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Physician Shortages Impacting Physicians

So many of the issues facing physicians and patients today come back to a shortage of doctors and other health care workers. This has become an important area of advocacy for us, because we know it’s important for you.

Earlier this week, we heard about how a lack of effective overnight coverage for Grace Hospital medical wards is causing distress for physicians working there. We’ve heard from other physicians about similar overnight coverage issues in services ranging from surgery to women’s health to pediatrics, as well as how coverage gaps are hitting hospitals hard in Brandon and many rural and Northern communities. Please continue to share your examples of how physician coverage gaps are impacting you and your patients. Doctors Manitoba is here to work with you through these issues. Email us at general@​doctorsmanitoba.​ca.

We also learned this week about a new national report from the House of Commons Standing Committee on Health about the health workforce crisis. The report includes 20 recommendations to help address the shortage of physicians and other health care workers. Some of the recommendations validate initiatives already underway in Manitoba following our advocacy, such as reducing administrative burdens, expanding peer support, and increasing spaces for medical training. The report also shines a spotlight on the urgent actions necessary now to retain physicians, the need for a rural recruitment and retention strategy, and the importance of exploring alternative payment models for physicians. Learn more about the report and our analysis here.

Over the last couple of weeks, our President Dr. Candace Bradshaw has been in the news talking again about the shortage. Addressing the shortage won’t be easy, with shorter and longer term solutions needed. We have been advocating to focus first on retaining the physicians we have, because better retention is the road to better recruitment. This includes ensuring funding for medical practices is increased and competitive with other jurisdictions, while also addressing other issues that affect the quality of work for our members, such as administrative burdens and working with the health system to value and embrace physicians’ ideas and priorities. 

Here is a sample of some of the recent news stories:

Join Us — Renewing Family Medicine and Primary Care

There’s a common message many of us are hearing lately: primary care and family medicine are in crisis. While the reasons cited for this crisis are as varied as the solutions offered, there’s no question that something has to change. We are hearing regularly from family physicians who feel the current model of funding and support is outdated and not keeping up with escalating costs and increasing patient complexity. We also hear often from specialists who are also deeply concerned about primary care and their family medicine colleagues, and patients who cannot access a family physician.

For over a year now, we have been preparing and now negotiating the next Master Agreement for physicians, and we see this as a once-in-four-year opportunity to transform how the provincial government funds and supports family physicians delivering longitudinal primary care. We’ve spent considerable time studying how other jurisdictions are approaching this, reviewing the various supports and resources currently available in Manitoba, and consulting our members on what’s needed to help their practice survive and thrive.

It’s now time to have your say. We are inviting you to join a Town Hall event to help shape the future of family medicine and primary care!

The Town Hall will feature the following:

  • What needs fixing? Summary of the current challenges we’ve heard.
    • How can we fix it? Option to renew family medicine and primary care, including:
    • Overview of BC’s new Blended Remuneration Model and what it would mean in Manitoba.
  • Alternatives to a blended remuneration model. What’s happening in other provinces? What is the potential value of expanding or strengthening what we already have in Manitoba?
  • Feedback and discussion.

With a mix of education, discussion and feedback, Town Hall participants will learn more about how new funding and support models could help family physicians and renew primary care and have a chance to offer valuable feedback and help prioritize the wide range of policy options to modernize and renew family medicine and primary care.

The Town Halls will all be conducted virtually, on Zoom, and due to the interactive nature of the program a recording will not be available for on-demand viewing. 

Here’s the schedule and registration link:

EIA Disability Changes — Webinar

Major changes are coming April 1 to Manitoba’s Employment and Income Assistance Program for Manitobans with Disabilities (EIA Disability). This will have a direct impact on physicians who play an essential role providing medical assessments as part of the application or reassessment process. 

We have organized a webinar next week with a senior government official to provide a brief overview for physicians about the new programs and who is eligible. She will also discuss how the medical assessment form is changing as part of the application and re-assessment process, with an eye towards reducing physicians’ administrative burden. 

