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Employer health plans and the shortage of family doctors in Canada

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It was another day of strange contradictions.

The media was full of excitement over pop star Aaron Carter moving to Yarmouth, Nova Scotia, while at the same time the media is shining a light on the shortage of doctors in Nova Scotia and across Canada.

According to a report from CTV News, more than 50,000 Nova Scotians do not have a family doctor. This means delays in diagnosis of illnesses that may be treatable in the early stages, until the point-of-no return for some. As we know, an ounce of prevention is worth a pound of cure, so catching disease early is crucial not only to recovery, but to cost management. Advanced stages of disease typically require more expensive interventions and have longer recovery times.

Isn’t this a political problem?

The lack of family physicians is not unique to Nova Scotia. According to CTV News and Statistics Canada, some 4.8 million Canadians do not have a regular doctor. Many people are hoping this will become an election issue, however, it seems to be overshadowed by national pharmacare, climate change and taxes. This may be because, technically, while funded federally, healthcare is a provincial mandate, or it may just lack the appeal of some of the other headline-grabbing issues.

There are many factors causing our shortage of physicians. Family medicine is a demanding job with long hours and little work/life balance and this is only compounded in an area where physicians are in short supply. It takes a long time to train new doctors, so we can’t expect a huge influx of them to ease the burden in the short term. And, with new doctors coming out of universities with significant debt, it is only reasonable to choose the most lucrative areas and specialties for their practice.

So, what can employers do to reduce the demand for family physicians?

A lot more than you might think.

Does your health plan really need to insist on a doctor’s note for every illness? This distracts doctors from their real work.

Are insurer forms for prior authorization of drugs and long-term disability benefits too onerous and time consuming? Insurers and plan administrators can help to reduce or streamline requirements from doctors.

What about nurse practitioners and pharmacists? These are both highly trained professional who can assist with minor illnesses. Should your benefit plan have a provision to cover costs for professional advice?

What about technology? Virtual doctors are relatively new in Canada, but they can definitely step in to meet the needs of some patients. The virtual professionals are doctors and nurses who work according to the same requirements as doctors and nurses in bricks and mortar practices. Sure, they can’t diagnose or treat every illness, but they can assist with the myriad of minor illnesses that family practitioners see every day, like sore throats, coughs, and rashes that take us to the doctor’s office or worse, the emergency room, regularly.

Wellness programs that encourage proactive maintenance of health are also valuable, as they can help employees manage chronic diseases like high blood pressure and Type 2 diabetes. Encouraging flu shots (or even hosting onsite clinics) is also effective in reducing pressures on family doctors.

Small changes can help.

In order to manage the physician shortage, we have to acknowledge that medical care covered under provincial plans isn’t really free. We must be prepared to make some investments to take the pressure off our declining population of family physicians while supporting employee health.

I know none of these will resolve the doctor shortage immediately, but small changes in the way we all approach healthcare could change the demands placed on family physicians to allow them to do the things they trained for. That shift could change new grads’ perception of the job and encourage more to consider family medicine.

Otherwise, Aaron Carter, please spread the word. Canada is a really great, really beautiful place to live and, if you’re coming, please bring a doctor or two.

 

 

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