23 January 2004

You Know There's A Shortage of Doctors When ...

The Province of Alberta is facing a serious shortage of medical personnel, and if something isn't done about it soon then we are going to be in some serious trouble.

The exact nature of our shortage was brought to my attention in a very direct way when I went to see my family doctor the other day. Why I went to see him in unimportant for this discussion. The waiting room was pretty hopping with patient parents sitting around reading magazines and energetic children milling about in the middle of the floor paying with whatever they could get their grubby little hands on.

I didn't think anything of it at the time because there's always a lot of people in the waiting room at this clinic. That's just the way things are. I sat down and waited patiently for my turn. Finally the nurse called my name and took me back into one of the examination rooms, told me to climb up on the scale. After recording that I weighed 194 pounds (I can't remember ever being that heavy in my life, but scales don't lie) she told me to sit in a chair and bare my arm. She then wrapped a BP cuff around me and started pumping. Out of morbid curiosity I asked her what the verdict was.

The nurse told me that my blood pressure was 106 over 92. The 106, she said, was an excellent number but the 92 was higher than it should be. But she wouldn't tell me anything more than that. I just shrugged and decided I would ask my doctor.

Now I remember a time when I was growing up when a family doctor would actually be able to sit down and talk about whatever little thing was concerning you. I remember it as a more personal approach to family medicine, which is an especially personal business. These days when you go to the doctor you're lucky to get them in the exam room for two and a half minutes before they have to move onto the next patient. It's like being in the pits at a race track. That day was a perfect example of it. The doc came in, asked what he could do for me. I told him what I needed and he wrote the prescription for me, and then he was gone before I could ask him about my blood pressure.

Somehow I feel kind of cheated, you know? I mean, I know that the doctor is busy, and I know that local doctors are getting busier and busier with each passing day, so it follows that they have to sacrifice some elements of patient care just to get through all the cases they have to see in a day. Long consultations are a thing of the past. Getting to know your doctor, and conversely your doctor getting to know you, are things of the past. The single most personal profession mankind has ever practiced is now so unpersonable as to be almost mechanical. Indeed, under these circumstances I would probably feel better about things if I was being examined by a trained and programmed machine. At least then there would be some kind of excuse.

Of course, the reason why there is such a shortage of doctors is simple economics. For practicing physicians all of the money is in the States, so over the years there has been a mass exodus of doctors flooding across the border. I know this because a doctor that my family visited religiously for a number of years did exactly that. He could make more money in the states doing exactly the same work so he went south and never looked back. I can't really say that I blame him. I think that in his position I would probably do the same thing.

The other side of the equation is just as damaging, for a number of the doctors that are left practicing on this side of the border are middle aged and close to retirement. There was a news story on the TV a couple of days ago about a number of local doctors who are about to retire and how that's going to hurt local health care.

The bottom line is if something isn't done soon then we aren't going to have any doctors left. So how do we keep our doctors on this side of the border? How about doing the same thing to keep them here that the Americans are doing to lure them south?

I think that the government should provide economic incentives for graduates of medical school to remain in this country to practice medicine. The practice seems to work for the United States, so why can't we make it work here. Funneling more money to University Medical programs couldn't do any harm either. In fact if it was done right it would probably lower the cost of a medical education, and that would encourage more people to pursue the career, because all of a sudden it's in reach and it wasn't before.

Whatever happens we are going to require government intervention to entice doctors to practice in this country, and to keep the ones we have from going south on us. The unfortunate thing is that means it will be a long long time before it happens, and when it does it's going to be screwed up royally because everyone knows that an elephant is a mouse built to government specification.

Here's hoping I don't get sick anytime soon.