2010 National Physician Survey Q&A

Transcription

1 2010 National Physician Survey Q&A General 1. What trends were revealed by comparing the new data with past surveys? The time physicians spend on direct patient care each week has been decreasing since the 2004 NPS survey. This is true for male and female physicians and all age groups. Time required on items such as filling out forms, charting, phone calls, etc. - has increased since Access to physicians for patients requiring urgent care has worsened since % of urgent care cases for family physicians are seen within one day; 32% are seen within one day by other specialists. For both groups this is lower than in 2007 when the figures were 65% and 37% respectively. Physicians continue to identify increasing demands for their time as the result of five key factors: increasing complexity of patient caseload (identified by 72% of NPS respondents) managing patients with chronic conditions (63%) increasing administrative work and paperwork (61%) ageing population (59%) increasing patient expectations (58%) Use of electronic records is steadily increasing. 39% of respondents have electronic records on a PC or laptop, an increase of 13% since 2007; an additional 11% intend to start using electronic records on a computer or a wireless device within two years. Retirement 2. How many physicians are planning to retire in the near future? 7.3% indicate they plan to retire from clinical practice over the next two years. This could mean upwards of 5,000 physicians could stop providing patient care by According to the survey, the most popular enticement for physicians to stay in practice is increased flexibility in work schedules and an ability to work part-time. 3. How does this compare to previous years?

2 Since the economic downturn of 2008 we have seen fewer retirements than expected. Currently almost 40% of licensed physicians are 55 or older. Clearly some of these would be semi-retired and therefore providing less patient care. The number of physicians who intend to retire within 2 years has increased to just under 4,200 since 2007 when it was reported to be just over 3, Are we going to have enough physicians coming into the workforce to replace the ones who are retiring? There has been a 77% increase in first year enrolment in Canadian medical schools since It s very positive that we are graduating more new doctors each year, but we also have to keep planning for changing requirements such as retirements and other demands on physicians time e.g. the increasing complexity of patient care, the increase in chronic diseases and an aging population is already evident. 5. Is there anything that would make physicians consider putting off full retirement? Increased flexibility in work schedules and ability to work part-time 62% Financial incentives 49% Reduced on-call duty 42% Access to Care 6. How easy is it to find a family doctor? The survey indicates that overall 58% of family doctors are accepting at least some new patients (compared to 62% in 2007), but this varies depending on location. It is as high as 66% in Quebec and as low as 46% in PEI. There are also variations between rural and urban communities. 7. Are wait times to see a physician improving? Wait times for an appointment with a physician in their office are worsening for both urgent and non-urgent care. An urgent case can be seen within a day by 61% of FPs and 32% of other specialists which is down from 65% and 37% in Wait times for nonurgent care averaged 3.2 weeks for FPs and 12 weeks for other specialists compared to 2.7 and 10 weeks in How are physicians work weeks changing? What caused those changes? The time physicians spend on direct patient care each week has been decreasing since 2004 survey. This is true for both male and female physicians of all age groups. Time spent on things like filling out forms, charting, phone calls, etc. has increased since Some physicians are trying to create a healthier balance between their work and home lives. According to the survey, 57% were satisfied with the balance. 9. How is it possible that access to physicians for patients requiring urgent care has worsened since 2007? Aren t governments spending more and more money to reduce wait times? Much has been done to address the wait time issue for patients. Since 2004 we have seen significant improvements in access to care as a result of initiatives such as increasing the number of physicians, implementing new models of care, EMRs and other technology, and introducing inter-professional health care teams. Despite these

3 improvements we now see an impact on wait times that may be the result of changing demographics. The impacts include: increasing complexity of patient caseload (identified by 72% of NPS respondents) managing patients with chronic conditions (63%) increasing administrative work and paperwork (61%) ageing population (59%) increasing patient expectations (58%) Physician Workforce 10. What is the impact of more women coming into the Canadian medical workforce? Women have traditionally worked fewer hours per week than men but the gap is closing. In this survey, the male physicians indicated working 5 hours more each week than their female colleagues compared to a difference of 7 hours in Past analyses of NPS data has shown that if male and female physicians have no dependents their hours are almost identical. Females spend 51 hours/week in childcare, compared to only 21 hours/week for males. 11. Are younger doctors working fewer hours? The weekly working hours for physicians under 35 (50.6 hours/week) are very comparable to the national average (51.4 hours/week). Physicians of all ages are spending fewer hours in direct patient care than in the past. Younger physicians actually spend more time providing patient care while on-call each month than older physicians. The survey does indicate though, that younger family physicians have fewer patients in their practice than their more senior colleagues. Electronic Medical Records 12. How are electronic medical records being adapted into the Canadian healthcare system? 39% of respondents have electronic records on a PC or laptop, an increase of 13% since 2007; an additional 11% intend to start using electronic records on a computer or a wireless device within two years. The progress here is slow but steady. 13. So 61% of doctors still haven t joined the 21 st century? How is this possible and what is your association doing to end this foot dragging? Rate of adoption of electronic records is the same as for IT tools in other sectors. Physicians are learning to integrate electronic records into their care delivery processes. Change management programs have been setup in five provinces to help physicians transition into an EMR-enabled practice and funding is now available in all provinces and territories to facilitate an increased level of uptake by physicians We can expect an increased rate of electronic records adoption in the coming years.

