Bucking a trend that has seen most countries significantly bolster their physician ranks over the past 15 years, Canada continues to have one of the Organisation for Economic Co-operation and Development's (OECD) lowest ratios of practising doctors per 1000 population (Table 1).
Table 1
According to the OECD's annual health data statistics, released in late June, the average rate of physicians per 1000 population across member nations (from which data could be obtained) increased to 3.1 in 2004 from 2.3 in 1998.
But while the overall average was rising by roughly 35% Canada's rate remained entirely stagnant at 2.1 per 1000 population over the same time period.
“Canada is the only country not to show some kind of increase since 1980,” notes Canadian Institute of Health Information Vice-President Jean-Marie Berthelot.
The 2.1 rate placed Canada in 26th place in the rankings of countries by physician density, well under half that of the top-ranked nation, Greece (see Table 1). Only Korea, Mexico and Turkey have lower ratios (Japan might also rank lower but failed to file 2004 data).
Berthelot surmised the wide variation in physician density rates was a function of the way countries organize their health care systems. He also argued that the numbers should not be viewed in isolation. “Doctor consults per capita also vary quite significantly from 1 country to the next. For example, in Canada, it's 6.1 doctor consults per capita, while for Japan, it's double, at 13.8, while for the US, it's much smaller at 3.9.”
“We should also look at outcomes, particularly life expectancy. Canada ranked second in 2004 and 79.9 years. Japan topped the world at 81.8 years and the US was 22nd at 77.5 years,” Bertholet added. — Wayne Kondro, CMAJ