily retired for many years. Instead, the MSP Helpline will be directing me to the nearest pharmacist who will be pleased to prescribe something for me. 

James A. Wilson, MD. Growing our own. BCMJ, Vol. 50, No. 4, May, 2008, Page(s) 180 - Editorials.

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