Canadian doctor total at record high

Canada had a record 75,142 doctors last year and they earned $328,000 gross on average, according to two new reports.

The annual reports on physician supply and payments for both general practitioners and specialists were released Thursday by the Canadian Institute for Health Information.

"The year 2012 saw the highest level of physicians per capita ever recorded in Canada," the authors of the reports said.

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What's more, the six-year trend of growth in the number of doctors outpacing population growth is expected to continue since data from medical schools indicate more students are graduating with MD degrees.

Between 2008 and 2012, the number of female physicians increased by nearly 24 per cent, while the number of male doctors increased by 10 per cent. In all provinces, women represented a larger proportion of family doctors than specialists.

Since 2008, the number of doctors working in rural areas increased five times faster than the rural population, with almost 6,400 physicians in 2012.

But the numbers alone don't present the full picture. It's important to ask not just how many doctors are needed, but where are they most needed and in what specialties, said Geoff Ballinger, CIHI's manager of physician information.

Kristin Speth, 35, of Toronto, has been looking for a regular doctor since she moved from Alberta four years ago. She's had headaches since childhood and has been going to walk-in clinics but is frustrated with the experience.

She's tried the provincial service to find a doctor but keeps getting notices saying there are no leads.

"It is extremely frustrating," said Speth.

"It's just so hard to find someone who will just stay longer than the one year that I need for my physical. They just don't stick around or you know, you can't find anyone who is taking new patients."

 In 2011-12, clinical payments to doctors' offices also increased nine per cent over the previous year to more than $22 billion, the institute reported. In the two previous years, the increases were 6.1 per cent and 7.9 per cent, respectively.

How doctors are paid is also changing.

Fee-for-service payments that reimburse doctors for each clinical service they provide continued to be the majority, at 71 per cent, last year. The average cost per service paid was $56.99.

Out of the gross amount, doctors pay for taxes, rent, salaries and equipment.

Alternative clinical payments, such as paying by hour or by the number of patients in a doctor's practice, rose to 29 per cent, up from 11 per cent of total payments a decade ago.

"Now they're being paid in ways that encourages them to see perhaps fewer patients but spend more time with patients, which is particularly important for older patients or patients with chronic disease," Ballinger said in an interview.

Ontario's health minister, Deb Matthews, said the province is moving towards team-based models of care that maximizes the ability of nurses, nurse practitioners and others to provide primary care.

The per capita number of doctors "becomes a little bit less meaningful than it would have in the old days when you had a family doctor or nothing at all," said Matthews.