A physicians performance is affected by many factors. One of the most important factors is the systemic deficiency in the health care area. Most physicians work very hard to compensate for these deficiencies to provide excellent care to the patients. This, of course, comes at a personal cost to the physicians own health and quality of life..
Let us look at some of these deficiencies in our health care system.
1. Shortage of physicians:
In 1993, there was one physician for every 528 Canadians, compared with one for 541 today. Almost 47 percent of family physicians under 40 are female. Not all of them work full-time. Each year, 650 Canadian doctors move to U.S. Today, Alberta needs 333 full time doctors and rural Canada needs 1652 doctors. Are we ever going to have enough doctors?
2. Specialists are getting older and working longer:
Canadian Medical Association data show that almost 49 percent of all active general surgeons are older than 55. Forty one percent of general internal medicine specialists, 40 percent of ear, nose and throat specialists, and 39 percent of obstetricians and gynaecologists have relatively old specialists. Seventy two percent of general surgeons older than 55 and 73 percent of general internists work more than 40 hours per week. As we continue to be short on all types of specialists, these numbers are going to get worse with burnouts and early retirements.
3. Nursing shortage:
Canada is in the grip of a serious shortage of registered nurses. This is expected to get worse over the next few years. The most comprehensive national study, published by the Canadian Nurses Association, predicts a shortage in Canada (except Quebec) of between 59,000 and 113,000 by 2011. Quebec has its own nurses association and they are predicting a shortage of 11,000 nurses between 2001 and 2015. Are we ever going to have enough nurses to look after us?
4. Shortage of other health care professionals:
Currently there is a significant shortage of speech therapists, occupational and physiotherapist, ultrasound technicians, MRI technicians and many other non-physician, non-nursing specialists in health care fields.
5. Shortage of doctors in rural areas:
Many Canadian physicians are reluctant to work in rural areas because of high level of on-call, long distance to secondary referral centre, lack of speciality services, too few family doctors, absence of equipment such as x-rays and laboratory services, difficulty in obtaining locums, no ambulance service, inability to provide services such as obstetrics and general surgery, sparsely populated catchment areas etc. Is this ever going to get better?
6. Shrinking medical schools:
There has been steady decline in the size of first-year classes at Canadian medical schools during the past 15 years. In 1997, 1577 students enrolled in first-year classes, compared with the peak of 1887 students in 1983. The number of applicants to U.S. medical schools has dropped by 18 percent since 1996, while the number applying to Canadas 16 schools declined by eight percent in the same period. Why? Because potential medical students have more career opportunities in non-medical fields, have fear of difficulties in health care system, and are afraid of huge debts associated with medical education.
7. Shortage of acute car beds:
As a result of massive bed closures over the past ten years or so, there are now only 1.74 hospital beds per 1,000 people in Calgary and 1.70 beds per 1,000 people in Edmonton. This is a substantial decline from 1993, when the provincial average was 4.7 beds per 1,000. Similar shortages are felt outside Calgary and Edmonton.
There are two other issues not dealt with here: funding and waiting times to see specialists and get investigations done. All in all not a healthy picture of our health care system. But all types of health care professionals work hard at great personal cost to provide good care to the people of our province. Hats off to them and their families!
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