Fall 2005

E x e c u t i v e   d i r e c t o r ' s   m e s s a g e
Actions needed now to shore up medical care system

Dawn Mason Photo

New recruits Drs. Carla Tulk (left), Jacqueline Elliot and Terence Fogwill are among the new physicians recruited to practice in Newfoundland and Labrador in the past several years, thanks in large part to the current MOA which closed the income gap between this province and the rest of Atlantic Canada.

Both government and the medical profession have vital leadership responsibilities in ensuring that the public has a sustainable and stable medical care system.

By Robert Ritter

Over the last number of years there has been increasing evidence that the medical care system is eroding despite ever-increasing expenditures. Concern about the future has given rise to a great deal of activity and cooperation among the public, private and voluntary sectors. Many parallel initiatives are now under way to find enduring solutions with respect to timeliness, accessibility and equitability. The recent Supreme Court decision affirming the rights of individuals to seek alternatives when the public system fails them has given rise to passionate public policy debate with respect to the future complexion of our health care system.

Many reform measures are already under way to mitigate against further deterioration of medical services. Re-organization and redistribution of resources will go a long way to improving care, as will better use of new digital technology. More rigorous professional resource planning and forecasting at all levels will also be helpful. But improved efficiency and tighter controls will only go so far. The plain truth is that there is an inadequate supply of the skilled medical professionals today. And, there is compelling evidence that our medical education system presently is not equipped to produce the number and mix of skilled professionals will be needed to meet needs over the next twenty years. Moreover, the problem will be exacerbated when the baby boom bulge graduates to senior life.

The health care system is not immune from the forces of the marketplace. Given the prospects of diminishing supply and increased demand, the competition for qualified medical practitioners will become correspondingly fierce. Our province will need to remain competitive to ensure sustainability. While financial incentives are not the only motivators to recruit and retain, they are the most crucial.

Recent statistical data presented by the Canadian Institute for Health Information (CIHI) received a great deal of media attention. There was much hoopla around the fact that more Canadian physicians returned from the U.S. than left, for the first time since 1969, when CIHI began recording this information. On the home front in Newfoundland and Labrador, CIHI reported that there was an increase in the number of physicians between 2000 and 2004. When asked to comment on this positive development, a spokesperson for the province’s health boards association suggested that more physicians are choosing to come here because of the beautiful scenery and favorable working conditions. There is not one physician in this province that would agree with this assertion. In fact, our membership data indicates that the increase actually occurred within the 2003 to 2004 timeframe, after the physician income gap with the rest of Atlantic Canada began to narrow in a meaningful way.

There are other supply side issues that apply to our current scenario. Approximately one-quarter of our physician complement (250) are over 55 years of age and will be winding down or leaving their practices over the next decade. They will have to be replaced by a new breed of professional who is not prepared to work 70 to 80 hours a week as many of the last generation have. The workforce will have to be increased accordingly.

Both government and the medical profession have vital leadership responsibilities in ensuring that the public has a sustainable and stable medical care system. The NLMA is now engaged in intensive discussions with government that will shape the course of service delivery in the province for years to come. We will be promoting many new and innovative ideas with a view to securely anchoring our professional resources for the long term. Newfoundland and Labrador has the capacity to become self-reliant and secure in medical care. This will require developing a clear vision beginning with recognition of physicians as a value centre rather than a cost centre. Now is the time to address the issues facing the profession to ensure the people of Newfoundland and Labrador receive the best medical care possible today and for years to come.



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Nexus is published quarterly for Newfoundland and Labrador's physicians. It is a forum for the exchange of views, ideas and information for members.