Ontario Geriatric Specialist Physician Resources 2018

Abstract

Background 
 The number of older adults with complex health needs in Ontario is growing. The Ministry of Health and Long-Term Care requested a resource mapping project to assess the current 2018 and projected 2025 number of specialist physi­cian resources.
 Methods 
 Geriatric specialist physicians were defined as geriatricians, geriatric psychiatrists, and Care of the Elderly (COE) physi­cians. We determined the current number of geriatricians, geri­atric psychiatrists, and COEs and clinical full-time-equivalent complement (CFTE) for geriatric medicine and geriatric psychiatry specialists. We projected the number of new train­ees expected to enter practice and the number of physicians expected to retire by 2025. We compared these numbers and projections against established specialist/population ratios for geriatricians and geriatric psychiatrists.
 Results 
 There was a deficit of geriatricians and geriatric psychiatrists (geriatricians: CFTE deficit of 150.5; geriatric psychiatrists: CFTE deficit of 116.3). In 2025, the projected CFTE deficit of geriatricians will increase to at least 210.35 and geriatric psychiatrists to 194.6. Only about 30% of COE physicians work in direct support of specialized services for the elderly.
 Conclusions 
 There is significant current and anticipated undersupply in the required number of geriatricians, geriatric psychiatrists, and COE physicians to meet anticipated population demand.

Updated Inventory and Projected Requirements for Specialist Physicians in Geriatrics

“…Monisha Basu BHSc, MD(c) 1 , Tracy Cooper, BA(c) 2 , Kelly Kay, MA, PhD(c) 3 , David B. Hogan, MD, FACP, FRCPC 4 , José A. Morais, MD, FRCPC 5 , Frank Molnar, MD, FRCPC 6,7 , Robert E. Lam, MD, CCFP(COE) 8 , Michael J. Borrie, MB ChB, FRCPC 9 interdisciplinary teams with the additional training required to deliver CGA and its associated interventions. These services are organized in comprehensive, coordinated systems of hospital and community-based care that are able to assess, diagnose, and manage older adults with complex health conditions.…”

“…In Ontario and other Canadian provinces, SGS is commonly understood to include physicians trained in geriatric medicine, geriatric psychiatry, and Care of the Elderly who work with other health disciplines, including nurses, pharmacists, social workers, physiotherapists, and occupational therapists, among others, in interprofessional geriatric teams. (6,7) These physicians are key to the provision of SGS, making physician human resource planning in geriatrics of particular relevance in addressing the anticipated growth in health service demand.…”

“…Some regions in Ontario have been successful at engaging COEs in SGS with enhanced APP funding arrangements. (7) These regions have been able to increase substantially the trained geriatric expertise availability.…”

“…As in 2011, this study did not include geriatric psychiatrists who, in some regions of Canada, are becoming increasingly integrated in models of interdisciplinary geriatric care. (7) Future studies of geriatric resources in Canada should include geriatric psychiatrists, and recognize the contributions of the interdisciplinary teams with whom all specialist physicians in geriatrics work.…”

Unmet Needs for Geriatric Medicine and Care of the Elderly Physicians Work Force in Canada

“…Basu et al present an update both to the 2011 Geriatric Specialist Inventory published in the CGJ in 2012, (5) as well as building on the Ontario Geriatric Specialist Physician Resource Inventory for 2018 published in the CGJ in 2020. (6) In brief, despite an increase of 25 per cent in the supply of both geriatricians and COE physicians over the last five years (not a small achievement), the population of older adults has increased by a third, vastly outstripping our efforts. As outlined in their 2030 projections.…”