Doctor Shortage SOS: How Many Physicians Do We Really Need?

The 'needs-based assessment' method is a technique used by experts to calculate the number of physicians required by a population. It involves evaluating the burden of disease within a population and then estimating the number of doctors needed to provide optimal care, based on established best practice guidelines. This approach is important because it attempts to align physician supply with the actual healthcare needs of the population. However, it's challenging because the 'best practice guidelines' are constantly evolving, and the ideal physician numbers often exceed what can be realistically achieved, highlighting a gap between theoretical requirements and practical limitations.

The 'service-target' approach is a method used by regions to determine their physician needs by comparing their doctor-to-population ratios and service hours against those of neighboring areas or countries. This approach considers the actual workload and availability of physicians. The significance of this approach lies in its ability to provide a comparative analysis, benchmarking regions against each other. This method has become increasingly relevant as doctors, in recent decades, have been working fewer hours, which necessitates a larger workforce to maintain service levels, as shown in British Columbia, where it takes 2.5 new doctors to replace one retiring physician's workload.

The 'marginal approach' is a method used by health ministries to analyze past situations and adjust doctor numbers based on demographic shifts like aging populations. This method is significant because it acknowledges the dynamic nature of healthcare needs. For example, as populations age, the demand for healthcare services typically increases, affecting the required number of doctors. By using the 'marginal approach', ministries attempt to proactively adapt physician supply to meet these changing demands. This approach is often employed in combination with the 'needs-based assessment' and the 'service-target approach' to inform decision-making.

Canada is facing a potential doctor shortage. Concerns about shortages are growing louder, with specific examples mentioned such as the New Brunswick Medical Society reporting family physician vacancies and the family medicine 'crisis' in British Columbia. Even urban centers like Burnaby are experiencing shortfalls. The implications of a doctor shortage include increased wait times, reduced access to care, and potential strain on existing healthcare professionals. Addressing this requires a multifaceted approach, including innovative solutions beyond simply increasing medical student enrollment, such as recruiting doctors from other regions and countries, and optimizing the effectiveness of existing physicians.

Determining the 'right' number of doctors a region needs is complex because traditional supply and demand principles don't neatly apply to universal healthcare. Demand becomes almost limitless because costs are largely covered, requiring governments to strategically manage the supply of physicians. Government decisions are often influenced by political and financial considerations, adding another layer of complexity. There's no universally accepted formula for calculating the required number of doctors, and various academic approaches exist, like the 'needs-based assessment', the 'service-target approach', and the 'marginal approach'. The implications include the potential for understaffing, leading to inadequate patient care, or overstaffing, leading to inefficient use of resources.