TORONTO - The number of doctors in Canada has risen over the last five years, and the rate of increase is greater than the rate of population growth, says a new report that was greeted Thursday with cautious optimism.
"We have obviously woken up to the fact in the last few years that we have this significant shortage of physicians," said Dr. Cal Gutkin, executive director and CEO of the College of Family Physicians of Canada.
"And there are various strategies that have started to be put into place that I think are beginning to produce some results, so I think that can only be interpreted as an early piece of good news."
The 176-page study - Supply, Migration and Distribution of Canadian Physicians - was released Thursday by the Canadian Institute for Health Information. It makes use of Scott's Medical Database, which captures almost all medical doctors in Canada - not only those who see patients, but also those who are engaged in research, teaching and administration.
There were 65,440 active physicians in Canada in 2008, up from 60,612 in 2004, according to the study.
That's an eight per cent increase across the country, while the population grew by 4.3 per cent. And it translates into 195 doctors per 100,000 population last year, compared to 189 per 100,000 in 2004.
Each province saw an increase in its total number of doctors, and the overall increase has been occurring for a number of years, said Yvonne Rosehart, program lead of health human resources at the institute.
Canadian-trained and foreign-trained doctors both contributed to the increase. The report shows that since the late '90s, there's been a sharp rise in the number of students enrolled in medical schools.
"So we're starting to see the fruits of some of those programs," Rosehart said.
British Columbia, for instance, awarded 114 medical degrees in 2003, but that rose to 197 last year, the study shows. With the exception of Newfoundland and Labrador, every province with a medical school had a spike in the number of degrees awarded.
Dr. Bruce Fleming, executive co-ordinator for the Council of Undergraduate Associate Deans at UBC, said the medical school has been preoccupied with expansion.
"An important part of the message is not just expansion but distribution, to try to address the maldistribution," he said.
"We recognize that many of the rural and remote parts of the country are underserved by not just doctors, but all health professionals."
Doctors are now being trained in Prince George and Victoria. And in 2011, another 32 students will enter med school in the Interior - in the Okanagan and Kamloops areas.
At the other end of the spectrum, and also contributing to the overall increase, are those doctors who aren't retiring at the traditional age of 65.
The report shows that 13.8 per cent of specialists and 8.8 per cent of family medicine physicians are 65 years of age or older.
Rosehart said doctors in their 70s might be doing some clinical work, teaching and administration.
"But overall the workforce is benefiting from them being in it, and the wealth of experience they've accumulated over their career," she said.
Gutkin said many of them continue to work because they love what they do, but others are still tending to patients because there's no one to replace them.
"They haven't been able to find new physicians to take over their practices, and their patients would be abandoned," he said.
When they retire, "we may have a sudden gap that isn't totally filled by the numbers that are coming in through the entry part of the system."
There are currently about 27,000 to 28,000 family doctors practising clinical medicine, Gutkin estimated.
Efforts are underway to help students see family medicine as an attractive career.
"We were down to a low in 2004 of 23 per cent of students across Canada selecting family medicine as their first-choice career, and now, this year, we were up to 32.5 per cent," he said.
But more than 40 per cent need to choose the specialty to produce the number of family doctors needed on an ongoing basis in Canada, Gutkin said.
He noted that family doctors are starting to get better support - for instance, the opportunity to work in teams, and access electronic records - but there are still "huge gaps."
Despite the report's findings, Fleming, who works in emergency at Vancouver General Hospital, said he's still hearing of communities that are underserved, and not just in family medicine.
"Many of the small-and medium-size communities have shortages of specific kinds of physicians, for example, communities needing orthopedic surgeons or ... general surgeons. That kind of request is still certainly a major part of what we're trying to address."
