Re: Paediatric health care professionals in the next millennium

Abstract

In the editorial “Oops – There won’t be enough paediatric health care professionals in the next millennium!” (Paediatr Child Health 1999;4[4]:245), perhaps you should add a second oops, “and how could we be so blind?”. Paediatricians have joined the club of physician shortages right across Canada and in the United States. When I was a member of the British Columbia Medical Association manpower committee in 1978, a general practitioner in Vancouver who was also a member of the committee predicted that there would be a physician shortage by the year 2000. He is the only person that I know of who, at that time, had the foresight and who had bothered to study the demographics of Canadian physicians, their emigration from and immigration to British Columbia, and the effect of more women going into medicine, who appropriately work shorter hours because of family and other priorities. This physician predicted that even with the current enrolment, the University of British Columbia would not produce enough physicians to meet even a modest demand for physician services by the year 2000 or shortly after. It was not too many years later that the powers that be, the academics and others, decided that the university’s enrolment should be cut back. A similar reduction in medical school enrolment occurred across Canada. Now we are short of physicians in all categories, particularly the specialties. The specialty shortage has been further aggravated by the academics, colleges or whoever decided that graduates should determine their specialty by their third year in medicine, therefore, denying them the benefit of gaining experience and providing a service in general practice before deciding which specialty is best suited to them in the longer term. It seems that the physician supply is not unlike that of raising hogs – when the price of hogs goes up, farmers get into hogs, creating a surplus; and then, because of the surplus, when the price goes down, farmers get out of the hog business, creating a shortage. You would have thought that with our combined, so-called academic intelligence, we would have been able to do a better job. Such is not the case. Pity! With this ongoing physician shortage, the citizens of Canada and current physicians will suffer. Perhaps for the current enrollees in medical school, things will be better when they graduate and start their practice facing an acute shortage of medical practitioners. Perhaps the new doctors will have an advantage of negotiating more equitable terms with government, and others, which is not currently the case.