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Massive survey points to MD job angst, growing emphasis on care for seniors

A new national survey of almost 10,500 practising physicians points to growing concern about the employment outlook in some major specialties, although almost three-quarters of respondents (72%) were either satisfied or very satisfied with the state of their professional life.

On the employment front, the 2013 results from the National Physician Survey (NPS) indicate that only a small proportion of doctors reported being unemployed (1%) or underemployed (5%), but results were bleaker within several specialties.

For instance, underemployment and unemployment were major issues in some "resource-intensive" specialties, with rates ranging from 31% in critical care medicine to 28% in cardiovascular and thoracic surgery, and 20% in orthopedic surgery. Family physicians (3%) were far less likely to report underemployment than other specialists (8%). Overall, 59% of respondents reported they were "employed to their satisfaction."

The findings are significant because the NPS, which has been conducted every three years since 2004, is the largest census survey involving physicians and an important barometer of issues and concerns within the medical profession. This is also the first time the NPS has sought information on employment issues. When the last survey was conducted in 2010, MD unemployment and underemployment were not considered significant problems.

The 2013 results also indicate that Canada's aging population is having an impact on medical practice. A survey synopsis says that because of Canada's aging population, it is no surprise that geriatricians (59%) led the list of specialists reporting a major increase in the need for their services. Major increases were also reported by dermatologists (53%) and general pathologists (43%).

Overall, respondents reported working an average of 54 hours per week, and almost a third of them (35% of FPs, 30% of other specialists) said they were overworked. Extra services provided outside of office hours, such as on-call duty, added 110 hours per month to MDs' professional responsibilities.

The 2013 survey also reveals that the gap between hours worked by female and male physicians has narrowed to five hours per week, compared with seven hours when the first NPS was conducted in 2004. "Past NPS research has also shown that in the absence of children at home, the difference between female and male workloads was negligible," the survey's background document states.

Half of the physicians surveyed (49%) indicated they are satisfied or very satisfied with their work-life balance.

The survey also pointed to a major jump in the use of electronic health records (EHR), from 39% in 2010 to 62% this year, with usage rising to 70% for physicians under age 44. Among EHR users, 42% reported their productivity had increased because of the switch from paper records.

CMA President Louis Hugo Francescutti says the 2013 results leave the CMA and federal government with much to ponder in areas such as health human resource (HHR) planning and seniors' care.

"When it comes to seniors, the time to act is now," said Francescutti, pointing to the NPS results concerning demand for geriatricians' services. "The 2013 survey results show that the CMA is on the right track with its focus on seniors' care and the need for a national strategy surrounding this care."

He described the NPS as a "diagnostic tool" for health care planners. "The diagnosis in 2013 is pretty clear," he said. "We need a national approach to HHR issues instead of having a dozen different strategies across the country."

The NPS, a joint effort of the CMA, Royal College of Physicians and Surgeons of Canada and College of Family Physicians of Canada, is conducted every three years. Results are available online.

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