- Carolyn Brown, freelance journalist
- Ottawa
- carolynjbrown{at}bell.net
“We need to recognise that we’re in a crisis.” Alika Lafontaine is president of the Canadian Medical Association and an anaesthesiologist in the province of Alberta. Throughout the country, shortages of workers are causing emergency department closures1 and long waiting times for a range of medical services. Emergency physicians say that they can’t provide safe and timely care.2 The Canadian Medical Association Journal has called access “the most pressing concern” in Canadian healthcare today.3
Covid-19 is a major reason Canada’s healthcare system is at a tipping point. But it didn’t create—only worsened—shortages that experts say were developing before 2020. “As time goes by, fixing the system becomes harder and harder,” says Lafontaine. “We either fix it or face the consequences. I do not believe there’s a bottom to how low it can go.”
Pinpointing the cause of that crisis has proved puzzling. “When we talk to provincial planners, they say, ‘We have tons of physicians—we’re on track,’” says Arthur Sweetman, a researcher with the Centre for Health Economics and Policy Analysis at McMaster University in Hamilton, Ontario. Yet the fact remains that patients can’t get the treatment they need.
Declining hours, ageing citizens
Sweetman’s team has found that two issues go some way to explaining this paradox: physicians’ hours of work declining and the population ageing.4
Unlike the UK and many other countries, the vast majority of Canada’s physicians, even those in hospitals, are self-employed and can control their own hours. Those …