Skip to main content
NCBI home page
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1998 May 19;158(10):1275–1284.

How many physicians does Canada need to care for our aging population?

N P Roos 1, J E Bradley 1, R Fransoo 1, M Shanahan 1
PMCID: PMC1229321  PMID: 9614820

Abstract

BACKGROUND: There is concern that the aging of Canada's population will strain our health care system. The authors address this concern by examining changes in the physician supply between 1986 and 1994 and by assessing the availability of physicians in 1994 relative to population growth and aging, and relative to supply levels in the benchmark province of Alberta. METHODS: Physician numbers were obtained from the Canadian Institute for Health Information. The amount of services provided by each specialty to each patient age group was analysed using Manitoba physician claims data. Population growth statistics were obtained from Statistics Canada. Age- and specialty-specific utilization data and age-specific population growth patterns were used to estimate the number and type of physicians that would have been required in each province to keep up with population growth between 1986 and 1994, in comparison with actual changes in the physician numbers. Physician supply in Alberta was used as a benchmark against which other provinces were measured. RESULTS: Overall, Canada's physician supply between 1986 and 1994 kept pace with population growth and aging. Some specialties grew much faster than population changes warranted, whereas others grew more slowly. By province, the supply of general practitioners (GPs) grew much faster than the population served in New Brunswick (16.6%), Alberta (6.5%) and Quebec (5.3%); the GP supply lagged behind in Prince Edward Island (-5.4%). Specialist supply outpaced population growth substantially in Nova Scotia (10.4%), Newfoundland (8.5%), New Brunswick (7.3%) and Saskatchewan (6.8%); it lagged behind in British Columbia (-9.2%). Using Alberta as the benchmark resulted in a different assessment: Newfoundland (15.5%) and BC (11.7%) had large surpluses of GPs by 1994, whereas PEI (-21.1%), New Brunswick (-14.8%) and Manitoba (-11.1%) had substantial deficits; Quebec (37.3%), Ontario (24.0%), Nova Scotia (11.6%), Manitoba (8.2%) and BC (7.6%) had large surpluses of specialists by 1994, whereas PEI (-28.6%), New Brunswick (-25.9%) and Newfoundland (-23.8%) had large deficits. INTERPRETATION: The aging of Canada's population poses no threat of shortage to the Canadian physician supply in general, nor to most specialist groups. The marked deviations in provincial physician supply from that of the benchmark province challenge us to understand the costs and benefits of variations in physician resources across Canada and to achieve a more equitable needs-based availability of physicians within provinces and across the country.

Full Text

The Full Text of this article is available as a PDF (191.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barer M. L., Evans R. G., Hertzman C., Lomas J. Aging and health care utilization: new evidence on old fallacies. Soc Sci Med. 1987;24(10):851–862. doi: 10.1016/0277-9536(87)90186-9. [DOI] [PubMed] [Google Scholar]
  2. Dauphinee W. D. Medical workforce policy making in Canada: are we creating more problems for the future? Clin Invest Med. 1996 Aug;19(4):286–291. [PubMed] [Google Scholar]
  3. Denton F. T., Gafni A., Spencer B. G. System for Health Area Resource Planning (SHARP): an application to Ontario medical school enrollment. CMAJ. 1994 Jul 1;151(1):39–45. [PMC free article] [PubMed] [Google Scholar]
  4. Getzen T. E. Population aging and the growth of health expenditures. J Gerontol. 1992 May;47(3):S98–104. doi: 10.1093/geronj/47.3.s98. [DOI] [PubMed] [Google Scholar]
  5. Goodman D. C., Fisher E. S., Bubolz T. A., Mohr J. E., Poage J. F., Wennberg J. E. Benchmarking the US physician workforce. An alternative to needs-based or demand-based planning. JAMA. 1996 Dec 11;276(22):1811–1817. doi: 10.1001/jama.276.22.1811. [DOI] [PubMed] [Google Scholar]
  6. Mai J. Lamotrigin. Ny mulighed i epilepsibehandlingen. Ugeskr Laeger. 1996 Apr 1;158(14):1994–1997. [PubMed] [Google Scholar]
  7. Roos N. P., Fransoo R., Carrière K. C., Frohlich N., Bogdanovic B., Kirk P., Watanabe M. Needs-based planning: the case of Manitoba. CMAJ. 1997 Nov 1;157(9):1215–1221. [PMC free article] [PubMed] [Google Scholar]
  8. Roos N., Black C., Wade J., Decker K. How many general surgeons do you need in rural areas? Three approaches to physician resource planning in southern Manitoba. CMAJ. 1996 Aug 15;155(4):395–401. [PMC free article] [PubMed] [Google Scholar]
  9. Rosenberg M. W., Moore E. G. The health of Canada's elderly population: current status and future implications. CMAJ. 1997 Oct 15;157(8):1025–1032. [PMC free article] [PubMed] [Google Scholar]
  10. Ryten E. Physician-workforce and educational planning in Canada: has the pendulum swung too far? CMAJ. 1995 May 1;152(9):1395–1398. [PMC free article] [PubMed] [Google Scholar]
  11. Sullivan P. For first time, unemployment line awaits group of new Canadian specialists. CMAJ. 1997 Jun 15;156(12):1739–1741. [PMC free article] [PubMed] [Google Scholar]
  12. Watanabe M. Canadian physician supply. J R Soc Med. 1995;88 (Suppl 26):49–55. [PMC free article] [PubMed] [Google Scholar]
  13. Watanabe M. Physician resource planning: quest for answers. Clin Invest Med. 1994 Jun;17(3):256–267. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES