Manitoba could lose more than 300 doctors

Today is the first anniversary of The Flatlander.

It completely snuck up on me. (The same happens with my wedding anniversary every year. Luckily my husband also forgets until the day of too. Neither of us is exceptionally sentimental).

The first issue went out to 100 readers. Today’s issue goes out to over 6,000 readers.

As I reflect on this milestone, I’ll have more to say about The Flatlander turning one over the next few weeks.

Healthcare in Saskatchewan and Manitoba

One of several editorial priorities for next year, requested by readers, will be to examine the healthcare systems in Manitoba and Saskatchewan.

Today’s issue will look at how Manitoba and Saskatchewan are doing regarding the number of doctors. Spoiler alert: we don’t have enough. And burnout is causing some of the doctors we do have to leave the profession early.

Manitoba, for instance, will likely lose more than 300 doctors to retirement over the next three years.

An open letter to a departed great uncle

But before we get to discussing the doctor crisis, I wanted to share one more reader’s Remembrance Day contribution. Darrell Horn writes an open letter to his great uncle, who fought in the First World War.

Here is an excerpt:

Now our house was small, but your house was tiny. One bedroom for you and auntie, a cot on a porch where I slept with my dad, and a hide-a-bed in the wee living room for mom and grandma. With all the leaves of the table folded out, we crowded in and around at every holiday and during summer vacations, playing marathon matches of Canasta (hand and foot, of course) late into every night. I have no idea how Santa ever managed to sneak in. Then, after the last hand was played, we’d all cuddle up. And late, very late in the night, your screams would start.

There were two variations: “Get ready boys, get ready, they’re coming over,” and the worst, the most anguished call, “It’s gas, it’s gas, they’re gassing us boys…oh god”. I’d ask my dad, when I was maybe four or five, as young as I can remember, “What’s the matter with Uncle Lloyd?” A veteran of the Second War, he didn’t say much, just “bad dreams” and then he’d hug me tight. After a few years, I didn’t ask anymore. We’d listen while Aunt Lila calmed you, and my dad would always hold me close so I wouldn’t be afraid. These things were never mentioned in the light.

You can read the whole letter here.

Your holiday stories

For Christmas, The Flatlander is collecting people’s holiday stories and memories from around Saskatchewan and Manitoba. You can share yours here.

Healthcare systems in crisis

Both Saskatchewan and Manitoba are facing a critical staffing shortage when it comes to both doctors and nurses.

One of the issues making medical professionals quit their jobs or reduce their hours is burnout.

The lowest number of doctors per capita

Last month, Doctors Manitoba released a report that shows how dire the situation is in Manitoba and Saskatchewan.

Saskatchewan has the second lowest number of physicians per capita in Canada. There are 215 doctors per 100,000 people in Saskatchewan.
Manitoba has the third lowest number of physicians per capita in Canada. There are 216 doctors per 100,000 people in Manitoba.
PEI has the lowest number of physicians if you’re wondering. There are 201 doctors per 100,000 people in the province.

Canada compared to the rest of the world

No province in Canada has an abundance of doctors. Our country’s average number of doctors is far lower than most Organisation for Economic Co-operation and Development (OECD) nations.

The OECD comprises 38 democratic companies from around the world, like Germany, Japan and the U.S.

Compared to our peers, Canada has the seventh lowest when it comes to doctors per capita.

The OECD average is 359 physicians per 100,000 people.

Manitoba has the lowest number of family doctors per capita

Regarding family doctors, Manitoba has the lowest number of doctors per 100,000 residents.

Manitoba has 108 family doctors per 100,000 people.
Saskatchewan is the fourth-lowest number of family doctors. The province is ahead of PEI and Ontario, respectively.
Saskatchewan has 119 family doctors per 100,000 people.
The average per capita for the country is 123 doctors per 100,000 people.

All major Prairie urban centres are short doctors

When it comes to our cities, Regina has the lowest number of doctors per capita. The other major Prairie cities round out the bottom six.

Regina – 232 doctors per 100,000
Edmonton – 289 doctors per 100,000
Ottawa – 292 doctors per 100,000
Winnipeg – 293 doctors per 100,000
Calgary – 295 doctors per 100,000
Saskatoon – 308 doctors per 100,000

Even though Saskatoon has more doctors than the rest of the other Prairie cities, there are no family doctors there taking new patients.

