I'll begin the answer and hopefully I'm not being asked to solve all that in the next few minutes. We do have an important cohort of baby boomers who are at the end of their professional careers. Interestingly enough I think they remain quite engaged in clinical practice, but probably a proportion of them are actually slowing down a little bit and not necessarily working full time. That's one factor.
We do have a number of physicians who have important academic roles in teaching or research so obviously they are not full-time clinicians. Certainly with the feminization of the profession—and I am not pejorative when I say this but we still need to be realistic—new physicians entering practice in all of our specialties are entering practice very often when they are at the prime of their child-bearing years.
So the notion of a full-time equivalent I think is changing. I think that as we think about the renewal of that workforce we need to be able to recognize those factors, not to bemoan them and feel unhappy about them, but to plan for them.
For example, a family doctor working for 30 years in Corner Brook who is retiring and is being replaced by a woman family physician in the prime of her reproductive years.... We might in fact need more than one of those physicians to be able to replace the work of that physician. Then we may need not only more physicians and a bit, but we may need a family practice nurse or a nurse practitioner who can also do some of the work of that doctor.
We need and I believe we have a responsibility to also prepare our members as they are entering practice, if in fact they are women in their child-bearing years, to say if you are going to enter practice and you want to look after a population, there are a few things you need to put together. So we have work to do. Those are some of the factors. I'm not sure what my colleagues want to add to that.