Monday, January 21, 2008

Growing the pie

Two thoughts about this story:
For years, Belleville suffered from a severe shortage of family doctors that left thousands of its citizens without a physician of their own.

Then, in less than 12 months, the eastern Ontario city suddenly recruited 10 medical students or residents, who will all but close Belleville's gap in service as they finish their training and set up practice over the next four years.

Just down the highway, Hastings County has similarly beaten the odds in this time of doctor drought, convincing nine physicians-in-training to practice for at least five years in the community.

Both are pleasant spots with lots of recreational opportunities and the like, but their recruitment success seems tied to something more practical. Each municipality is offering physicians up to $150,000 for a promise to work there at least five years.
It turns out that basically amounts to free medical instruction if you agree to serve five years in the community.

So like I said, two thoughts: 1) Why isn't the Province of Ontario doing this already? Clearly, we value doctors. They're especially valuable in smaller communities. Problem is, doctors usually don't mind making tons of money, but they like to live somewhere where they can spend it. It shouldn't be up to cash-strapped municipalities to do this, the Province should be targeting communities that need new doctors the most and offer this exact kind of incentive.


2) It seems to me this is really wrong:
"I think it's unethical," said Bob Shepherd, Mayor of the Toronto-area township of Uxbridge, which eschews such tactics. "You get this endless spiral of one community trying to outdo the other…. You're stealing doctors from communities that need them as well."
Well, that's possible, but what it really does is make it easier to become a doctor. Belleville wants to pay my tuition to go to school and become a doctor? Well, that would be great if I wasn't already pursuing another avenue, but five years ago free tuition for medical school would have been... worthless to me because I'm woefully underqualified. But the long-term impact of these kinds of ideas is obvious: rather than robbing Peter to pay Paul, you'll see the pool of talent to draw from grow, meaning all municipalities will be better off.


Declan said...

I agree that financial incentives a la Northern Exposure can help distribute the doctors a bit more to where they're needed, but isn't the constraint on the number of doctors the number of places available in medical school, not the cost of medical education?

john said...

Honestly, I don't know. I'm assuming that with increased subsidies, you'd see an increased number of spaces in medical schools, but that could of course be totally unwarranted.

Now, if we'd get moving and certify some immigrant doctors, we could really make a difference.

Mike said...

The constraint is also the ridiculous rules foreign-trained doctors face as well.

Its was the CMA that said in 1990 that we had too many doctors? We suffer while they benefit.