Physician Distribution and Physician Shortage Intensity in Ontario

Abstract

Au cours des années 1990, en Ontario et dans de nombreuses autres jurisdictions, le point central du débat sur les ressources humaines en médecine s'est déplacé d'un surplus généralisé à une pénurie. Cependant, le problème demeure de l'accès équitable à ces ressources et aux services de santé en général. Pendant cette période, l'effort en matière de politiques gouvernementales a été largement orienté vers ce qui a été perçu comme une "maldistribution" des ressources entre les régions géographiques. Cet article applique l'index Gini, une méthodologie de la concentration des ressources, pour mesurer la maldistribution des ressources médicales en Ontario au cours des années 90. Notre article propose également et met en application, une méthode pour quantifier la pénurie de médecins au moyen d'un index de l'intensité de cette pénurie. Les résultats révèlent qu'en dépit de nombreuses politiques gouvernementales et de programmes destinés à remédier à la maldistribution géographique des ressources humaines dans le domaine médical, la répartition des médecins en Ontario est devenue plus inégale dans les années 90. Cela met en question l'efficacité des politiques gouvernementales quant à la correction de la maldistribution géographique. En outre, il n'y a pas eu de baisse significative de l'intensité de la pénurie générale de médecins au cours des années 90. During the 1990s, in Ontario and many other jurisdictions, the focus on the physician human resources debate has moved from aggregate surpluses to shortages. However, the problem of equitable access to those resources, and health services in general, has remained. During this period, much government policy effort has been targeted toward the perceived "maldistribution" of resources between geographic regions. This paper applies the Gini index of resource concentration methodology to gauge the maldistribution of physician resources in Ontario during the 1990s. It also proposes, and implements, an approach for quantifying physician shortages through a physician shortage intensity index. The results reveal that despite numerous government policies and programs aimed at alleviating the geographic maldistribution of medical human resources, the distribution of physicians in Ontario has become more uneven during the 1990s. This puts the efficacy of government policies to correct geographic maldistribution into question. Additionally, there has been no meaningful improvement in overall physician shortage intensity during the 1990s.

GP Surgeons’ Experiences of Training in British Columbia and Alberta: A Case Study of Enhanced Skills for Rural Primary Care Providers

“…The issue of mentorship in medical education is an emergent one, that previously took a back-seat to more pragmatic concerns such as the uneven distribution of physicians, often interpreted as a shortage. 17 Within medical education, mentoring is broadly defined as a process of extending supportive wisdom, guidance, and reflection in an informal way on the part of the mentor. It is regarded as a key component of ensuring recruitment and retention, 18 in role-modeling, 19 introducing practical training, and increasing confidence, 20 improving outcomes, 21 and encouraging trainees to take up surgical training.…”

Workplace responses to vacancies and skill shortages in Canada

“…The “textbook” response to reduce labour or skill shortages is to raise wages and/or non‐wage benefits (such as a pension plan or a group Registered Retirement Savings Plan or RRSP[3]) or alter the working conditions to attract or retain personnel. However, employers may fail to respond to labour and skill shortages through wage and benefit mechanisms because rigidities in wages and fringe benefits coverage can occur as a result of collective bargaining agreements (Simpson, 1985), public policies (Kralj, 2001), or a reluctance to raise wages to attract new recruits to the extent that they would have to raise wages of their internal incumbents for reasons of internal equity[4] (Johansen and Strom, 2001). Haskel and Martin (1993b) further argue that skill shortages can actually reduce productivity because skill shortages tilt the composition of employment away from skilled workers towards the unskilled; they also leave the firm less able to bargain higher levels of effort from their workers. Training expenditure per employee.…”

Determinants of Stress in Medical Practice

“…It is well established that there is both a maldistribution and a shortage of physician resources in Ontario, as is the case in most of Canada (Kralj, 2001a). The current Ontario shortage is estimated to exceed 2,300 physicians (Kralj, 2001b).…”

“…The overall supply of physicians, their geographic distribution, and productivity is an issue of concern for both the government and individuals as it determines service availability or access. Both national and provincial reviews of the health care system in Canada have concluded that there is a shortage of health care personnel, especially physicians (Standing Senate Committee on Social Affairs, Science and Technology, 2002;McKendry, 1999;Kralj, 2001a). Evidence of impending physician shortages are also beginning to appear in the United States (Cooper et al, 2002).…”