SASKATOON – If you ask Eldon Smith whether there are too many doctors, he’ll say you should be more worried about the number a decade from now.
“In the Sixties we had a shortage. We made some corrections. Now we have an excess and are making corrections. What will the situation be in the future?”
Smith is dean of the University of Calgary medical college. During a recent speech at the University of Saskatchewan, he said Canada has more doctors now than the ideal ratio of 1:600.
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Uneven distribution
However, doctors tend to be poorly distributed so rural and northern areas are short. Local health boards will have to use a combination of carrots and sticks to spread doctors around and fulfil “social obligations”, he said.
Getting the right number of doctors is just one of the factors the health system must improve.
“We’re very good at counting consumption and not very good at assessing needs.”
Smith said there are now 55,000 physicians in Canada, which has improved the doctor to patient ratio from 1:1,000 in 1961 to 1:520 in 1993.
In 1967 Canada added to its supply of new doctors through a combination of 900 graduates from Canadian medical colleges and 1,300 immigrant doctors. By 1993, Canada was graduating 1,700 and accepting 500 foreign-trained doctors.
Smith said there may not be enough doctors in the next decade with the current mood to cut health costs and the long training time – six years for family doctors and 10 for specialists.
By the year 2011, there should be 58,000 doctors caring for a Canadian population of 35.4 million, a ratio of 1:613. While this sounds adequate, Smith said there are other factors to consider.
By that time one in five Canadians will be over age 65, compared to one in eight now. And senior citizens use double the amount of medical services that people under that age do, Smith said.
Doctors are also working fewer hours and retiring earlier.
Meanwhile, enrolment at medical schools has fallen 17 percent since 1980. Immigration rules have tightened so only 250 foreign doctors came here last year, and more doctors are leaving Canada. Smith said 300 more doctors left the work force than entered it in 1994.
