Despite having the goal of universal healthcare and spending the money to achieve that goal, Canada’s health system is still struggling. There are long waiting lists to see healthcare professionals, particularly for Canadians living in underserved and more rural areas. Why is there such a problem despite the high levels of spending, and what can be done about it? This article will explore these questions in some detail, so read on to find out more.
Why is there a physician shortage?
The main contributing factor to the physician shortage is the simple fact that people are living longer.
The number of people aged 65 and older is increasing because thanks to better living standards and more universal access to healthcare, people are living longer. This age group is statistically more likely to require healthcare than other age groups.
The aging population means that the doctor to patient ratio effectively goes down, which means fewer healthcare professionals.
There are other factors at play when talking about the physician shortage than just numbers. An employment study found that although enough people qualify as physicians, there are problems getting them into jobs, particularly into primary care roles. Access to primary care is the main bottleneck in the current physician shortage, and so not matching doctors with these roles is exacerbating the problem.
There are a few reasons why physicians are struggling to get into job roles:
- Too few positions are available for a specific specialty. It is common for doctors to want to specialize in a particular branch of medicine, and more people are training for these specialty roles than there are roles available. This leaves specialist doctors without a position and primary care roles unfilled.
- Doctors are often with families, and so any job role they would take on needs to be near to their family and provide opportunities for their spouses to be employed as many doctors may have met their spouses while at medical school, there is competition for the same jobs in the same areas, while more rural areas are underserved.
- Poor access to job listings.
- Lack of available healthcare resources in the right places. For example, a particular area might not have funding, or an operating theatre might not have time available.
When a doctor cannot find work, one common solution is to carry out more training and become more qualified. However, this takes doctors even further away from primary care roles.
Difficulty navigating the healthcare system
Another issue that people have with accessing healthcare in Canada is navigating different healthcare departments and institutions.
For example, a person might see a diabetes specialist and then be referred by that person to an eye specialist to help them with a diabetes-related sight condition.
However, making an appointment with that eye specialist and even finding that eye specialist in the first place would fall back to the patient, and they will likely have to go on a waiting list again, which delays their care.
The problem is that physicians are so overstretched that they do not have the capacity to help patients navigate other healthcare systems.
What do nurse practitioners do?
A possible solution to some of these issues in accessing healthcare is to make better use of Nurse Practitioners.
In the States, nurse practitioners are increasingly being given more autonomy, helping more people get the primary care they need.
Nurse practitioners are registered nurses who have additional education and training, which makes them competent to carry out additional duties that a physician usually undertakes. The majority of nurse practitioners in Canada work in primary healthcare, looking after patients from all age ranges. They often work in the community more than in hospitals and are responsible for things like:
- Taking a patient’s history
- Assessing their condition
- Making a diagnosis
- Dispensing medications
- Ordering and interpreting tests
- Setting broken bones
- Consult and refer to specialists
Nurse practitioners in Canada must currently work under the supervision of a physician.
How does this help address the physician shortage?
If more of the responsibility for primary care could be given to nurse practitioners, this would help with the physician shortage in a number of ways.
As we discussed, one of the main factors in the physician shortage is that there are not enough primary care physicians. If nurse practitioners who were qualified in primary care were able to operate autonomously in areas where there is difficulty accessing primary care, this would mean that more patients could get the healthcare they needed.
Even when there are primary care physicians available, they are often overloaded with enormous patients, which can lead to stress and burnout. Doctors have reported that around forty percent of their days are spent doing tasks that other professionals could take on, such as nurse practitioners and physicians assistants. If these tasks could be redistributed to nurse practitioners, it would ease physicians’ load, leaving them free to concentrate more fully on the tasks that really need their attention and reducing the risk of absence due to burning out.
Nurse practitioners often work in rural locations where there is not good access to physicians. They do valuable work in treating illness and injury and educating their patients on how to live a healthy life and prevent disease. This, in turn, helps to ease the load on physicians.
Texas Woman’s University has created an illustrative infographic on how nurse practitioners can ease the load on physicians, which you can look at here.
What else can help with the physician shortage?
Many of the healthcare system problems are around access to the right professionals for people in the right places.
If more use were made of telehealth technology such as virtual monitoring and consultations over a video call, it would make it much easier for people to see the people they need to see and remove barriers currently put in place by location.
This content is a joint venture between our publication and our partner. We do not endorse any product or service in the article.
