Too many doctors, or not enough openings?

[NAB]

http://blogs.vancouversun.com/2013/10/2 ... ng-report/

[Merry]

I think part of the problem is that too many specialists are being trained, because we definitely have a shortage of GP's.

However, even though there appears to be a "glut" of specialists in certain fields, there are other fields where they do not have enough. I know someone who had a stroke over a year ago who STILL hasn't been able to get an appointment to see a neurologist in Kelowna. Last time he called and asked why he's still on the waiting list, he was told that there won't be any available appointments until at least January. That will be 18 months after the stroke happened, and probably way too late for there to be any "meaningful" treatment result emanating from the appointment. So I guess the question is, in this day and age of amassing statistics, how come we don't appear to have any statistics on which kind of physicians are in short supply in which areas of the country? And then inform our medical schools accordingly.

The Government appears to have plenty of money to monitor the activities of "ordinary Canadians" yet not enough to keep track of the sort of useful information that would help improve our health care system. Maybe if they focused a little less on invading folks' privacy it would free up funds to spend on more important stuff.

[Lady tehMa]

How odd. When my doctor retired last December, he had been trying for 6 months to find someone to take over his practice. I spent January knocking on doors and pleading and finally found a doctor for our family.

[shoo]

We have a glut of denists and within the next few years, we will have the same situation with doctors.

[Urbane]

The doctors that we do have are not keeping up with the workload and until we move to a public/private universal system as they have in much of Western Europe we're destined to suffer from longer and longer wait times.

Wait times for medical treatment getting longer: report

CTVNews.ca Staff
Published Monday, October 28, 2013

Canadians are waiting longer to see a specialist, undergo diagnostic testing and begin treatment for medical problems ranging from orthopedic surgery to cancer, according to a new report, despite recent government pledges to reduce patient wait times.
In its annual report, “Waiting Your Turn: Wait Times for Health Care in Canada,” the Fraser Institute said the median wait time in 2013 hit 18.2 weeks, three days longer than in 2012. Twenty years ago, the average wait time for treatment in Canada was 9.3 weeks.
Specifically, the average wait time for orthopedic surgery reached 39.6 weeks for treatment, while patients waited an average 17.4 weeks for an appointment with a neurosurgeon.

Cancer patients needing radiation experienced the shortest wait times for treatment, at about 3.5 weeks.
The report estimates that about one in 34 Canadians “may be in pain, off work, or suffering from depression as they wait their turn for treatment.”
"Canada is effectively reneging on its promise of universal healthcare for those citizens forced to endure these long waits,” Bacchus Barua, Fraser Institute senior health policy analyst and the report's lead author, said in a statement.
“Simply putting someone on a list is not the same as providing necessary medical attention in a timely manner.”
Co-author Nadeem Esmail, the institute’s director of health policy studies, said longer wait times are not the result of insufficient health care spending.
“Wait times can be considerably reduced without higher spending or abandoning universality,” Esmail said in a statement.
“The key is to better understand the health policy experiences of other more successful universal access health care systems around the developed world such as Australia or Switzerland.”
The study’s results are based on data gleaned from a survey sent to Canadian physicians practicing in 12 specialties. It is sent to doctors in all provinces.
The survey measures wait times from a GP’s referral to treatment, wait times between GP referral and consultation with a specialist, the wait time between seeing a specialist and receiving treatment, and wait times for tests such as MRIs, CT scans and ultrasounds.
According to the latest report, the delay between:
GP referral and specialist consultation increased to 8.6 weeks in 2013, up from 8.5 week in 2012.
Specialist consultation and treatment increased to 9.6 weeks from 9.3 weeks in 2012.
By province
According to the report, the province with the shortest wait times from GP referral to treatment was Ontario. Patients there waited an average of 13.7 weeks in 2013, down from 14.9 weeks in 2012. On the other end of the spectrum patients in Prince Edward Island waited about a year, 40.1 weeks, between referral and treatment.
The report also found that wait times to see a specialist increased in seven provinces between 2012 and 2013, but decreased in Ontario, New Brunswick, and Newfoundland and Labrador.
The shortest wait times to see a specialist were in:
Ontario, at 6.7 weeks.
Quebec, 7.4 weeks.
Manitoba, 8.1 weeks.
The longest wait times to see a specialist were in:
P.E.I., 24.9 weeks.
New Brunswick, 20.3 weeks.
Newfoundland and Labrador, 14.0 weeks.
Overall, the report said, Canadians across the 10 provinces were waiting for about 928,120 procedures, up 57,658 procedures from 2012.
"These lengthy delays have real and important effects on Canadians' health and wellbeing, imposing pain and suffering, mental anguish, lost productivity at work and leisure, and possibly even disability and death," Barua said.

