Where is the current agenda of healthcare change headed you ask?
Let us stand back and look at the big picture rather than our little kingdoms and let us look without blinders on and without cheerleading and posturing from politicians.
The Conference Board of Canada , an Ottawa-based, non-partisan think tank whose mission is to bring business people and policy makers together, has spent three years assessing where Canada is headed which will influence the sustainability of our universal healthcare.
In January 2007, the Conference Board’s Canada Project will release its report “Mission Possible: Sustainable Prosperity for Canada”. This research program has taken the rose-coloured glasses off and hopes to provide an honest assessment of Canada’s future.
Sure, Ottawa keeps racking up budget surpluses and our currency is strong but we are slipping in global rankings compared to other G8 countries.
“No one has been talking about our economy being adrift, but it’s an absolute fact,” says chief economist Glen Hodgson of the Conference Board. “The things Canadians cherish-our standard of living, our natural environment, our health care and public education systems-will become unsustainable if we don’t act now.”
“Mission Possible” set out five key areas for improvement and one includes addressing our aging labour force, which of course in my opinion, should include physicians. We need more seniors at work and we should be doing everything possible to keep our highly skilled and highly trained physicians working with as much support and incentive as possible.
I do say this without bias. I say this as a daughter of aging parents, as an aging individual myself, and as a mother to my children. As much as I appreciate what other healthcare providers offer, or even what complementary health care can offer, they do not offer the skill or expertise of a physician.
The first wave of baby boomers is about to turn 61, an average age for retirement for Canadians. Next year, 2007, will be a big retirement year where boomers are likely to be retiring in droves, physicians included. (Perhaps by coincidence, my eighty year old father’s physician is retiring in January with no one to replace him, not even me, as it is unprofessional to treat one’s own family and one risks the reprimand of physicians’ regulatory bodies.)
According to Hodgson, we have only about 10 years before the wave starts to undermine our economic performance and social well-being.
“Mission Possible” points out that immigration alone cannot come close to making up for the impending shortfall.
We will undoubtedly see that the numbers of IMGs being recruited from other countries will not make up for the physician shortfall in Canada. Also of interest, is the net migration of physicians to other provinces, mostly Alberta and BC, leaving Ontario with a net loss of physicians in 2005 as shown by CIHI.
Other countries are now doing more to enable older workers to extend their careers, including financial incentives, training programs, placement services, phased retirement programs and pension reforms. “Mission Possible” says Canada should do the same.
So why are physicians, particularly in Ontario and Quebec, seemingly under attack by government and its “transformation agenda” when our aging physician workforce should be supported and enabled?
Is it because other groups have managed to position themselves in the political arena and physicians have been too busy caring for the sick while others have found the most advantageous political seats? We have put veterinarians in charge of closure of hospitals, few physicians sit on LHIN boards in Ontario (except in rare instances in which I will not elaborate in this public forum) and we see more nurses taking on more prominent positions within the transformation hierarchy while physicians seem to be shunned.
How is this a balanced approach to finding solutions to provider shortages in healthcare, access shortages, and funding issues?
Instead of blaming medical workers for healthcare expenses, or creating more groups to scrutinize and regulate, we should be talking about how patients can contribute; how we can empower our providers to keep working; how we can allow market forces to help dictate numbers of physicians and other providers; how we can find other acceptable ways for Canadians to purchase healthcare, electronic medical records or other items that would contribute to more efficient healthcare.
Some say that physicians should just lump it and accept the transformation as it is unfolding; that it is a done deal.
I say that accepting this transformation is a big mistake and that more compromise is needed, more realism is needed and more understanding that sharing the facts with the Canadian people is necessary.
I guess time will tell, time we may not have.
As always, I am interested in the perspectives out there, particularly regarding non-physicians who might have something to say regarding contributing individually to EMR’s, to contributing to co-operatives, to how they might support their medical manpower.
Because ultimately, you don’t know what you’ve got ‘til it’s gone.