From this morning’s London Free Press (London, Ontario)

Doctor shortage predicted to worsen
Mon, November 12, 2007
By JOHN MINER, SUN MEDIA

If you think it’s tough to find a doctor in Ontario now, brace yourself for what’s happening in the U.S. presidential election campaign, warns the head of a Canadian doctors’ group.

With all the presidential candidates vowing to extend health insurance coverage to the about 47 million Americans without it, Canada’s doctor supply will be raided, said Brian Day of the Canadian Medical Association.

There’s no doubt the promise will be kept and have a dramatic effect on Canada’s supply of doctors, Vancouver-based Day said in London.

“We have always been traditionally the biggest source of manpower to the U.S.,” he said, adding Americans will also be looking for Canadian nurses and other health-care workers.

More than one million Ontarians have no family doctors, including an estimated 20,000 to 30,000 Londoners — in a medical-school city.

Ontario is short 2,000 doctors, a report last week by the Canadian Institute of Health Information found.

Already, Canada is losing the equivalent of two medical school graduating classes to the U.S., Day said.

“We can’t afford to lose those people because they tend not to come back,” he said.

The founder of Canada’s first private surgical facility, Day has been called “Dr. Profit” and the “Darth Vader” of health care for stepping outside the publicly funded hospital system.

If Canada and Ontario are going to keep doctors and eliminate waiting lists, the hospital funding system must be overhauled, he said.

The big problem, said Day, is that hospitals get a block grant for their operations.

That means every patient who walks in the door is seen as an expense, eating up part of the hospital’s budget.

“It is somewhat easier for the managers because they don’t have to worry about selling the product,” he said. “You don’t have to worry about pleasing the consumer.”

Instead, he said, hospitals should be paid for each patient they treat, making patients a source of value to them.

“Hospitals would quickly realize that if they open up operating rooms, they would actually generate more revenue and be able to do more . . . You would see change.”

Existing restrictions on operating room time is the reason half of the orthopedic surgeons and half of the neurosurgeons leave Canada, he said.

Day said his own decision to open a private surgical facility came when his operating hours were cut from 22 a week to five by the hospital.

DOCTOR SHORTAGES

- More than one million Ontarians, including 130,000 children, have no family doctor despite huge increases in provincial health spending and the introduction of a $2.5-billion personal health tax.

- In London, as many as 30,000 residents are believed to be without a family doctor.