Canadians love their health care system ...and for many it works very well, but it has become clear in recent years that as the needs of Canadians change, the system itself has not kept up. There is a growing consensus that something has to change. Canada has one of the most expensive systems in the world but it consistently performs near the bottom of the list of wealthy nations on a range of factors ...most troubling, waiting lists and access to care. Rising costs coupled with sub-standard performance: it presents a daunting challenge.

One aspect of the health system -- but obviously a key aspect -- is physicians. All the provinces are struggling with different ways to manage their doctors. Why? Because payments to doctors as a group are rising faster than some of the other costs such as hospitals and drugs. Individually, doctors' pay has not gone up but because there are more of them working, there are more of them to pay. But despite a dramatic increase in the number of doctors across the country, Canadians' access to GP's remains a significant problem ...especially in rural and remote areas. And when it comes to offering older people timely health care, a recent study puts Canada dead last, when compared with 10 other Western nations.

The provinces are making changes ...and there are more on the way. Ontario recently announced a cut to doctors' fees. Quebec is setting higher targets on the number of patients doctors must see. BC is hoping creating more nurse practioners will take the pressure off doctors. Some experts go further, suggesting putting doctors on salaries and assigning medical graduates to remote areas. Newfoundland hopes signing bonuses will attract doctors into rural areas.

We'd like to hear your views. What has your experience been with the health care system? Do you think that some or even many of your needs could be met without actually seeing a doctor?

Are you happy with the service you receive from your local health clinic and GP?

Do you have a family doctor? How long do you have to wait for an appointment?
What do you think of the idea of expanding the roles of nurses and nurse practioners?

Today we want to hear your experiences - the good and the bad.
Are there things that are working well? We'd like to hear about them as well.

Our question today: "Is it time to re-think the role of doctors in the healthcare system?"

I'm Rex Murphy ...on CBC Radio One ...and on Sirius XM, satellite radio channel 169 ...this is Cross Country Checkup.

Andre Picard
Globe and Mail health reporter and columnist
Twitter: @picardonhealth

Dr. Arthur Parsons
Retired physician from Halifax and author with Patrician Parsons of several books including "Healthcare Ethics" and "Patient Power"

Sabrina Wong
Director, Centre for Health Services and Policy Research and Professor, School of Nursing at UBC
Twitter: @sabrinawong88

Dr. Ben Chan
Assistant Prof, University of Toronto & past CEO of two Health Quality Councils in Canada
Twitter:@dr_benchan