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February 11 – COVID-19 highlights a shortage of nurses and doctors in Canada that dates from before the crisis and hampers patient access to healthcare, says a new report from the C.D. Howe Institute.

In “Help Wanted: How to Address Labour Shortages in Healthcare and Improve Patient Access,” Rosalie Wyonch evaluates factors contributing to healthcare labour shortages and investigates the inter-relationships between access to health services, the number of healthcare providers, compensation rates and migration patterns.

“To address a pandemic,” said Wyonch, “preserving and maintaining the healthcare system’s capacity is critical. Healthcare workers are the front line of defence against the worst consequences of a deadly global pandemic. In addition, they are at increased risk of being exposed to the virus. This makes it more important than ever to ensure Canada’s healthcare labour supply is sufficient.”

Increasing the supply of physician labour presents a complex puzzle for health human resource planners. The results of this and other analyses suggest that paying higher rates for physician services would have a negative effect on the number of health services provided per capita as physicians tend to reduce the number of hours worked as their pay increases. Nurses, conversely, have a positive – though small – correlation between remuneration, numbers per capita and health outcomes.

The time and costs associated with medical training rules out addressing labour shortages arising from a crisis simply through training more doctors. However, over the longer term, increasing the efficiency and supply of healthcare labour will require adapting medical education policies, remuneration and entry pathways to practising medical professions. In the meantime, the report advocates shifting methods and modes of care delivery, or adapting scopes of practice, are tools to address short-term healthcare labour supply gaps.

The report recommends:

  • Provinces should undertake a critical and strategic examination of fee schedules for physician services, with the goal of reducing the average cost per service but strategically increasing remuneration for difficult-to-access services.
  • Nurses and other care providers can increase the efficiency of healthcare delivery through expanding scopes of practice or filling gaps when there is a shortage of family or specialist physicians. Increasing wages would also help mitigate shortages in the field of nursing.
  • Continue the shift toward team-based care to encourage effective communication and knowledge transfer between supervising specialists and care providers.
  • Increase the number of places in medical schools, currently so low that a significant number of Canadians go abroad for medical school, incurring higher personal expenses and a lower likelihood of securing a residency position if they return to Canada to complete their training.
  • Increase the number of residency positions, both for Canadian medical graduates and internationally trained ones, particularly in disciplines projected to be in short supply.
  • Immigration of physicians and medical students should be also encouraged.

Read the Full Report

For more information contact: Rosalie Wyonch, Senior Policy Analyst; or David Blackwood, Communications Officer, the C.D. Howe Institute, 416-873-6168, dblackwood@cdhowe.org

The C.D. Howe Institute is an independent not-for-profit research institute whose mission is to raise living standards by fostering economically sound public policies. Widely considered to be Canada's most influential think tank, the Institute is a trusted source of essential policy intelligence, distinguished by research that is nonpartisan, evidence-based and subject to definitive expert review.