Mr. Chair and honourable members of the committee, hello and bonjour.
My name is Dr. Emil Lee, and this is Mr. Nicholas Neuheimer, our Canadian Association of Radiologists CEO.
I am a radiologist, a physician in the Fraser Valley, and the regional medical director of medical imaging for the Fraser Health Authority, which is the largest such health authority in B.C., serving 1.5 million Canadians. Today, I am speaking to you as the president of the Canadian Association of Radiologists, the national voice of radiologists in Canada, with over 2,500 members, and serving the entire Canadian population, 36.3 million patients.
Radiology is a key component of the health care system. We are the ones who specialize in interpreting the results of MRIs, CT scans, ultrasounds, and X-rays for patients right across Canada, in communities of all sizes. Many of us are also privileged to perform image-guided, minimally invasive surgery, from clearing clots inside our patients' brains and preventing strokes, to reconstructing blood flow to patients' legs to allow them to walk pain-free once again.
During the next five minutes I will speak about four points: one, the need for a new medical imaging equipment fund; two, enhancing referrals; three, incorporating artificial intelligence; and four, the unintended consequences of the proposed small business tax changes.
This will address the committee's call to improve productivity in the Canadian economy. The Conference Board of Canada reported that diagnostic imaging adds significant value to the health care system by reducing treatment costs down the road, but there is a lot of room for improvement. This year The Commonwealth Fund ranked Canada ninth out of 11 OECD nations studied, which brings me to our first recommendation, to invest $612 million to ensure that medical imaging equipment in Canada meets the standards that our patients deserve.
Canadian family practitioners reported that 40% of their patients have experienced difficulty accessing timely, specialized diagnostic imaging tests. That is double the current international average. While these patients wait, they are not productive. In 2004, the previous federal government invested $2.5 billion to support the purchase of equipment. Today, many of the machines we have are outdated. New equipment emits less radiation and provides better, higher resolution images.
Our second recommendation asks for $9 million over three years to fund projects to enhance and integrate electronic referrals. This investment in clinical decision support systems would help family practitioners and other referring physicians to request the most appropriate test for every patient, to reduce waste and ensure quality care. There are projects under way at St. Michael's Hospital in Toronto, as well as in Saskatoon, and on Vancouver Island, which we believe will show the value and effectiveness of e-referrals.
Third, we are seeking an investment of $10.5 million over three years to implement the use of artificial intelligence in imaging. In the 2017 federal budget, the government committed funds for the pan-Canadian artificial intelligence strategy. This is a great first step. We are recommending the development of a pan-Canadian AI research network in imaging. This type of innovative investment would have a great impact on Canadian patients and their productivity in the years to come.
Last, there is the tax issue. The government's proposed changes to the small business tax structure would have a significant negative impact on radiology and medicine. We have heard from and met with many patients, members, and members of Parliament who have voiced their concerns, especially the chair. Thank you, Mr. Chair.
Here are some facts. The majority of physicians—66%, or 54,000—own and operate a small business corporation. In 2016, physician offices paid $6.2 billion in wages and salaries, employed 137,000 people, and contributed $643 million in tax revenues to governments. Unlike salaried employees, physicians pay for their own medical coverage, maternity leave, and extended health benefits, and must entirely fund their own pensions.
In a recent survey of New Brunswick physicians, 82% said they would consider scaling back their practice or reducing hours if these proposals go forward. I am worried. We are small business owners. These changes could negatively impact health services across Canada, particularly in rural and remote regions. We are asking that the government reconsider the proposals, or at the very least, extend the time frame for comment and consultation on these proposals.
In conclusion, we are asking for: one, a new medical imaging equipment fund; two, investment and leadership to enhance e-referrals; three, the thoughtful deployment and integration of artificial intelligence in health care; and four, reconsideration of the proposed small business tax changes.
Thank you for your time and for inviting us to speak.
Thank you for your attention. I look forward to your questions.