Doctor shortage to increase by 2015 without foreign-trained physicians: study

CALGARY (CP) - Provincial governments across Canada should stop regulating who gets into Canadian medical schools and consider allowing qualified potential physicians to foot their own training costs, says a new study from the Fraser Institute. The move would help ease a doctor shortage and reliance on foreign-trained doctors that will only get worse in the next decade, says Nadeem Esmail, a director at the economic think-tank.

"Abandoning medical school admission and training restrictions would mean that the supply of doctors would be determined by patients' needs, not provincial funding decisions," said Esmail, whose study was released Monday.

He said would-be doctors either abandon their medical dreams or choose to pay for their education in the United States or the United Kingdom, many choosing not to return to Canada.

The study also recommends the adoption of user fees and lifting restrictions such as how many operations a surgeon can perform.

"There are a number of ways the system can be reformed that will increase the volume of services provided to Canadians through the universal health-care system without an increase of cost," Esmail said.

"The system is very expensive and delivers very poor access to care because of its structure. Changes to that structure will mean better access to care today."

The report notes Canada has been relying on foreign-trained doctors to fill the gap in recent years. Without a change in medical training policy, importing health-care workers will have to continue or Canada will see the number of doctors per capita drop by 2015.

Previous studies have concluded that government restrictions on education and training in the late 1980s created the shortage. And, although the numbers in medical schools have expanded in recent years, one in 10 doctors is now trained in another country.

Esmail said it's wrong to encourage doctors from poor nations to fill the gap here and force countries such as South Africa and India to make do with fewer physicians.

"Right now, government decides what the need is going to be down the road and then decides what the training numbers are going to be. That system has clearly failed us in the past and it will not work in the future because this is a very complex area that needs to be driven by the needs of patients directly."

Although Canada has long tried to manage the number of doctors, other studies have found that countries which allow the market to determine how many are needed have been able to retain more domestically trained physicians.

Esmail suggests Canadian doctors be allowed to employ international medical graduates in training, much like apprentices, and oversee their work. The provinces should also allow nurses and nurse practitioners to have a larger role in a doctor's private practice under supervision.

Although the country's medical schools have been allowing more students in recent years, it takes up to a decade to train a doctor, meaning the shortage will not be quickly solved.

And a large number of doctors are approaching retirement age.

The Canadian Medical Association has said that more than one third of this county's doctors are 55 or older.

© The Canadian Press, 2006