Canadian Medical Association

What would happen if half of Canadian physicians suddenly cut back their clinical hours? 

What would that mean for Canadians trying to access health care? Or for patients who are waiting for surgeries and screenings delayed by the pandemic? To the remaining physicians and other health workers who are already struggling to provide timely access to care amid massive backlogs? What would it mean for our economy, our communities, our society as a whole?

These are the difficult, frightening questions that our governments and policymakers must consider. Preliminary data from the Canadian Medical Association’s National Physician Health Survey shows more than half of physicians and medical learners (53%) have experienced high levels of burnout, compared to 30% in a similar survey conducted in 2017. 

The most jarring figure to come out of this data is that nearly half, or 46%, of respondents are considering reducing their clinical work in the next 24 months. 

The repercussions of this could be devastating in a country where more than five million people have no regular health care provider and only 40% of those who do can get an appointment within 48 hours. 

We should all be deeply concerned. 

Patients in every province and territory are already struggling to access timely care, a struggle made significantly worse by the pandemic. Many are suffering in pain and discomfort awaiting surgeries, while others require important diagnostics like cancer screenings. 

Physicians are just now starting to work through backlogs that are tens of thousands of cases (read: patients) deep. They have trudged through a global pandemic that has worn all of us down over the past two years and, despite what many seem to believe, is far from over. 

These health care challenges will become insurmountable if health workers start leaving their professions in droves. Our health workforce is in the biggest crisis ever seen. Because of this, and because of pre-existing gaps and inequities in the system, Canada’s health system is on life support.

Physicians are not the only health workers struggling. Nearly 40 national and provincial organizations representing a wide variety of health professions met earlier this month to discuss the health worker crisis. 

All agreed that the challenges we are facing have worsened since the first Health Worker Emergency Summit in October 2021. Health workers across professions are exceedingly distressed, with many choosing to leave their careers for the sake of their own health. 

The organizations were united in calling for urgent action to address the worsening health workforce crisis, including creating a robust source of data so we can truly understand the needs and gaps across the country, implementing a national human health resources strategy and rebuilding Canada’s health care system for the future. 

While governments have acknowledged the struggles of the health workforce throughout the pandemic, commitments to address the systemic issues impacting that same workforce have so far been modest. 

Health care is a primarily a provincial/territorial responsibility, but the crisis has evolved beyond what any one jurisdiction can manage alone. This is a pan-Canadian problem that will require the close collaboration of federal, provincial and territorial governments to solve. Strategic federal leadership and investment are required to support rebuilding health care delivery in Canada. 

Federal Health Minister Jean-Yves Duclos acknowledged this fact last week when announcing $2 billion in funding to help provinces and territories to address immediate pandemic-related health care system pressures, particularly the backlogs of surgeries, medical procedures and diagnostics. The federal government’s investment in addressing this backlog is welcomed. 

We need pan-Canadian, integrated health human resources planning. We know there are about 118,200 job vacancies in health care and social assistance across the country, but there is no plan for addressing that massive shortfall. 

We also need to increase patient access to family doctors and primary care teams, and we urge the government to make this a priority now.

To this end, the CMA recommends that $1.2 billion over four years be dedicated to a primary care access fund and $2 million be earmarked to undertake an assessment of inter-professional training capacity of family physicians and other professionals in primary health care. Scaling up collaborative, inter-professional primary care is central to increasing access to care. 

Finally, we need a pan-Canadian medical licensure model that removes barriers to physician mobility to expand care to rural and remote communities, address virtual care, and deliver care where it is most needed. 

Until governments and policymakers across all levels of government begin to collaborate and plan concrete solutions to address our health system’s shortcomings, the system and those of us working within it will continue to struggle. And regretfully, as a result, all Canadians will suffer. 

Dr. Katharine Smart is a pediatrician in Whitehorse, YK and the president of the Canadian Medical Association. 

Republished with permission from The Hill Times.

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