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Fall 2005 |
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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
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Dawn Mason Photo |
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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. |
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Both government and the
medical profession have vital leadership responsibilities in ensuring
that the public has a sustainable and stable medical care system.
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By Robert Ritter |
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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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