Older physicians can help in health crisis

Health care will be the subject of the First Ministers’ meeting in Ottawa Tuesday. A recent Leger poll found that 86 per cent were worried about the state of health care. The premiers will be pushing for an increase in federal health transfer funding, but a more important issue is the severe national shortage of health professionals.

Some 1.8 million persons in Ontario have no family physician; another 1.7 million have one age 65 or greater. Over 6 million Canadians lack a FP.

In 2020, among 36 OECD countries, Canada ranked 29th in beds/1,000 population and 26th in its physician/patient ratio.

Admittedly, provinces are being creative. Several are fast-tracking the licensure of foreign nurses and physicians. Newfoundland and Labrador, through its Family Practice Renewal Program, is sending a team including the health minister to recruit MDs and nurses in Ireland, and possibly later in South Africa and India.

Ontario is expanding the role of free-standing surgical clinics for cataract and joint replacement procedures outside of hospitals. It is also allowing members of 26 different health professional groups to come and practise without formally registering with their licensing bodies for a year. Yet until the overall lack of sufficient numbers of nurses and MDs in Canada has been addressed, it is difficult to see how these measures will not exacerbate the staffing shortages in hospitals.

In the meantime, we need to quickly reorganize care with health-care teams and we must retain our older physicians. In Canada, over 15 per cent of doctors are over age 65; in Ontario, 16 per cent of MDs are over age 65 and eight per cent over age 70.

Federal Health minister Jean Yves Duclos has urged the premiers to focus on recruiting and retaining health professionals. Thus, a first step in at least stabilizing the current shortage of MDs would be financial support for older physicians. This includes a major reduction in annual licence fees (about $2,000 in most provinces). The Royal College of Physicians and Surgeons, College of Family Physicians, and Canadian Medical Association already give a major discount of dues to older MDs.

In addition, older MDs need government-funded short-term income stabilization. Physicians may to take time off work for a few weeks of months due to a heart attack, severe infection such as COVID-19, resection of a malignant breast or bowel tumour, prostate or cardiac surgery, a knee or hip replacement, etc.

Sadly, private disability insurance is usually unavailable, and has a long waiting period to collect benefits. As a result, a prolonged illness or surgery may result in permanent retirement.

As a precedent, note that all provinces offer parental leave benefits. These are paid usually for 17 weeks, and vary from $1,000 per week in British Columbia and New Brunswick to $1,500 in Nova Scotia.

I propose that some of the likely increased federal health transfer payments be earmarked to cover physicians and surgeons from age 65 to at least age 80 with no waiting period.

While waiting for fast-tracking of foreign graduates, increased medical school enrolment, increased residency training positions, and national portable licensure to take effect, in the short term we must do whatever it takes to encourage our older physicians to resume work after surgery or a major illness, even if only part time.