Physician Shortage in Canada: A Review of Contributing Factors

Abstract

The physician shortage in Canada is multifactorial. It is important to identify potential factors and policies contributing to the problem. An extensive literature review to retrieve primary source articles was performed using the PubMed database. Other sources of information included reports identified using the websites of organizations, associations, government bodies and Google scholar, as well as additional primary source articles identified using reference lists of retrieved articles and reports. Healthcare policy changes in the 1990’s limited the growth of physician supply through the reduction of medical school enrolment, restrictions on recruitment of international medical graduates into the workforce, redistribution of family physician and specialist mix and loss of physicians to the US. Inadequate supply of primary care physicians is reflected in the low interest among medical students in a family medicine career and the shortage of physicians in rural areas. Reduction of physician productivity is characterized by an aging physician population, greater proportion of women in the workforce and the reduction of direct patient care hours among the new generation of physicians. The problem is further exacerbated by inefficiencies in healthcare expenditures, judging from high healthcare spending and low physician-to-population ratio. An understanding of factors contributing to the physician shortage is essential in order to develop successful strategies to alleviate inadequate physician supply.