Family physicians in Canada don’t work as many hours as doctors did 30 years ago
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Canada’s family doctor shortage: The public, and politicians, worry about it a lot.
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Most everyone believes it’s a crisis that almost six million Canadians are without a family doctor, and waiting times are lengthening.
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The solutions trotted out most frequently involve governments paying to expand medical schools to train more physicians, or luring more doctors to Canada from other countries.
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The Canadian Medical Association, the country’s physicians group, says the reason the “number of family doctors is not keeping up with demand” is because of retirements, fewer doctors choosing family medicine, limited pay, and Canada’s population getting “older and sicker.”
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But there is another factor, which is less discussed.
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And that is that Canada’s family physicians don’t, on average, work as many hours as they did 30 years ago.
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Health researchers, particularly Lindsay Hedden at Simon Fraser University and David Rudoler at the University of Toronto, have found that a family physician in Canada, depending on the province, is seeing a median of 515 to 1,736 fewer patients a year than they did in the late 1990s.
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UBC prof. Paul Kershaw is among those trying to figure out why there are constant concerns about a “doctor shortage” even though, while Canada’s population has grown by 75 per cent since 1976, the number of physicians has increased nearly 200 per cent.
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“Physician head count has surged, but total physician hours have grown more slowly,” said Kershaw, a professor of public health.
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“Doctors today work fewer weekly and annual hours than in the 1970s. This reflects expectations for better work-life balance, and a rising share of doctors in dual-earner households.”
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As researchers assess the significance of how 54 per cent of physicians under 40 in Canada are now female — compared to about 15 per cent four decades ago — Hadden and others refer to the trend as “workplace feminization.”
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But the term may over-simplify the choices that doctors, female and male, are making about how much they intend to work. More family physicians overall want balanced lifestyles, including to spend time with their children.
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They don’t want to burn out, like some physicians did in the past. Two generations ago, it was not unusual for family physicians, also known as general practitioners, to operate in a “cradle-to-grave” model that included office, hospital, and emergency care for patients, often making themselves available on weekends, including for house calls.
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Male physicians in 1990, worked an average of 55 hours a week, according to the Canadian Medical Association Journal. Today, they work just under 48 hours per week.
