The crisis with medical workers

NL Health Matters, by Mardi Collins

The backbone of our health care system is staff. Doctors and nurses are leaving the field at an alarming rate. They are asking for fair compensation, reasonable hours to permit work-life balance, reduced administrative overhead and respect for their work and their suggestions.  As many as 50 per cent of nurses consider leaving their jobs, while 30 per cent of doctors are considering leaving each year.

In January 2025 the Canadian Medical Association reported on a shocking study on doctor requirements for the future. The international average number of new graduates is 14.2 doctors per 100,000 population, Canada is at the bottom of the pack, producing 7.5 new doctors per 100,000. There is currently a deficit of approximately 23,000 family physicians in Canada, and only some 1,300 new graduates per year. At this rate it will take over 30 years to catch up to the deficit.

Canada can never train enough doctors to meet the demand. Butwe can multiply the work force, if we try new ideas. Here are a few:

Increase Physician numbers – To retain doctors allow the formation of group practices, which provide professional collaboration, improved efficiency and more flexibility in work schedules.  Streamlining coding systems for procedures can reduce administration, improve efficiency and reduce wait times. 

To attract doctors from out of province, encourage private clinics. This allows specialists to create efficient elective procedure centres, where expensive diagnostics and treatment equipment can be made available to all patients. It will result in reduced wait times, expanded patient services and more doctors from out of province.

• Interprovincial barriers to certification – All certified medical workers in any province should be certified immediately in Newfoundland. Requiring additional examination or training discourages migration of much needed medical workers.
• Internationally Trained Medical Workers – Only a small minority (10 per cent) of internationally trained physicians ever work as doctors.   What a waste!  In 2022 there were approximately 25,000 internationally trained doctors in Canada and our national shortfall of family doctors was 23,000. Obviously not all will qualify but surely we can do better than a meagre 10 per cent.

Historically, provincial professional associations created a series of barriers that have prevented certification of many thousands of doctors and nurses that we desperately need. Reducing barriers to these medically trained immigrants can fill a significant gap in the hiring of essential medical workers.

• Expanding the Team – Nurse practitioners are increasingly being given first line triage responsibilities. Imagine if paramedics were included in the mix. This group has years of training which prepares them for first responder work with trauma, heart attacks, burns and infectious diseases. If paired with a triage clinic overseen by an experienced Teledoc, they could significantly reduce the strain on urgent care facilities.
• Hiring US trained medical workers — Currently US medical workers are coming to Canada in significant numbers. Despite the shortcomings of our system, many appreciate the universality of our system and our commitment to compassionate care. Medical workers in large Canadian centres are looking for a quieter, less stressful location for work. Many of these workers would enjoy the outdoor life that we have to offer. If Newfoundland were to mount an effective hiring campaign in the Northeastern United States, Toronto and Montreal, it is likely that trained workers would choose our fair province. 
• Better Use of Technology — The use of teledocs is expanding. One teledoc can supervise many first line workers thus freeing up the time of doctors on site. Similarly artificial intelligence is becoming more widely used and can assist medical workers in the field to be more productive without demanding physician time.

Send me your concerns or ideas. If you really want a better system, you will need to speak up.  email: mardicollins7@gmail.com