Montreal, April 22, 2009 – Quebec could reduce waiting lists for medical specialists and maximize their supply of available hours if they were allowed to work both in the public sector and in the private sector, and this would add the equivalent of 790 full-time medical specialists on weekdays.
In an Economic Note published by the Montreal Economic Institute (MEI), economist Julie Frappier, one of the authors of this survey on mixed medical practice, states that “more than half (51%) of medical specialists are willing to work four hours a week in the private sector, even though 68% of them would favour the government imposing a minimum of 35 hours of work per week in the public sector before they could provide hours in the private sector.”
Marcel Boyer, MEI vice president and chief economist, concludes that “Quebec has the resources to increase access to health care. As long as the opening to greater private sector participation – while preserving the government’s role in insurance – continues to be blocked, the waste of resources will continue.”
Doctors willing to work more
The results of the survey of medical specialists shows that, in addition to being interested in working in the private sector in the daytime on weekdays, 38.6% and 30.4% of them, respectively, are willing to provide an average of nearly four hours on weekday evenings and weekends. This would amount to adding 740 full-time specialists on weekday evenings and 1,924 on weekends. Allowing medical specialists to work both in the public and private sectors would thus largely help fill the shortage of specialists.
Under-use of resources
Last June, the MEI noted in a survey that 54% of nurses are willing to work on weekdays in the private sector in addition to their normal workweek in the public sector. In December 2007, another MEI survey revealed that operating rooms in Quebec hospitals are used at 50% of their capacity on weekdays.
Many measures will be needed to correct the shortage of medical specialists. However, the provincial health care systems still operate largely within the framework of the Canada Health Act, which runs counter to reforms that could improve access and alleviate pressure on taxpayers.
Canada lags behind most other OECD countries in access to medical specialists. Many European countries, such as France, Germany and Sweden, have mixed health systems, with private health care providers able to make a major contribution to public health, increase the efficiency of the system and reduce waiting lists quite considerably.
Methodology of the survey
The sample that was examined consists of 581 medical specialists. The survey used two forms: a comprehensive questionnaire posted on the Web and a shorter questionnaire emphasizing the parameters of reserve time supply. The latter questionnaire was sent to doctors through medical specialists’ associations which agreed to send the questionnaire to their members by e-mail.
The presidents of the associations affiliated with the Federation of Medical Specialists of Quebec (FMSQ) were approached to solicit their members’ participation. Following a review of literature on the subject, 19 interviews were conducted with various presidents of these associations to validate the contextual framework of health care and the study’s hypotheses. The questionnaire was approved by five doctors before the study was launched so as to ensure its pertinence. Quebec medical specialists were then asked to fill out the questionnaire on a voluntary basis.
The Economic Note titled Medical specialists in Quebec: How to unlock the reserve supply, was prepared by Marcel Boyer, vice president and chief economist of the MEI, and Julie Frappier, health economist and holder of a master’s degree in economics from the University of Montreal.
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The Montreal Economic Institute is an independent, non-partisan, not-for-profit research and education organization. Through studies and speeches, the MEI contributes to debate on public policy in Quebec and across Canada, suggesting reforms for wealth creation based on market mechanisms.
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