Latest news with #physicianshortage
CBC
14-07-2025
- Health
- CBC
'Keep the doors open': As ERs close, doctor speaks out on the challenges of practising in rural Sask.
The senior lead physician of a Saskatchewan Medical Association program that provides help for rural doctors is speaking out on the challenges they face, after a number of temporary rural emergency room closures forced by a shortage of medical professionals in the province. "We tend to get the feeling that from an emergency perspective … the importance is placed on just keeping the door open, not necessarily, you know, keeping the door open when we are adequately staffed," Dr. Francois Reitz said in an interview Tuesday, as he was coming off a 24-hour emergency room shift. Reitz works with the medical association's rural relief program, which provides short-term locum relief to general and family doctors working in rural communities with fewer than five practising physicians. The workload for health-care workers in rural areas has increased from when he first started with the program 20 years ago, he said, including greater demand from patients as health conditions have become more complex. At the same time, there is a shortage of health-care workers in rural areas. "It's not just physician shortages that we're seeing," Reitz said. "My nursing colleagues, my pharmacy colleagues, my lab techs, etc. — there's a shortage of everybody." That's resulted in many rural health-care workers who are on call "every single day," he said, which means they struggle with work-life balance or may have to reduce services. When somebody calls in sick, there's often nobody to replace them, Reitz said. "I need certain things to be able to deal with the heart attack or if there's a motor vehicle accident," he said. "If I don't have those resources available to me, I cannot do the best that I can from a rural perspective. And rural, classically, we deal with fewer resources that we have to juggle." The expectation to "keep the doors open" for health services like emergency rooms can compromise the quality of care for patients, which is top of mind for doctors, said Reitz. "Our concerns are more about not being able to provide that quality of care," he said. "When one hasn't had sleep or [doesn't] have enough staff, what is slipping through the cracks?" Shortage has been approaching for years Reitz said the current doctor shortage is not a complete surprise. He said by 2018-19, it was known the field would run into a "mass retiring of doctors," due to the number of baby boomers working at that time. Then came the COVID-19 pandemic, which was both a wake-up call and catalyst for the health-care system, he said. "I think it highlighted a lot of weaknesses within our health-care system, both with current planning and future management," said Reitz. Many health-care workers also started to reassess their roles within the system and opted for better work-life balance, leading some to restrict their practices. Residents and leaders in some rural Saskatchewan communities have started to speak out about the shortage of doctors, and how many resign early. That comes down to a few factors, said Reitz. As the population grows, the province is not producing enough physicians to replace those who leave the field, he said. Instead, Reitz said Canada has relied heavily on international medical graduates — he was recruited from South Africa just over 20 years ago. "You are more likely to find an international medical graduate in rural Saskatchewan than you are to find a Canadian graduate," he said. Typically, a rural doctor will do a roughly five-year term, Reitz said. But as recruitment relies more heavily on international doctors, there seems to be fewer who stay in rural areas long-term. For those from some religious or cultural backgrounds, it can be hard to access community, traditional foods or religious services in rural areas, he said. "Saskatchewan has traditionally been very, very difficult for international medical graduates who are not of a Christian or atheist background," Reitz said. Many come to realize they would be "happier, healthier and in a better financial state after a year … moving anywhere else, whether it's centrally or out of province," he said. Pay is another factor in turnover, with the compensation not always matching the long hours rural physicians are expected to work, said Reitz. "Being a physician is not the high-paying job that it used to be 20 or 30 years ago," he said. "But then again, how do you sell to the public that a doctor is not being adequately paid? This is something which both culturally, as well as historically, is a very difficult argument to make." 'We have a lot of interest' The head of the Saskatchewan Healthcare Recruitment Agency says it works with international applicants to try to ease the transition. "Once we are aware of an applicant, we start working with them to understand where they were educated, what their currency or practice is, if they would be new to Canada," said chief executive officer Terri Strunk. The provincial agency's role is to reach out to medical residents and graduates locally, nationally and globally to try to find physicians, she said. There are many qualifications that have to be met through the Royal College of Physicians and Surgeons of Canada, the national regulatory body, she said. Once a doctor is deemed eligible, the College of Physicians and Surgeons of Saskatchewan and the Saskatchewan Health Authority work to determine which vacancy they could fill, said Strunk. The province offers competitive incentives and opportunities to doctors, and "we have a lot of interest in Saskatchewan because of the nature of our physician workforce here," she said. "They want to make that decision, and then what's the fastest way I can get there." With that, there needs to be consideration for international workers around where they should be located and how they can best be prepared to practise there, said Strunk. "Practising in a rural area of Saskatchewan is different from practising in one of our rural centres," she said. "You might have a physician, you know, practising in a remote or rural community of Saskatchewan that may have never seen … an agricultural accident before." The recruitment agency has worked hard over the last year to share information with communities about which factors influence retention of health-care workers in rural and remote areas, said Strunk. "Communities are the first to want to keep their health facilities open — they want to keep their doctors there, but oftentimes they don't know what they don't know," she said. "They may not realize that … [doctor] might be feeling socially isolated, or perhaps the spouse hasn't been able to find work." The agency is also looking at what has worked for communities that have good retention, and sharing that with others through a health-care tool kit. "It's just also about making sure that we, as a recruitment agency … and the employer at the Saskatchewan Health Authority and that community know who that physician is, what their needs are, as much as we can," Strunk said.
