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We are plagued by many predictions about the demand for medical staff in Canada, and yet somehow they all turn out to be wrong.
Published date May 17, 2024 • Last updated 48 minutes ago • Reading time 3 minutes
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This illustrated photo shows a doctor examining a patient in a hospital.Photo: Brunswick News Archive
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Crisis: Healthcare Workers is the country's longest-running television novel.
Each season ends with a cliffhanger. Will operating theaters close due to lack of perfusionists? Why can't Ajay, who trained in Mumbai, get a medical license? By 2035, all nurses will need a PhD Is there an incentive to convince young doctors to choose full-service family medicine?
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It is the religion of the end times. Liquidation always takes place after several years. In 2009, the Canadian Nursing Association predicted a shortage of 60,000 nurses by 2022. The 2019 model projects that the number of nurses will increase to 118,000 by 2030.
According to a 2022 report from RBC (yes, it's a bank), there is currently a shortage of 14,000 family doctors, and there will be a shortage of 30,000 by 2028. Manitoba has only half the number of psychologists per capita as the national average. There are only five geriatricians in Saskatchewan.
There is no shortage of shortage predictions. Governments, professional associations, academics, think tanks, and now banks regularly publish this research, estimating the huge gap between what we need and what we will have in the future.
But despite sophisticated mathematics and NASA's powerful software, the numbers are always wrong. In Canada, people are routinely caught with their pants tied around their ankles.
Many protrusions fail the most basic smell test. A full-time family physician can easily accommodate a patient roster of 1,200 patients. Claiming a current shortfall of 14,000 means around 16 million people do not have a family doctor. The usual estimate is 6.5 million, but you probably don't care much about half of that.
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The workforce plan appears to be as dysfunctional as the health care system it is supposed to provide, but above all it shows admirable consistency. but why?
First, most projections assume that health care needs and treatment options will evolve gradually, that health science education will be efficient, and that workforce deployment will be optimized. None of these are very convincing. We are running at breakneck speed towards an uncertain future.
Reliable predictions are not possible without critically considering at least the following issues: What does the population need, and how is it changing? Will an aging population require more high-tech medicine, or more social, high-touch care? Is it necessary? Do we have the appropriate staffing structure to meet these needs?
Is the current division of labor efficient? Too many specialists are doing work that should be done in primary care. Registered nurses (RNs) perform tasks that certified associate nurses can perform. Few community pharmacists play a meaningful role in drug therapy.
Are healthcare professionals spending too much time on redundant paperwork and other tasks that do little to improve care? Every survey says yes. Just because there's a shortage of nurses doesn't necessarily mean there's a shortage of nurses.
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If RNs could reallocate even 10 per cent of their time from low-value jobs to jobs for which they are uniquely trained, Canada would be able to train and hire one more nurse. This would mean an additional 30,000 additional nurses without the need for The same goes for doctors.
How will technology change the way healthcare workers work and how they do it? Artificial intelligence and machine learning are already outperforming humans in diagnosing many conditions. Virtual care has already replaced many in-person visits.
Physiological measurements (blood pressure, heart rate, respiration) can be performed, transmitted, and monitored electronically. If you're betting on how many care processes will be fully or partially automated, always take over.
Can healthcare workers be trained more quickly and efficiently? Other countries are doing the same. To train a physical therapist he does not need 6 years of post-secondary education. Just because demand for medical school seats exceeds supply is no reason to require a bachelor's degree as a prerequisite.
Unexpected new developments are sure to undermine your best efforts to anticipate future needs. It's easier to learn from history. Lesson 1: Never train too much or too little. Shortages put patients and health care workers at risk and drive up wages. Expanding the training program would be cheaper than paying temporary nurses $280,000 a year.
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Current training and deployment approaches are too static and rigid to keep up with the pace of change. These are not sound foundations for creating tomorrow's workforce. Predicting requirements 10 years from now is a tricky game.
It's time to make uncertainty the new normal, recognize agility and lifelong learning as essential new skills, and develop better strategies.
Stephen Lewis spent 45 years as a health policy analyst and health researcher in Saskatchewan and is currently an adjunct professor of health policy at Simon Fraser University. Contact him at slewistoon1@gmail.com.
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