My name is Dr. Willy Miller. I'm a neuroradiologist at the Ottawa Hospital, just about five kilometres away. I've been practising for 25 years in both Canada and the United States. I present today in my capacity as the president of the Canadian Association of Radiologists.
It is an honour to speak to you today. My statement is based on our organization's pre-budget submission to this committee, which of course I am sure you've all read. I know this is the end of a long day.
Thank you for giving us the opportunity to make this presentation.
Today I want to focus my remarks on investments for medical imaging equipment, clinical decision support tools, and the value of group medical practices.
Medical imaging is the hub at the centre of health care. Although Canada has long prided itself on its record of achievement in health care, the rhetorical vision of what Canadian health care is and should be is increasingly distant from the reality.
Canada is ranked 10th out of 11 nations based on a comparative study of system-wide health spending and health outcomes. Canada is in the lower 50th percentile of OECD nations in terms of the number of MRI and CT units per million people.
Forty per cent of Canadian primary care physicians report that their patients have difficulty getting specialized diagnostic tests. People in Canada wait nearly twice as long on average as their OECD peers to get CT and MRI scans that are necessary for their treatment and optimal care.
We are at a tipping point for health care in this country, and I believe we all know that. It's not just about the numbers, the finances, and the investments. Health care is personal. The need for medical imaging is personal. We all have a sister, brother, father, or grandmother who is ill and awaiting an important diagnosis or cannot access the imaging they need. When one arrives at the correct diagnosis using the appropriate test at the optimal time, lives are literally changed and can even be saved.
The most complete surveys of the impact of wait times and their downstream economic burden are a few years old now, but the reality hasn't changed much. Lost output, reduced productivity, and forgone tax revenues while people are waiting for care cost the Canadian economy $13.8 billion in 2007. By 2020, that impact will be closer to $23 billion.
Medical imaging has not received significant infrastructure investment since the 2004 health accord. We are well past the point of needing to make replacements.
We need new investment in imaging equipment. Many of the machines we have are old and outdated. Canadians deserve the best care they can get, and that requires current, updated equipment. New equipment emits less radiation, and provides better high-resolution images and new capabilities.
We propose an investment of $600 million over five years to address the equipment needs of Canadian patients and communities. However, infrastructure investments aren't made in a vacuum. Our goal must be the integration of these investments into data-driven, patient-centred approaches to care. We can make better use of medical imaging with the use of clinical decision support tools. These tools assist referring physicians when they order tests by helping physicians request the best test for every patient, reduce waste, and ensure top-quality care. Such a system advises referring physicians of the best and most appropriate test for a given patient in a given clinical situation immediately at the point of ordering. Evidence shows that patient outcomes and system performance both improve when clinical decision support systems are introduced.
We propose an allocation of $65 million over five years for clinical decision support. These funds would be managed by Canada Health Infoway. Infoway's experience and leadership in digital health should be leveraged to the greatest possible effect for patients and physicians alike. The CAR, the Canadian Association of Radiologists, has had discussions with Infoway about how we can work together to achieve these goals.
At the end of the day, radiology and the delivery of medical imaging services is not just about updated technology and integrated systems. The care providers matter. Radiologists across Canada mostly work together in groups. This structure allows them to pool resources and expertise to deliver comprehensive care. For example, at the Ottawa Hospital, where I work, we are organized in a group of 62 radiologists. This structure enables us to provide quality care across a broad range of body systems using various imaging modalities. It also enables us to work together in education and research. The proposed tax code amendment is a strong disincentive for doctors to work in groups. This will have far-reaching, unintended consequences.
Radiologists stand united with other medical professional groups in asking the government to reconsider the proposed change to the federal tax code for the sake of ensuring patient access to quality care and for the sake of Canadian medical education and research.
In conclusion, we urge this committee to consider how the government can leverage investment to spur additional innovation and to improve health outcomes for our patients. Let's put Canada back in its rightful place as a health care leader in the global community.
Thank you for your attention.
I look forward to your questions. Thank you.