CTV News
08-07-2025
- Health
- CTV News
Regina Urgent Care Centre forced to close early for second time in a month
WATCH: Regina's Urgent Care Centre is on regular hours again after being forced to close early on Sunday due to staff shortages. Wayne Mantyka reports. Regina's Urgent Care Centre is back to operating on regular hours again after being forced to close early on Sunday due to a physician shortage – which has spurred questions from the NDP Opposition. Sunday, July 6 marks the second time in less than a month that the facility was forced to close its doors early due to staffing issues. The facility normally accepts patients until 9:30 p.m. but was forced to close at 4 p.m. Sunday. The centre was supposed to be operating 24/7 last fall. As the Saskatchewan Health Authority (SHA) COO Derek Miller told reporters Monday, recruiting doctors has been an ongoing challenge for the agency. 'We have been careful to understand the impact of recruiting physicians from community – away from family practices for recruitment of family physicians and also the emergency room physicians,' Miller explained. 'We need to be able to sustain emergency room services at the Pasqua Hospital and the [Regina General Hospital].' Originally, Regina's Urgent Care Centre was supposed to be open around the clock. Now the SHA says that between the centre and emergency rooms, patient demand is being met. 'We know that our peak demand throughout the day for urgent type services be it that are coming through the emergency rooms or the UCC we're covering that now,' Miller added. The province plans to open additional urgent care centres in Saskatoon, Moose Jaw, Prince Albert and North Battleford. The NDP Opposition questions how the government plans to staff more facilities given the situation in Regina. 'They can't even properly staff the one facility that they have open,' NDP MLA Keith Jorgenson said. 'You know, this is all smoke and mirrors.' The SHA says it will continue to assess how the Urgent Care Centre and emergency rooms are working together in meeting patient needs. The assessment will guide a future decision on Urgent Care Centre hours. In the meantime, physician recruitment continues.
Medscape
19-06-2025
- Health
- Medscape
Wait Times to See Physicians Continue to Climb
Your patient has waited 4 weeks for a 15-minute visit, and you're double-booked and distracted. As physician shortages collide with rising demand, wait times have increased, and appointment delays are the norm, not the exception. Patients are frustrated, and physicians are overwhelmed. In fact, according to a new survey conducted by AMN Healthcare, the average physician appointment wait time in 15 major metropolitan areas has increased by 19% since the survey was last conducted in 2022 and by 48% since it was first conducted in 2004. This translates to patients waiting 31 days on average to book time with a healthcare provider, up from 26 days in 2022 and 21 days in 2004. Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, Medscape's Artificial Intelligence (AI) Adoption in Healthcare Report 2024 found that Just 18% of physician offices use AI to create staff schedules, yet 30% predict they'll use AI for this in the future. 19% of physician offices use AI for patient census predictions, yet 40% predict they'll use AI for this in the future. One big surprise about the survey is that appointment wait times weren't even longer, Jeff Decker, president of AMN's physician and leadership solutions division, told Medscape Medical News , adding that in Boston, wait times were the longest (65 days), while Atlanta had the shortest wait times (12 days). 'Anecdotally, we've heard of physician appointment wait times that commonly extend 2 or 3 months or more rather than a few weeks or 1 month,' Decker said. 'We think this may be a result of medical practice consolidation, where more physicians are part of large medical groups than has been the case in the past.' In addition, wait times can vary based on whether (or not) the physician accepts Medicare or Medicaid and tend to be even longer when new patients book an appointment with a specialist. The survey found there was a 42-day wait for obstetricians and gynecologists (ob/gyns), a 40-day wait for gastroenterologists, and a 36.5-day wait for dermatologists, something Dara Spearman, MD, a board-certified dermatologist in private practice in Fort Wayne, Indiana, said sounds accurate. 'There are fewer than 10 dermatologists in Fort Wayne, so this creates quite a backlog,' she said. 