Thank you very much, Madam Chair. I'm pleased to address the standing committee today on health human resources, an issue of ongoing concern to family physicians and the College of Family Physicians of Canada.
With over 22,000 members across the country, the CFPC is the professional organization responsible for establishing standards for the training, certification, and life-long learning of family physicians in this country. As the voice of family medicine, we also advocate for specialty family physicians and, very importantly, their patients.
About half of all doctors in Canada are family doctors, which is one of the strengths of our country's health care system, yet we still have roughly four million people in Canada without a family doctor. For many years we have sought ways to increase the number of Canadians with a family doctor, but the CFPC cannot do this alone. Key stakeholders include government and medical schools.
We believe two issues are central to family physician planning: the balance of supply and demand, and changes in patterns of practice. These two are intertwined.
The number of medical students choosing family medicine as a career is a vital issue affecting supply. We need to have 45% of all graduates enter first-year family medicine residency programs if we are to have enough family physicians to meet present and future workforce requirements.
While we strive to train more family doctors and more young family doctors, we also face the realities of an aging workforce, where 13% of the family physician workforce is older than 65 and looking at retirement. Many young family doctors are also seeking better work balance. Changes in work and scope of practice are having an effect on the number of family physicians we need. Over 50% are women who require time away from active practice during their child-bearing years. Governments must be cognizant of shifting patterns in family practice if they are to plan for sufficient family physicians in the future.
A priority for the CFPC is the training, recruitment, and retention of family physicians who provide a broad range of medical services for their patients. However, one-third of today's family physician workforce has a special interest in practice. While this affects the total number providing comprehensive care, these physicians are meeting health care needs within their communities. Family physicians with special interests or focused practices collaborate with their associates, and they are changing the way comprehensive care is delivered. The CFPC recognizes this, and it is supporting these physicians.
With an aging population, we see an increase in patients with chronic diseases and, in turn, complex co-morbidities. These factors are placing more pressure on the demand for family physician services at the same time as demographic factors affect supply. While Canada has begun to address its past mistakes in physician resource policies, it could take another decade to reach the goal that developed nations have already attained in some areas, and that is every person with a family doctor.
Just as population migration from rural to urban communities leaves many towns and villages with scarce human resources, the shortage of family physicians can often be felt more acutely in rural locations. There is thus a disproportionate shortage of family physicians in remote communities and a dire need for medical services for high-risk populations in first nations, Inuit, and Métis communities. These challenges continue to call for a strategic approach.
I'd like to speak briefly about international medical graduates. IMGs are highly valued contributors to our family physician workforce, but we should not rely solely on IMGs to address our physician shortages. We must consider the ethical implications of luring family doctors from countries that need their services.
Further, for those Canadians who are educated at accredited foreign medical schools, we need to ensure there are enough training spaces available to welcome them home to practise in Canada. For its part, the CFPC is pleased to report that we now have reciprocal agreements to certify and welcome board-certified American physicians and Australian-certified family medicine graduates. And we're working on other countries as well.
It's essential that those responsible for physician resource planning address all of these issues. Our college would welcome an opportunity to meet with the FPT Advisory Committee on Health Delivery and Human Resources to discuss the changing horizons in family medicine.
Finally, we would be remiss not to highlight the growing importance of inter-professional collaboration in primary care teams as an increasing preference for many family physicians. Overwhelmingly, young family doctors now prefer to work in collaborative health care environments. We are thankful for the support our governments have given to this development.
Taking all our concerns into consideration, the CFPC believes all these challenges call for a pan-Canadian coordinated approach to health human resource planning. Physician resource planning, as with all other health human resource planning, is a national issue that affects all of us.
To conclude, the CFPC respectfully encourages the government's support for a pan-Canadian health human resources plan that assesses the health needs of the population in each and every community and ensures that we have enough doctors, nurses, and all other professionals to meet our population's health needs. This plan must address the right number and appropriate mix of health care providers, including the training, recruitment, and retention of family doctors, as well as other medical graduates.
An adequate supply of physicians, including family physicians, continues to be a top priority for Canadians. It should remain a top priority for governments and health planners. To maintain the number of family doctors required to meet the health needs of people in Canada, we require a commitment from our health system and medical schools to have 45% of graduates enter family medicine.
We must also ensure that IMGs, international medical graduates, have appropriate opportunities to be assessed and to be offered further training, when necessary, so that they can enter the physician workforce alongside Canadian medical graduates.
Family physician teachers and other resources required for family medicine academic and distributive learning sites are currently strained and need to be augmented if we are to assess and train more family physicians.
Comprehensive care must be supported through our health care system to encourage family physicians to provide patients with the broad range of front-line medical services they need from cradle to grave. As advocated in our recently released discussion paper, “Patient-Centred Primary Care in Canada: Bring it on Home”, governments should support new or enhanced primary care models through which patients have access to a family doctor and an inter-professional team of providers.
We must maximize the use of electronic information in pulling teams together. This nation is trailing most developed countries in this area, and it should be addressed with urgency.
In closing, the CFPC and family doctors in Canada are confident that by working together with government, we can improve access to high-quality health care for all Canadians. To achieve this, we need a health human resource plan that ensures that every Canadian has a personal family doctor.