CIHI study shows number of practicing physicians in Canada has increased by 8%

The number of practising physicians in Canada increased at a faster rate than the population over the past five years, according to a new study released today by the Canadian Institute for Health Information (CIHI). The study, Supply, Migration and Distribution of Canadian Physicians, 2008, shows that between 2004 and 2008, the number of active physicians in Canada grew from 60,612 to 65,440, representing an 8.0% increase across the country. In comparison, the Canadian population grew by 4.3% over the same time period.

"From 1989 to 2004, the physician-to-population ratio was relatively stable in Canada. But over the past few years, there have been steady gains in the number of practising medical doctors in this country," says Geoff Ballinger, Manager of Health Human Resources at CIHI. "We're also seeing increased enrolment in Canadian medical schools, which may lead to further increases in the supply of physicians over the next few years."

CIHI's study shows the overall physician-to-population ratio grew from 189 per 100,000 Canadians in 2004, to 195 per 100,000 in 2008, though ratios and growth rates varied among provinces, territories and health regions. Overall, the number of new medical students in this country increased from 8,236 to 9,640 from 2004 to 2007.

Physicians are getting older but retire later than other health professionals

Due to the length of education required to become a doctor, physicians traditionally entered the workforce at older ages than other health care professionals and tended to retire later in life than other health care professionals. Between 1978 and 2008, the average age of general practitioners (GPs) in Canada increased by 5.6 years, to 49.0, and the average age of specialists increased by 3.4 years, to 50.6.

"The physician workforce in Canada is getting older; however, the data shows that doctors' retirement patterns are very different than the patterns of other professionals," explains Yvonne Rosehart, Program Lead of Health Human Resources at CIHI. "Many physicians work well into their senior years. In fact, the majority of physicians age 70 to 79 in 2004 were still in the workforce in 2008. This pattern is not seen with other health care professionals, such as nurses."

CIHI's study found that many physicians who were older than age 65 in 2004 had still not left the workforce in 2008. The study found more than two out of three (69.2%) physicians who were between age 70 and 74 in 2004 were still working in 2008, and slightly more than three out of five (63.0%) physicians who were between age 75 and 79 were still practising in 2008.

More women continue to enter the physician workforce

Women are becoming a larger proportion of the physician supply in Canada. Between 2004 and 2008, the number of male physicians increased by 3.8%, while the number of female physicians grew by 16.3%. Last year, almost two out of five (39.6%) GPs in Canada were women and close to one-third (29.4%) of specialists were women.

The feminization of the physician workforce is expected to continue. In 2008, women accounted for more than half (52.1%) of new GPs in Canada and close to half (45.1%) of new specialists.

Canadian-trained physicians less likely to migrate between provinces

Since 1978, approximately 1% of physicians moved within Canada to another jurisdiction every year, but there were differences in migration trends between Canadian-trained physicians and internationally trained physicians. CIHI's study found that after 10 years, almost two-thirds (66.2%) of Canadian-trained physicians were still working in the jurisdiction in which they first started, compared to slightly more than one-third (33.5%) of foreign-trained doctors.

From 1998 to 2008, Alberta and British Columbia experienced a net gain of physicians every year due to interjurisdictional migration, compared to Newfoundland and Labrador, Quebec, Manitoba and Saskatchewan, which all experienced net losses of physicians every year.

Payments to physicians increasing overall but continue to vary across the country

Across Canada, total expenditures on physicians' services are forecast to reach an estimated $25.6 billion in 2009, representing an increase of 8.8% over the previous year. According to a separate CIHI report, National Physician Database 2007-2008-Data Release, average payments to physicians increased across the country; however, they varied considerably across the provinces and territories. In 2007-2008, the latest year of available data, the average payment per physician who received at least $60,000 in fee-for-service payments increased to $266,031 nationally, representing an increase of 4.6% from the previous year. These payments ranged from highs of $315,405 in Saskatchewan and $311,799 in Alberta to lows of $242,571 in Nova Scotia and $198,455 in Quebec.

In 2007-2008, Prince Edward Island, Alberta and Ontario experienced the highest annual percentage increases in clinical payments to physicians of all the provinces at 13.9%, 12.6% and 10.0%, respectively. Newfoundland and Labrador, Nova Scotia and the Northwest Territories all experienced the lowest annual percentage increases at 4.7%, 3.9% and 1.3%, respectively.

Source: CANADIAN INSTITUTE FOR HEALTH INFORMATION