Doctors Today and Tomorrow: Planning British Columbia’s Physician Workforce

Yogi Berra said it best: "It's tough to make predictions, especially about the future".

In the realm of physician workforce planning, the proof of his statement lies in the cycles of shortages and surpluses of physicians in British Columbia over the years. No one seems able to get the right number, and perhaps—absent a crystal ball—no one ever will. It may be that the challenge of forecasting physician supply; an endeavor that requires consideration of multiple and difficult to measure variables—just does not lend itself to easy prediction.

However, good policymakers never let perfection be the enemy of the good. And if cycles of surpluses and shortages are an inevitable part of physician workforce planning, our goal should not be a futile effort to eliminate them, but rather to minimize them as much as possible. The central message of this paper is that the physician workforce planning process in British Columbia is too fragmented and too short-term in its focus to do so.

In this policy paper, the BCMA examines the challenges of physician workforce planning through the lens of the medical career lifecycle. Each stage—medical student, resident, practicing physician, and near-retirement—offers opportunities for stakeholders to improve current policy and understanding on the individual choices that physicians make about what, how, and where they practice. Doing so will align physician resource planning more closely with the population’s need for health care services. Some of these can be implemented immediately by the government. For example, an increase in the number of government-funded residency positions would add greater flexibility in the postgraduate training system and allow opportunities for re-entry and enhanced skills training for practicing physicians. Others will take longer. Among the most significant recommendations of the paper are:

• Establishing a multi-stakeholder provincial committee led by the BCMA, Ministry of Health, and the health authorities to direct and coordinate the development of physician resource plans and to identify short- and long-term physician resource priorities.
• Developing a provincial analytical framework for needs-based physician resource planning, and
• Creating a provincial physician workforce database to form the basis of physician resource planning.

For the full policy paper, please see, “Doctors Today and Tomorrow: Planning British Columbia’s Physician Workforce”.