Yogi Berra said it best: “It’s tough to make predictions, especially about the future.”
In the realm of physician workforce planning, the proof of his statement lies in the cycles of shortages and surpluses of physicians in British Columbia over the years. No one seems able to get the right number, and perhaps—absent a crystal ball—no one ever will. It may be that the challenge of forecasting physician supply—an endeavor that requires consideration of multiple and difficult-to-measure variables—just does not lend itself to easy prediction.
However, good policymakers never let perfection be the enemy of the good. And if cycles of surpluses and shortages are an inevitable part of physician workforce planning, our goal should be not a futile effort to eliminate them, but rather to minimize them as much as possible.
The BCMA attempts to do this with a new policy paper titled “Looking Beyond the Numbers: Planning British Columbia’s Physician Workforce.” The central message of the paper is that physician workforce planning in BC needs to be better coordinated, more responsive to population health needs, and longer term in its focus.
The shortcomings of physician workforce planning are obvious to the multiple stakeholders influencing physician resource planning, including the provincial government, health authorities, the BCMA, universities, regulatory bodies, and medical community.
Too often, each develops and implements their policies in isolation. The result compromises British Columbians’ access to timely, high-quality, and effective physician services. Moreover, the health care system continues to face growing pressures from the increasing complexity of patient case mix and the resulting demand for more physician time and services.
The ongoing evolution of the practice of medicine and the changing demographics of the physician population also affects the supply of physician services. Fully 42% of BC’s physicians, for example, are 55 years old or older.
In “Looking Beyond the Numbers: Planning British Columbia’s Physician’s Workforce,” the BCMA examines the challenges of physician workforce planning through the lens of the medical career lifecycle.
Each stage—medical student, resident, practising physician, and near-retirement—offers opportunities for stakeholders to improve current policy and understanding on the individual choices that physicians make about what, how, and where they practice. Doing so will align physician resource planning more closely with the population’s need for health care services. Among the most significant recommendations of the paper are:
• Establishing a multi-stakeholder provincial committee led by the BCMA, Ministry of Health, and the health authorities to direct and coordinate the development of physician resource plans and to identify short- and long-term physician resource priorities.
• Developing a provincial analytical framework for needs-based physician resource planning.
• Creating a provincial physician workforce database to form the basis of physician resource planning.
Physician resource planning is not solely a technical exercise; it is also a value-driven one. The future need of physicians is influenced by the political and social choices that underlie the health care system, and how the future role of the physician is defined. There is no one ideal physician-to-population ratio or optimum number of physicians—other than the one that fully informed British Columbians support.
By adopting a more collaborative and comprehensive planning approach, both provincially and nationally, stakeholders can minimize unintended policy impacts, the mismatch between supply and needs, and costly duplication. Addressing the challenges facing physician workforce planning ultimately requires leadership and a commitment from all parties to not fall back on the status quo.
The BCMA hopes that the paper will propel stakeholders to work together thoughtfully and collaboratively to improve physician workforce planning because what we prepare for now will be what we get later.
For the full paper, click here.
—Shelley Ross, MD
Chair, BCMA Physician Workforce Project Group
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