'Because dermatologists can treat over 3000 diseases, I'm trying to triage a bit and see if we can overlap with other specialties, like having pediatricians or primary care start treatments for a patient with acne, to leave room for patients who need to see us immediately.' Appointment times for serious cases, such as the skin cancers she sees among her farmer patient population, are Spearman's greatest priority. 'When you're talking about melanoma, time is of the essence,' she said. 'Patients have to get in quickly to get it recognized, and the earlier you get it out, the less likely it is to spread. That's why I use the Secure Chat feature on Epic. This way, when primary care reaches out about something they're worried about, I can get that patient in as fast as possible.' Like Spearman, physicians around the country are coming up with other unique solutions to make sure they can get patients into the office as quickly as their schedules will allow. For one, partnering with other professionals can open up patient appointment slots, and many medical practices today, both in primary care and in specialty areas, are using advanced practice professionals to do just that. 'Medical practices are using locum tenens physicians to extend services and patient access, particularly during peak usage periods,' AMN's Decker said. 'Working alongside nurse practitioners (NPs) and physician assistants (PAs) will also ease their workload and free up their time.' Partnering with NPs was exactly what Ashish Nanda, MD, director of Stroke and Neuro-Interventional at Providence Health System in Orange County, California, proposed to his hospital as he sketched out the creation of a stroke clinic there, which will open in August 2025. 'I realized that our stroke patients were getting discharged but needed follow-up to prevent another one from occurring,' Nanda said. 'The only way to do that was to see them in clinic, so I proposed a dedicated stroke clinic staffed by one specialist and one NP. With two clinicians, we can see more volume and make sure appointments are easier to book.' Another way to boost efficiency is to 'divide and conquer' health conditions within your own practice. 'For example, one partner in the practice can do skin cancer evaluations while the other can focus on complex dermatology procedures,' Spearman said. 'That can be boring for some physicians, but this can really help with scheduling.' This is something Spearman has observed among her ob/gyn colleagues. 'As ob/gyns get older, many are done with the OB life of being on-call,' she said. 'They can opt to focus instead on pelvic disorders or endometriosis. By rethinking how your practice is run, you can streamline the process for patients, too.' Ultimately, the physicians Medscape Medical News spoke with agree that technology will be the ultimate solution to the extensive physician wait times patients are currently experiencing. 'Right now, physicians are spending 50% of their day on administration, whether it's writing notes, following up on labs, and documenting visits, which means they can't see the many patients that need to be seen in a day,' Nanda said. In turn, if AI can cut that administrative time down to 10%, it means a physician can double the number of patients they see, which will ease the current bottleneck, added Samuel R. Browd, MD, PhD, professor of neurological surgery at the University of Washington and attending neurosurgeon at Seattle Children's Hospital in Seattle. 'Our hope is that the emergence of new technology that's clumped under AI is going to create the ability to have more efficiency within the system and allow the current number of providers to be able to scale what they're able to do,' Browd said. 'I'm doing clinic today and probably spend half of the time, if not more, managing Epic, doing paperwork, and documenting visits instead of engaging with patients.' The goal is for AI-powered documentation tools to become more and more of a norm in the hopes that this will help lessen administrative tasks. 'The more burdened we are, the less quality care we can deliver,' Browd said. 'The hope is that with AI and other emerging tools, we can create a better work environment, too.' Happily, Browd says technology is moving rapidly, which may mean that within the next 3-5 years, it will become increasingly easier to make a doctor's appointment — quickly and efficiently. 'If you fast forward to 5 years down the road, what we do day-to-day will be significantly different and will be beneficial in terms of enabling patients to have better access to care,' he said. This will improve the caregiving experience for physicians, too. 'My hope is that this will also change the work environment for doctors in a positive way,' Browd said. 'This will allow us to get back to being doctors, back to the things that brought us into the field in the first place — like taking our time to care for and listen to patients.'