As we learned in a previous issue of The Flatlander, going into family medicine is no longer seen as a viable career by new doctors fresh out of school.

The pandemic made it worse

It should be noted that the numbers above are taken from before the pandemic, which made the situation worse.

Since the pandemic, more than 50 per cent of doctors in Canada say they are burned out.
The pre-pandemic Canadian baseline was 31 per cent
Sixty-seven per cent of Manitoba doctors say they are burned out

Saskatchewan doctors and mental health

I couldn’t find any numbers for Saskatchewan doctors when it comes to burnout, but in a Saskatchewan Medical Association (SMA) survey released this spring, 49 per cent of Saskatchewan doctors said their mental health was worse than before the pandemic started.

Seventeen per cent of Saskatchewan doctors said their mental health was much worse.

According to the 2022 National Physician Health Survey, doctors across Canada are feeling more anxious and depressed.

The top concerns for Saskatchewan doctors were

the lack of physician voices in the pandemic response (76%),
concern for the health of patients with non-COVID needs (60%),
concern for their own or their families’ safety and health (43%),
poor communication (42%),
and feelings of less connectivity to their colleagues (42%).

Over the next three years in Manitoba:

Eleven per cent of Manitoba doctors plan to retire
Eleven per cent of Manitoba doctors plan to leave Manitoba
Twenty-one per cent of Manitoba doctors plan to reduce their clinical hours.
Manitoba could lose 348 physicians to retirement over the next three years.

Top reasons Manitoba doctors site for leaving practice or reducing hours:

Frustrated by “system issues” outside of my control (49%)
Feeling burned out or distressed by work (45%)
Personal reasons (45%)
Don’t feel valued by the healthcare system (44%)
Workload too heavy (29%)
Need to focus on family (20%)
Remuneration not competetive (18%)

Meanwhile, in Saskatchewan:

Almost one in five Saskatchewan doctors is thinking of retirement.
More than six out of 10 Saskatchewan family doctors said they were “likely” or “very likely” to cut clinical hours in the next two years.
More than seven in 10 Saskatchewan doctors said they had not had adequate time to rest during the pandemic.
Fifty-seven per cent of Saskatchewan doctors said their workloads had increased during the pandemic.
About three-quarters of Saskatchewan doctors said their practice was “less satisfying” than before.
Nineteen per cent of Saskatchewan doctors said they plan to retire, compared to five per cent who reported the same in a similar survey in 2020.

Hiring more doctors and nurses

In September, Saskatchewan announced plans to hire 1,000 healthcare professionals over the next few years. It’s estimated this will cost the province $60 million.

Last week, Manitoba announced plans to hire 2,000 healthcare professionals for $200 million.

Hoping to bring in more international workers

To meet these hiring targets both provinces are recruiting internationally.

Saskatchewan’s plan specifically targets medical professionals from the Philippines and Ukraine.

Aggressive recruitment of Filipino nurses

Paul Merriman, Saskatchewan’s health minister, is leading a five-day delegation to Manila on Nov. 28 in hopes of recruiting nurses and other healthcare professionals from the Philippines.

And Saskatchewan and Philippines post-secondary institutions are working on aligning nurse training programs to fast-track Filipino health sciences graduates wanting to move to Saskatchewan.

Manitoba is also looking to recruit Filipino workers and plans to update its memorandum of understanding with the country.

Australia poaching Canadian healthcare talent

While Canada is recruiting nurses from the Philippines, Australia has been recruiting Canadians to study medicine in their country in hopes of keeping them on as doctors once they graduate.

OzTREKK Education Services is a company working in Canada recruiting potential doctors.

Their slogan is “Helping students to get to Eh to Oz.”

Internationally-trained Canadian healthcare workers

The Saskatchewan government plans to recruit Canadians who are internationally trained but not licensed to work in Canada.

There are hurdles for Canadian internationally-trained doctors to return home to practice, and it looks like the Saskatchewan government has plans to set up online resources to help those medical professionals navigate those challenges.

Manitoba’s plan doesn’t mention assisting internationally-trained Canadian doctors. The province’s plan does say it will address testing costs and remedial training for returning, retired and international nurses.

Here are a few related Flatlander issues from the archives:

Until next time…

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