Physician workforce planning in Canada: the importance of accounting for population aging and changing physician hours of work

Islam, Md. Rabiul; Kralj, Boris; Sweetman, Arthur

doi:10.1503/cmaj.221239

Cited by 12 publications

(11 citation statements)

References 18 publications

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“…The way forward will likely involve policy-makers increasing the size of the medical workforce — including physicians and other occupations involved in interdisciplinary care — faster than population growth to accommodate historical and potential future hour reductions (and increasing demand from an aging population). 10 …”

Section: Discussionmentioning

confidence: 99%

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Long-term trends in the work hours of physicians in Canada

Kralj,

Islam,

Sweetman

2024

CMAJ

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Background: Physician work hours directly influence patient access to health care services and play a vital role in physician human resource planning. We sought to evaluate long-term trends in hours worked by physicians in Canada, overall and by subgroup. Methods: We used Statistics Canada’s Labour Force Survey to identify physicians via occupation and industry coding information. We estimated descriptive statistics and performed graphical analysis of the average weekly hours worked by physicians over the 1987–2021 period. Results: Overall, weekly physician work hours remained stable from 1987 until 1997, after which they declined. Average weekly hours decreased by 6.9 hours ( p < 0.001), from 52.8 in 1987–1991 to 45.9 in 2017–2021. Among male physicians, work hours declined notably after 1997, while those of female physicians remained relatively stable at around 45 per week. Hours worked by married physicians declined significantly, amounting to 7.4 fewer hours per week ( p = 0.001). In contrast, unmarried physicians displayed a statistically insignificant decline of 2.2 hours ( p = 0.3). The COVID-19 pandemic was associated with a sharp but brief disruption in weekly hours; by the end of 2020, physicians’ work hours had returned to prepandemic levels. Interpretation: These findings may indicate a long-term shift in work preferences among Canadian physicians; male physicians may be seeking a better work–life balance, which, in turn, has narrowed the gap in hours worked by sex, with potential implications for pay equity. Policymakers and planners should carefully consider changes in hours worked, rather than just the total number of physicians, to ensure an accurate evaluation of the physician workforce.

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Section: Discussionmentioning

confidence: 99%

“…Using the LFS to analyze physicians is not common, but we are aware of 1 recent study using this rich data source. 10 …”

Section: Methodsmentioning

confidence: 99%

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Long-term trends in the work hours of physicians in Canada

Kralj,

Islam,

Sweetman

2024

CMAJ

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“…Sweetman’s team has found that two issues go some way to explaining this paradox: physicians’ hours of work declining and the population ageing 4…”

Section: Declining Hours Ageing Citizensmentioning

confidence: 99%

Canada tackles workforce shortages with international fast tracks and federal cash injections

Brown¹

2023

BMJ

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“… 6 There is an urgent need to understand factors contributing to the gap between a growing number of primary care providers per person and declines in the availability of primary care services. 7 To some extent this gap may reflect declining hours worked 8 or service volume 9 per physician, but evidence also points to broader health system changes that may impact workload in primary care 10 over and above visit volume. Neither the extent of these changes, nor their impact on provider experience and patient access have been carefully studied.…”

Section: Introductionmentioning

confidence: 99%

Understanding and addressing changing administrative workload in primary care in Canada: protocol for a mixed-method study

Lavergne,

Moravac,

Bergin

et al. 2023

BMJ Open

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IntroductionMany Canadians struggle to access the primary care they need while at the same time primary care providers report record levels of stress and overwork. There is an urgent need to understand factors contributing to the gap between a growing per-capita supply of primary care providers and declines in the availability of primary care services. The assumption of responsibility by primary care teams for services previously delivered on an in-patient basis, along with a rise in administrative responsibilities may be factors influencing reduced access to care.Methods and analysisIn this mixed-methods study, our first objective is to determine how the volume of services requiring primary care coordination has changed over time in the Canadian provinces of Nova Scotia and New Brunswick. We will collect quantitative administrative data to investigate how services have shifted in ways that may impact administrative workload in primary care. Our second objective is to use qualitative interviews with family physicians, nurse practitioners and administrative team members providing primary care to understand how administrative workload has changed over time. We will then identify priority issues and practical response strategies using two deliberative dialogue events convened with primary care providers, clinical and system leaders, and policy-makers.We will analyse changes in service use data between 2001/2002 and 2021/2022 using annual total counts, rates per capita, rates per primary care provider and per primary care service. We will conduct reflexive thematic analysis to develop themes and to compare and contrast participant responses reflecting differences across disciplines, payment and practice models, and practice settings. Areas of concern and potential solutions raised during interviews will inform deliberative dialogue events.Ethics and disseminationWe received research ethics approval from Nova Scotia Health (#1028815). Knowledge translation will occur through dialogue events, academic papers and presentations at national and international conferences.

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Physician workforce planning in Canada: the importance of accounting for population aging and changing physician hours of work

Cited by 12 publications

References 18 publications

Long-term trends in the work hours of physicians in Canada

Long-term trends in the work hours of physicians in Canada

Canada tackles workforce shortages with international fast tracks and federal cash injections

Understanding and addressing changing administrative workload in primary care in Canada: protocol for a mixed-method study

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