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Column: The world is short on healthcare workers, what do we do?

An opinion piece on healthcare workers shortages in Estevan and everywhere else.
nurse 2022
Access to primary health care is a problem in both rural and urban settings.

Estevan had been short on doctors and healthcare specialists well before the pandemic.

Probably every person in the area has been affected by it in one way or another. Be it long waiting times for virtually any medical service, lack of a family doctor, regularly changing doctors, an impossibility to get help when needed or a burn-out vibe. Seems that the problem is almost as old as this community.

When I was talking to Dr. Christie about her career in Estevan, she recalled that back in 1983 she ended up signing her first two-year contract here, as they were "really short on doctors".

Of course, the problem is not specific to Estevan and rather global and very deep. Even before COVID-19, the growing aging population, a rapid increase in chronic diseases – that same problem of boomers getting closer to retirement also affects the health workforce – and the highly stressful nature of work all contributed to shortages among physicians and nurses.

The pandemic that hit medical professionals the hardest made it even worse. Too many died, too many burned out.

And it's really difficult to fill the void. Health education programs have limited capacity. It takes a specific and relatively rare set of talents and skills for one to become a doctor. It takes a long time to educate and train a healthcare worker. And while millions are undergoing their programs right now across the world, others retire or die at the same time. A tough catch-up game to play.

The global medical recruitment and retention crisis led the World Health Organization to create the Global Strategy of Human Resources for Health: Workforce 2030 in 2016. At that time, they predicted a global staff shortage of 18 million by 2030 and started working to cut this number. By 2020 their efforts resulted in a 29 per cent growth in the health workforce. The original shortage forecast decreased to 15 million by 2022 and potentially will go down to 10 million by 2030. Yet, it's still far from problem solved.

There is some progress globally, but we here, in rural settings, see signs of any progress later and need to put in more effort to actually get our piece. Steps are being done to attract physicians to rural Saskatchewan. The latest one was the announcement of the enhanced Rural Physician Incentive Program (RPIP) aimed at attracting and retaining more family physicians in rural and northern communities across the province.

The total incentive is now up to $200,000 over five years (instead of four), more than four times the amount that was previously offered. Eligibility for the incentive also expanded beyond new graduates and will now include physicians practising in rural and northern communities who have been assessed through the Saskatchewan International Physician Practice Assessment Program.

It sounds like a good plan and a big increase from the $47,000 in total offered before. But will $200,000 be enough to stimulate the rural medical community growth? Time will show. Now that everybody is fighting for their physicians, the cost of having doctors will probably go way up. 

While countries and communities are trying to find ways to ease the crisis, the entire healthcare system may eventually change. How may it look? It's hard to say. I believe there will be more and more digitalization where possible, more virtual contacts for consultations and assessments, more online forms and more initial digital analysis.

AI will probably be able to take over some of the tasks soon, but definitely not all of them, not even the majority. And as long as we want to live bright and long lives, we'll need a healthcare system with doctors and nurses.

The Canadian Medical Association developed their solutions to the healthcare crisis. Their suggestion list includes the expansion of a team-based approach so that more patients have timely access to family doctors, creation of a national health human resource strategy to rebuild the country's health workforce, improvement of workforce data collection across the system to track ongoing gaps, investment into the new training and education infrastructure, and introduction of pan-Canadian licensure to allow for better physician mobility.

Their recommendations also include scaling up virtual care and leveraging the promise of artificial intelligence to improve access to care.

When and if implemented, these measures may reverse the situation long term. Other solutions will be found along the way. But in the meantime, I feel that the most useful thing to do is to take the best care possible of our health and well-being, so that at least some stress is off the system.

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