Forbes
03-06-2025
- Business
- Forbes
Visa Pause Could Leave U.S. With Fewer New Doctors Amid Shortage
About a quarter of doctors currently in practice were educated in foreign medical schools and the United States faces a growing physician shortage. Newly-minted M.D.s are among the thousands of students, trainees, teachers and exchange visitors put in limbo after the Trump State department hit pause on new visa appointments last week, as it develops a plan to vet visa candidates' social media. For foreign-born and educated doctors who haven't snagged an appointment yet, the timing couldn't be worse—most medical residencies officially begin July 1, with orientations for the newest M.D.s (known as interns or P.G. 1s) starting some time in June. International medical graduates without visas could miss their start date, putting their positions at risk and leaving hospitals in the lurch, since interns provide hands-on medical care under the supervision of more experienced doctors. According to the American Medical Association, about a quarter of doctors currently in practice in the U.S. were educated in foreign medical schools and the nation faces a growing physician shortage. But before a foreign-educated doctor can be licensed to practice medicine in the United States, they must complete a U.S. residency, making these programs crucial to keeping the needed supply of foreign doctors flowing. In March, in what's known as the 'main residency match,' 37,677 graduates of medical schools and schools of osteopathy were placed into first year jobs. Of those, 6,653 were foreign-born students who graduated from a non-U.S. medical school per data from the National Resident Matching Program. (Another 3,108 were U.S. citizen graduates of foreign medical schools.) These figures don't include the 2,374 positions that were initially unfilled in the March match; 300 of those jobs later went to foreign-born and educated students. 'Some people are saying, 'Oh, maybe [foreign doctors] are taking all the spots,' says Sebastian Arruarana, a resident physician at the Brookdale University Hospital and Medical Center in Brooklyn, New York. 'But no, they're not taking the spots—there's a bigger number of positions to be filled than the number of medical students graduating here.' Most international medical graduates (who aren't U.S. citizens) come to the United States on J-1 visas, which are reserved for exchange visitors participating in teaching, research and other training. Many of this year's incoming interns have already made their visa appointments, but about 5%—or more than 300 doctors—have not, estimates Zain Abdin, a Chicago-based physician and founder of the international medical graduate support organization IMG Helping Hands. Arruarana, who is also a social media influencer focused on international medical graduate issues, has been hearing from some of those doctors stuck in limbo. 'We are stuck and we are helpless,' one international medical graduate who matched at a Texas medical center said in a message to Arruarana. The new resident's orientation program began on June 3, which is on the early side. 'I don't know what to do in this position.' 'I just got matched on May 23 after so many challenges and against all odds,' another messaged Arruarana. 'My program just started the J1 visa sponsorship process, so I don't have an interview slot.' Some residencies start later in the year, explains Abdin, primarily in September. Those residents, on the whole, are more likely to be impacted by this visa hold. Big states like New York and Florida—where 1,592 and 698 foreign-born international medical graduates matched this March, respectively—are home to the most foreign medical residents, according to NRMP data. But they represent only 24% and 19% of residents. Less populous states like North Dakota, Wyoming and Arkansas—all of which supported Trump in the last election—rely more on foreign medical residents, with foreign-born and educated medical graduates making up 38%, 33% and 32% of their incoming residents, NRMP data shows. The ongoing appointments pause affects all student visa types, including F-1 visas, primarily issued to foreign undergraduates and graduates at colleges and universities, and M-1 visas, issued most often to foreign students studying at trade schools or in non-academic programs like flight school. State department correspondence said the scheduling pause would stay in place until further guidance is issued 'in the coming days,' Politico reported last week. In the meantime, leadership from the Educational Commission for Foreign Medical Graduates (ECFMG), which essentially serves as a gatekeeper for foreign medical graduates entering the U.S., is attempting to gain an exception for physicians, according to Arruarana, who says he spoke with a staffer there. An email from the ECFMG warned current residents who need to renew their visas not to travel outside the U.S. until the pause is ended. The ECFMG did not return Forbes' request for comment. More From Forbes
CBC
28-05-2025
- General
- CBC
Woman, 96, puts ad in newspaper to find family doctor
Dorothy Lamont, like more than 90,000 Nova Scotians, doesn't have a family physician. Having been without one for three years, she decided to take matters into her own hands. Nicola Seguin has the story.