Webinar Details

  • When: Thursday, March 23, 7:00PM to 7:30PM
  • Who: Doctors Manitoba with guest Ms. Jennifer Mussell, Director of Transformation and Strategic Supports, with Employment, Income and Health Supports in the Department of Families.
  • Register Here

Summary of Changes

Currently, EIA Disability is open to individuals with both life-long and shorter term disabilities or medical conditions that prevent employment for 90 days or more. Starting April 1, this will be transformed into two new programs:

  • Manitoba Supports for Persons with Disabilities: Clients must be financially eligible and have prolonged and severe disability. A prolonged disability is one expected to be permanent, and a severe disability is one that results in barriers that significantly limit their activities of daily living or full participation in society. You can also learn more here about Manitoba Supports.
  • EIA Medical Barriers to Full Employment: Clients must be financially eligible and have a disability or medical condition that prevents them from working for more than one year, but may not be lifelong and/​or considered severe. This category is otherwise simply a renamed EIA Disability.

Masks in Your Practice — Snap Poll

With warming weather and Spring right around the corner, we are hearing some health facilities are considering changes to their mask requirements for patients, visitors and for staff. We are interested in your views to help us update our advice and advocacy in this area.

Currently, mask requirements in Shared Health and RHA-run facilities are set by Shared Health. Masks are required for patients, visitors and staff, including in primary care and outpatient settings. For community-based doctors’ offices, mask policies are set independently by the clinic under direction from CPSM. You can view our summary on the current masking requirements and guidance here, issued just over a year ago as public health restrictions were lifted. 

→ You can share your views on masks in your practice location here

CME Rebate — Higher Limits for 2023 

We are hearing from more and more physicians who are getting back to in-person continuing medical education, including local, national and international events. The chance to reconnect with colleagues and make new connections at these events is invaluable. However, we are also aware that registration fees and travel costs are up.

We are happy to report that we are increasing the maximum CME rebate for 2023! We are also keeping some program enhancements for this year as well. As you plan your CME for this current year, which you will be able to claim for a rebate in 2024, please keep in mind these changes:

  • The new maximum rebate for 2023 is $4,000, up from $3,800.
  • An increase to the maximum airfare/​travel expenses per conference from $800 to $1,000.
  • We are maintaining a pilot started last year, allowing physicians to submit expenses that were traditionally excluded. This means any expense that you incur primarily to support your continuing medical education could be eligible (e.g. more than 50% of the cost is to support CME). This will help us to identify new types of expenses physicians are incurring to support their CME. 
  • We are adding a new eligible expense based on your feedback! You will be able to claim up to $1,000 for costs of publishing articles in journals. This is a new category and is part of your maximum $4,000 rebate.

A reminder that these changes are for CME expenses you incur during the current 2023 calendar year, to be claimed next year. Expenses you incurred last year, in 2022, can be claimed soon when we open up the 2022 CME rebate applications this Spring. 

Group CME Grant Reminder

A reminder that you can now apply for a grant of up to $20,000 to support group CME initiatives. Learn more here.

Spring COVID Booster Guidance

Today, Manitoba Public Health issued guidance around Spring booster shots for COVID-19. Manitoba Health recommends those at highest risk can choose to receive a Spring COVID-19 booster if it has been at least 6 months since their last dose or infection. Higher risk groups include:

  • Adults age 65+
  • Indigenous People age 45+ (including First Nation, Inuit and Métis Peoples)
  • Residents of long term care, assisted living or supportive housing facilities
  • Adults age 18+ who are moderately to severely immunocompromised.

Physicians and patients should keep in mind that if a spring booster dose is administered, this may result in delayed eligibility for a fall booster dose. It is anticipated that a fall 2023 COVID-19 booster program may be offered for the general population, pending NACI recommendations. These considerations need to be clearly communicated with clients.

Any individual who has not received a fall 2022 booster dose are still encouraged to get one. 

For all boosters, Manitoba Public Health recommends offering a bivalent vaccine. If an individual chooses not to receive a bivalent booster option, they may be offered a monovalent booster dose, if available .

This advice is largely aligned with that of the National Advisory Committee on Immunization (NACI), which released recommendations earlier this month. 

