By Dr. Michael Boroditsky

As published in the Winnipeg Free Press Thursday, April 112024.

DOCTORS Manitoba commends the Manitoba government’s pledge to add 100 physicians to the province this year. This is an ambitious goal and would be the largest single-year increase in our province.

Over the last five years, Manitoba has added an average of 60 doctors per year. The best year ever saw a net increase of 83 doctors. Last year, Manitoba added just 44.

This begs the question: how could the government achieve this desperately needed, but never achieved, goal?

Before I answer that question, it’s important to reflect on where we are, and how we got here.

Today, Manitoba has 215 doctors per 100,000 residents, the second lowest rate in the country. It would take 445 more doctors to reach the national average and that’s a record high for our doctor shortage.

It hasn’t always been this way. Twenty years ago, Manitoba had among the most doctors per capita in Canada.

So what changed? Several factors have contributed to the current shortage, including population growth outpacing physician numbers, freezes on medical school training seats and chronic change and instability in the health-care system that long predated the pandemic and marginalized physician input and feedback.

Fortunately, recent initiatives, such as expanding class sizes at the University of Manitoba and increasing medical residency spaces offer promising steps toward cultivating local talent. However, these efforts will take six to 10 years to yield results.

What would help this year? The answer is focusing on improving both recruitment and retention.

Despite an average annual influx of 213 new physicians, the loss of 153 to other provinces or retirement dampens the net increase to a mere 60 per year.

Increasing the number of physicians who enter practice in Manitoba by 10 per cent while reducing departures by the same margin could realize the target of adding 100 doctors this year.

This goal is achievable and the answer lies in the recommendations Doctors Manitoba has offered to the government.

Effective recruitment strategies must address both retaining graduating physicians and attracting qualified international candidates. Simplifying immigration and licensure processes, alongside financial support and referral programs for doctor-to-doctor recruitment, could be pivotal. The increase to the rural doctor recruitment fund in the provincial budget is a great start, but more is needed.

To put it simply, the best doctor recruiters out there are other doctors. We want to see the government support and empower them to succeed.

Recruiting physicians is complicated, especially in a highly competitive environment with a global shortage. Manitoba has to punch above its weight. The only way to do this is a true all-in” partnership with all the players working together, including the government, Shared Health, regional health authorities, the College of Physicians and Surgeons, the University of Manitoba and Doctors Manitoba. This work has to be done

in partnership, with doctors at the table.

It’s important to involve other players who can help too, such as local municipalities and the business community. We have to not only recruit physicians, but their families, too. This was a key recommendation coming out of the Rural Health Summit we hosted over a year ago in partnership with the Manitoba Chambers of Commerce.

Once doctors arrive in Manitoba, we hope to see more of them stay. Doctors Manitoba is launching a new program to support physicians as they start their practice in Manitoba, with funding from the provincial government.

Retaining doctors, however, needs a focus at all career stages.

When we look at the doctors we do have in Manitoba, half plan to retire, relocate, or reduce their clinical hours in the next three years. This is a major risk to health care in our province. The top reasons for these plans are fixable: burnout, feeling undervalued or unheard, frustration with a complicated and under-resourced health system and excessive administrative burdens and paperwork.

Some foundational actions are now in place that we believe are improving retention. A new physician services agreement is bringing more predictable funding and support for physician practices, making Manitoba more competitive with other provinces. The government has committed to continue the focus on reducing unnecessary paperwork. This is critical, as we know administrative burden is a top cause of burnout.

The current state of siloed, disconnected records means doctors are repeatedly logging in to multiple apps for each patient visit to piece together vital information. Patients don’t have access to their own chart or results. We are encouraged the budget sets aside significant funding to improve electronic records in the province, however this will only help if doctors and other providers are a partner in planning, selecting, and implementing new integrated electronic systems. All too often, in countries around the world, electronic record systems are planned by consultants without front line input, resulting in complicated systems that take doctors and nurses away from patient care. We want to ensure that doesn’t happen here.

To put this all together, achieving a record increase of 100 doctors in Manitoba by this time next year demands co-ordinated efforts and proactive measures. While the goal is ambitious, solutions are within reach, and physicians stand ready to collaborate towards a healthier future for all Manitobans.