Abstract
Objective
Public health emergency planning includes a consideration of public health human resource requirements. We addressed the hypothetical question: How many public health physicians could Canada mobilize in the event of a public health emergency?
Methods
We used the 2004 National Physician Survey (NPS) to estimate the number of public health physicians in Canada. Using weighting to account for non-response, we estimated the numbers and population estimates of public health physicians who were active versus ‘in reserve’. We explored the impact of using diverse definitions of public health physician based upon NPS questions on professional activity, self-reported degrees and certifications, and physician database classifications.
Results
Of all Canadian physicians, an estimated 769 (1.3%) are qualified to practice public health by virtue of degrees and certifications relevant to public health, of whom 367 (48%) also report active ‘community medicine/public health’ practice. Even among Canada’s 382 Community Medicine specialists, only 60% report active public health practice.
Conclusion
The estimation of the size of Canada’s public health physician workforce is currently limited by the lack of a clear definition and appropriate monitoring. It appears that, even with a reserve public health physician workforce that would almost double its numbers, Canada’s available workforce is only 40% of projected requirements. Public health emergency preparedness planning exercises should clearly delineate public health physician roles and needs, and action should be taken accordingly to enhance the numbers of Canadian public health physicians and their capacity to meet these requirements.
Key words: Health manpower, Canada, physicians, public health
Résumé
Objectif
La planification des services de santé publique d’urgence comporte la prise en compte des besoins en ressources humaines en santé publique. Nous avons abordé la question hypothétique: combien de professionnels en santé publique pourraient être mobilisés au Canada en cas de crise sanitaire?
Méthodes
Nous avons utilisé les résultats du Sondage national des médecins (SNM) de 2004 pour estimer les effectifs des médecins-hygiénistes au Canada. En utilisant la méthode statistique de pondération pour tenir compte des questions restées sans réponse, nous avons évalué combien de médecins-hygiénistes pratiquaient dans le secteur de la santé publique par comparaison avec les médecins-hygiénistes «de réserve». Nous avons étudié les répercussions dues à l’utilisation de différentes définitions du médecin-hygiéniste sur la base des réponses aux questions du SNM sur l’activité professionnelle, les diplômes et titres de compétence reportés par les intéressés, et les classifications de la base de données des médecins.
Résultats
Parmi tous les médecins canadiens, on estime que 769 (1,3 %) ont les qualifications requises pour pratiquer dans le secteur de la santé publique en vertu de diplômes et de titres de compétences pertinents, et parmi ces derniers, 367 (48 %) font état d’une pratique active dans le domaine de la «médecine communautaire/santé publique». Même parmi les 382 spécialistes en médecine communautaire du Canada, 60 % seulement déclaraient pratiquer en santé publique.
Conclusion
L’évaluation des effectifs des médecins-hygiénistes est limitée à l’heure actuelle à cause d’un manque de clarté dans la définition de la profession et de l’absence d’un contrôle adéquat. Il semble que, même en comptant les médecins-hygiénistes de réserve qui viendraient presque doubler leur nombre, les effectifs disponibles au Canada ne couvrent que 40 % des besoins projetés. Des exercices de planification d’intervention en cas d’urgence sanitaire devraient délimiter de manière précise les rôles et les besoins des médecins-hygiénistes, et par conséquent, des mesures devraient être prises pour augmenter le nombre des médecins-hygiénistes au Canada et pour développer leurs aptitudes à répondre à ces exigences.
Mots clés: main-d’oeuvre sanitaire, Canada, médecins, santé publique
Footnotes
Acknowledgements: This study was supported by a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada. The study described in this paper was conducted utilizing original data collected for the College of Family Physicians of Canada (CFPC), the Canadian Medical Association (CMA), and the Royal College of Physicians and Surgeons of Canada’s (RCPSC) 2004 National Physician Survey (NPS) Database. The NPS was also supported by the Canadian Institute for Health Information, and Health Canada. The NPS and all of the data contained therein are the copyright-protected works of the CFPC, CMA, and RCPSC and cannot be copied or reproduced in whole or in part without permission of the CFPC, CMA, and RCPSC. The authors acknowledge data analysis support from Sarah Scott, MHSc, National Physician Survey and Janus Project Coordinator at The College of Family Physicians of Canada. We thank David Paton, Senior Methodologist, Canadian Institute for Health Information (CIHI), for helpful comments on the manuscript. The views expressed herein do not necessarily represent the views of CIHI, the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada.
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