Meet Our Physician of the Week

Our Physician of the Week is Psychiatrist, Dr. Jennifer Hensel. Dr. Hensel loves the variety of patients and tasks her specialty provides. Working with unique individuals and having the privilege of hearing their personal stories and helping to reduce their suffering is immeasurably rewarding for her. She has been instrumental in creating new ways mental health supports are being delivered to Manitobans. As a response to COVID-19 and the resulting public health restrictions and with very limited resources, Dr. Hensel transformed the Crisis Response Services to a virtual program, a first in Canada. Within weeks, Dr. Hensel had implemented virtual options for patient assessment and treatment that spanned almost all facets of clinical service, even virtual hospital wards. While virtual care has tremendous potential, Dr. Hensel has been conscious about the appropriate and safe use of virtual care as a complement to in-person visits.

For 2023, Doctors Manitoba has established a new way to recognize dedicated and hardworking physicians. Our Physician of the Week initiative has been recognizing physicians weekly. They exemplify the best of the medical profession, including a commitment to delivering exceptional patient care, to supporting the health and wellness of their colleagues, and/​or to leadership in the medical profession. Read more about Dr. Hensel.

→ Suggest a colleague as Physician of the Week here.

→ Read about other Physicians of the Week so far this year here.

Health System Updates

Feds crack down on private billing for virtual care

Late last week week, Federal Health Minister Jean-Yves Duclos sent a letter to provinces warning that we could see future federal funding cuts if they continue to allow clinics to charge patients for virtual care. Medically necessary services are covered by the Canada Health Act, even if they are provided online or by phone. Duclos intends to send another letter clarifying how virtual care will be treated under the act, which prohibits patient fees in a universal health-care system.

Duclos also informed some provinces their next transfers will be clawed back because of the last Canada Health Act clarification, which was issued in 2018. That year, Ottawa told provinces and territories that diagnostic tests are covered by the act and gave them two years to address the problem of allowing patients to be charged fees for testing. Duclos said provinces can see some or all of the funds restored if they take steps to end the practice. 

Respiratory Virus Updates

Manitoba Public Health produces a weekly report on respiratory viruses. Below are highlights from this week’s report.

This week’s report covers the week ending March 11. The monitoring suggests similar COVID activity to last week. Highlights include:

  • There were 53 hospital admissions, down from 59 last week. This week included 9 ICU admissions, up from 8. Weekly hospital admissions last peaked at 264 in the week ending April 16, 2022.
  • There were no COVID deaths recorded over the last week. Down from 2 last week. 
  • There were 129 lab-confirmed cases reported in Manitoba, down from 150 last week.
  • The test positivity rate was 14.7%, up slightly from 14.2% last week.
  • Wastewater surveillance data up to March 7 indicated sustained activity of COVID-19 in Winnipeg and Brandon at lower levels compared to the fall of 2022.

This week’s report shows similar influenza activity. Highlights include:

  • The predominant strain circulating right now is still Influenza A (H3N2), with 3 lab confirmed case and there were no cases of Influenza B reported. For the flu season the total cases of Influenza A is 2,636 and Influenza B is 7.
  • There were no hospital admissions as a result of flu/​RSV.
  • There were 1,347 respiratory related visits to EDs in the province this week, down from 1,366 from last week.
  • Test positivity rates for RSV was 3.0%, for Influenza A was 0.4% and 0% for B.

Health in the News

We’ve curated some of the top recent stories, to help you stay on top of what’s new in health care. This includes free access to some subscription-based content. 

DRMB in the News
Other Health News

ICYMI

Here are some of our top recent posts, in case you missed them:

Events

Upcoming events are always listed on our events calendar.

Featured Event

CFMS & Doctors Manitoba — Insurance for Residents — April 3, 2023 | 6 – 7pm

Matched to Manitoba? As a new resident, Doctors Manitoba provides compulsory lifestyle insurance to meet your needs. Find out whats included and how to sign up. Join us for this informative session. Topics will include: 

  • Welcome to Doctors Manitoba
  • Insurance and Risk Management?
  • What is Life, Disability, and Accident Insurance — what am I signing up for?
  • What else does Doctors Manitoba provide?
  • I matched to another Province, now what?

Please email Mark Venton, Insurance Coordinator at mventon@​DoctorsManitoba.​ca if you have any questions.

Other Events

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