Saturday, 14 July 2012

An Idea for Solving the Doctor Shortage

I keep hearing about the difficulties in the medical system in Canada, the lack of doctors in rural and Northern areas, the lack of doctors in general practice.  Years ago, my grandfather had an idea about how to fix that and I think it would still be a valid option.

Take a lesson from the military.  It provides an education and in return, recruits serve for a set number of years.  One of the big factors which keeps doctors from staying in Canada, taking on general practice or serving in low population communities is the high levels of student debt from undergrad and medical school.  They have a lot of debt to repay and so they take on high-paying specialties in urban centers or go south to for-profit medical service.

If the government paid medical tuition for qualified students, they could then ask that those graduates serve as doctors in places of the government’s choosing.  Seven years of medical school for seven years of government doctor service.  There’s benefit to areas which aren’t attracting doctors now.  First of all, they would start getting doctors.  Second, those doctors would be up to date on the latest techniques.  New doctors would get a chance to build up their resumes.  The government would have a dedicated pool of medical practitioners.  It’s a win across the board.

There would probably be some initial costs to the system.  It would not be practical to expect these new doctors to pay for office space and equipment, especially if they’re kept in transient mode.  So the government would have to set up clinics for these doctors to practice out of.

I’m sure lots of people will tell me this wouldn’t work and I’ll admit I don’t have hard numbers to back up my opinion on the matter.  But I think it’s clear our health-care system needs some major overhauling.  The old models no longer keep things running smoothly.  If it were up to me, I would have my mandatory service doctors but I would also allow nurse practitioners to start doing routine diagnosis and prescription.  Most visits to the doctor are not House-worthy with bizarre symptoms and inexplicable illnesses.  The patient can predict the result: I have an infection, I need antibiotics.  It might be boring for the nurses but it’s equally boring for the doctor.

I believe in publicly-funded health care.  I think for-profit health care is too contradictory.  Treating patients and making maximum money are mutually exclusive goals.  I believe a two-tier system inevitably allows the lower tier to drop in quality.  I don’t believe the current system of public health care is sacred.  Canadians are an efficient people and we deserve better than to be caught by a nostalgic view of times past.

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