Read more: http://www.ctvnews.ca/health/wait-times ... z2j2epqorQ

[Glacier]

Princeton had massive doctor shortage recently. Same goes for Burns Lake, and many other small towns who cannot find any unemployed doctors willing to re-locate. One small community of 100 residents had to literally go to the ends of the Earth to find a doctor.

I wonder if the glut in certain fields like heart specialties stems from the change in demographics. ie. cancer and many disease have rocketed up in recent decades (mostly because of an aging population), while heart disease has not changed.

[grammafreddy]

Sure is a shame the government closed all those small community hospitals, isn't it?

[underscore]

I think the real problem is that doctors are in control of who else gets to become a doctor, so they make it more difficult to become a doctor in the interest of driving up their own wages.

[Rwede]

Sure is a shame the government closed all those small community hospitals, isn't it?

Nope. It's a shame we wasted billions on inefficient health care provision for so many years by keeping small community hospitals open.

[Urbane]

Sure is a shame the government closed all those small community hospitals, isn't it?

The trade-off has been the expansion of services to the regional hospitals like KGH. It's a damned if you do and damned if you don't situation and in the meantime the percentage of the provincial budgets, in all provinces, going to health care is increasing all the time. While a lot of people seem opposed to any increase in private health care they also don't want to see their taxes go up so it's difficult for any government to satisfy people at this point. What seems to be working relatively well in Europe isn't even something that most Canadians seem willing to consider. Too bad.

[Poindexter]

We have some lousy specialists in kelowna but because they aren't going anywhere soon they hold a monopoly over certain fields. Don't want to point fingers but if you need a good dermatologist, good luck.

[Urbane]

Nope. It's a shame we wasted billions on inefficient health care provision for so many years by keeping small community hospitals open.

When we look to our regional hospitals like KGH we see some world class specialists and there's no way we could afford things like the new cardiac department at KGH while still keeping all of the small community hospitals open. As I say, it's a trade-off but the right decisions have been made. I understand why people in the small communities might not like it but they need to look at the big picture.

[grammafreddy]

I can see the value both ways. I am very fortunate I still have a hospital here. We have a traveling cardi, podiatrist, and respiratory specialist, as well as video links with oncologists but if you want to have a baby, you have to travel 200 kms for that. I suppose babies now are born by c-section via appointments out of town - Kelowna or Trail. The Ministry also spends huge bucks moving patients by ambulance for tests out of town.

Maybe this is also what's causing such a backlog for joint replacements, too. The hospitals that do that now have a much larger area to service.

[Glacier]

Have any regional hospitals closed? I can't think of any, though I haven't been following very closely.

Even though rural BC is shrinking, the demand for doctors is growing quite quickly because rural BC is aging twice as fast as urban BC. In the example of the 100-ish population community above that went to Antarctica to find a doctor, they never had a doctor until Dr. Mike showed up 5 years ago. Having the doctor in the community is saving taxpayer's money (he works out of the permanent nursing clinic, though when he started he was working out of his home and going to people's homes). 20 years ago when the population was almost twice that of today, there was no demand or need for a doctor, but now the majority of the population is over 60, the demand is high.

[southernfrau]

Some of the problem could be alleviated if the College of Physician and Surgeons would allow doctors from other countries to practice here. Just because these doctors didn't graduate from a school that was acceptable to our college, they are now driving taxi's, delivering pizza's and doing other jobs. All the while holding a doctorate. To me if they went through medical school, they are qualified. You don't find many medical schools that are back alley teaching businesses.