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aceventura3 · 03-03-2006, 02:02 PM

Seems like doctor shortage in Canada is reaching "crisis level".

Quote:

WHITBY, ONTARIO -- Esther Pacione needs a family doctor. At age 56 she is afflicted with severe ataxia, a neurological condition that causes her acute pain, choking and loss of consciousness.

The walls of her home are scuffed from the times she has fallen and hit her head.

Her regular doctor suffered a stroke a year ago, and all the local doctors she has contacted say they cannot take new patients, so now Pacione, a retired bookkeeper, goes to a walk-in clinic whenever she has an emergency. At the clinic, she waits hours and sees a different doctor each time, and no one there is familiar with her medical history and what drugs she has been taking.

"If you are not bleeding all over the place, you are put on the back burner," Pacione said. "Unless, of course, you have money or know somebody."

The publicly financed health-insurance system remains a prideful jewel for most Canadians, who see it as an expression of communal caring for the less fortunate and a striking contrast to a U.S. health-care system that leaves 45 million people uninsured. But polls indicate that public confidence in Canada's system is eroding, although politicians remain reticent to urge increasing privatization of services.

During the recent closely fought election campaign, Prime Minister Paul Martin promised to fix Canada's health-care system "for a generation," focusing on trimming waiting times for diagnostic tests, cancer treatment and elective surgery such as hip replacements. But medical professionals and local officials say a major reason it may not be easy to address the problem of slow access to treatment is because doctors who do preliminary diagnostic work, refer patients to specialists and monitor the care of chronically ill people are less and less available -- especially in small towns and rural areas.

A 2002 report from the Canadian Senate said that the actual number of family doctors had decreased only slightly in recent years but that the demands of an aging population were growing. Meanwhile, several recent studies have shown that family doctors are working shorter hours.

Young doctors are more likely to seek the most lucrative work in cities or go to the United States rather than start more modest practices in small towns because of growing debts when they leave medical school. That has set off an increasing competition among small towns to attract doctors.

Pacione's predicament is surprisingly common, even in her upper-middle-class community on the north shore of Lake Ontario.

Whitby has only 63 family doctors to care for its 110,000 people (medical officials and local officials say at least 16 more are needed), and many residents drive 45 minutes or more to Toronto for basic medical care. Whitby is one of 136 communities, encompassing a total of a million people in Ontario, Canada's most populous province, that are not adequately served by family doctors, according to the Ontario Medical Association. That is up from 100 communities in 2000.

Whitby officials estimate that 22,000 people there have no doctor at all, forcing them to go to emergency rooms at overcrowded local hospitals to wait in line for as long as four hours simply to refill a prescription, get a doctor's note for an employer or care for their flu symptoms.

"It's like winning the lottery to get in and see the doctor," Mayor Marcel Brunelle said. "This is a very wealthy country. What happened to bring the situation to this point?"

Shortage worsening

The government statistical agency estimates that more than 3.6 million Canadians, representing nearly 15 percent of the population, do not have a family doctor. That remains better than in the United States, where an estimated 20 percent do not have a regular doctor.

But there are signs that the doctor shortage in Canada is worsening. The Canadian Medical Association estimates that the country requires 2,500 medical graduates annually but is producing 2,200 a year.

Brunelle formed a task force in June to recruit young doctors by introducing them to real-estate agents and giving them advice on how to start new practices, and the town government is considering building a municipal clinic. The town of Peterborough is offering large monetary incentives and a grab bag of perks, including memberships at the YMCA and cable television. Other municipalities offer moving expenses and the inside track on real estate next to golf courses.

But experts say those efforts may not be enough. "If the current trends continue, we can anticipate a crisis," warned Joseph D'Cruz, a University of Toronto business school professor who specializes in health care. "People will actually find it impossible to get general medical services in their towns."

The doctor shortage is hurting the economies of small towns seeking to attract businesses. But it is also taxing the energies of the doctors who do live in those towns, as well as the resources of local hospitals -- and patients often complain that their treatment is rushed.

Administrators at the nearby Lakeridge Health Oshawa, an acute-care hospital, estimated that more than 30 percent of the patients who went to the emergency room would go to a family doctor instead if they could do so quickly. It is a burden on the hospital's staff, space and financial resources.

One patient who went to the emergency room recently, Crystal Bentley, 22, complained of cysts behind her ears. She said she would prefer to see her family doctor but would have to wait in his office for hours. She said she went to the hospital because the emergency room was faster.

"Seeing a doctor and not having to pay is phenomenal," she said, "but here I am taking up emergency time from doctors. I really do wish I could see my family doctor instead of coming here and talking to a total stranger."

http://www.angelfire.com/pa/sergeman...shortage2.html

Just to be fair here is a link the article is titled "What doctor Shortage", it appears there are lots of foriegn trained doctors working low wage jobs who can not get licensed, but the article still acknowledges a shortage.

http://www.caribbeanmedicine.com/article26.htm

O.k. defenders of the Canadian run system how about some facts to support the system has long-term viability. If Canadian trained doctors on a net basis are leaving the country, how are they going to fix that?