4 Miscellaneous 14. Why are more doctors charging for services that used to be provided for free? Don t you think that s a bit of a contradiction? Some provincial governments have de-listed certain medical procedures that used to be covered by the medical care plans. Unless a physician charges the patient they will not be reimbursed for their work. Forms required by third parties (such as insurance companies) can be very time consuming and take hours of a physician s time each week to complete. Again physicians cannot be reimbursed for this time unless they charge a fee. 15. How do physicians work with other health care professionals? Physicians have had a long history of working collaboratively with many health professionals and this continues today. One in five physicians (21%) report being part of an interprofessional practice. Almost 40% of the survey respondents said that limited funding models were preventing them from engaging a nurse practitioner or physician assistant in their practice. Methodology 16. Who is paying for the National Physician Survey? NPS is made possible with contributions from the Canadian Medical Association (CMA), College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (Royal College) with financial support from Canadian Institute of Health Information (CIHI). 17. If only a fifth of all physicians in Canada completed the survey, how reliable are the results? Are they really reflective of the physician workforce in Canada? With our response rate we have a rich and comprehensive data base of responses of over 12,000 physicians. This is more than enough to make accurate assumptions about Canadians physicians and the respondent group is representative in terms of age, sex, broad specialty type (FP/other specialties), etc. Analyses will be more limited for small jurisdictions and some individual specialties. Statistical tools were employed to ensure that the data collected is highly representative of the population of Canadian physicians as a whole. 18. How do these results vary between one province and another, or between one type of physician and another? A few provincial comparisons have been highlighted in our media release and backgrounder. Please visit our website to access provincial results for every question in the survey. 19. You first reported on these issues after the first survey in 2004 and 2007 what should the government be doing in response to the survey s findings to improve the Canadian health care system?

5 The government is very aware of all these issues and has responded in a variety of ways. Funding has been available to address wait times in certain areas such as joint replacement, treatment of cataracts but other areas remain backlogged. There are greater opportunities for IMGs to become fully licensed but hundreds still await the chance for postgraduate training. There are dozens more training locations outside large urban centres than a couple of decade ago. Governments have provided many incentive programs for recruitment to area of need but attention also needs to be directed at retention programs to address distribution issues but also to keep doctors in the workforce as long as possible. 20. What steps are needed to thoroughly identify the changing demographics within Canada's health care workforce and plan appropriately for the future to ensure that Canadians have the access to health care that they need? Surveys like NPS are key to monitoring physician resource issues and enabling comparisons within the profession and across all jurisdictions in Canada. Leading medical organizations including the College of Family Physicians of Canada (CFPC), the Canadian Medical Association (CMA), the Royal College of Physicians and Surgeons of Canada (Royal College) and Canadian Institute for Health Information (CIHI) support the research that determines the needs of current and future populations and insures sufficient supply of healthcare providers. 21. It seems all three surveys pointed to long wait times, increasing time spent on paperwork, too few doctors using electronic medical records, doctors retiring and cutting back their hours. Nine years later, nothing much has changed. Why is that? Is anyone in your organization paying attention to these results? Quite a lot has changed over the last nine years since our organizations started the National Physician Survey. The survey input has provided valuable input to many important health care issues across the country. It helped identify and support improvements to the supply of physicians, changing trends in how they work, access to care issues, physician demographics identifying how they work and when they plan to retire, the impact of changing technology and how it s used by physicians. We ve made great progress in many areas, and the NPS continues to provide valuable insight to the ongoing trends in our health care system. Despite these improvements, Canada s health care system is under-performing. Transformational change is necessary if we hope to build a truly patient-centred system able to deliver high-quality and timely patient care. Governments and health authorities should be challenged by the NPS results to address the education, training, recruitment and retention of physicians to ensure a sustainable workforce that is ready to meet the changing health needs of Canadians. While it is acknowledged that the last few years have seen many positive steps in the right direction, the NPS data also present physician resource challenges for which successful solutions have yet to be found.