Canada's family doctor shortage remains a pressing concern for the public and politicians alike. With nearly six million Canadians lacking a family physician and waiting times growing, the crisis is widely acknowledged. Common solutions include expanding medical schools and recruiting international doctors. However, a less discussed factor is the decline in average work hours among family physicians over the past three decades.
Fewer Patients Seen Annually
Health researchers Lindsay Hedden from Simon Fraser University and David Rudoler from the University of Toronto have documented that family physicians in Canada are now seeing between 515 and 1,736 fewer patients per year compared to the late 1990s, depending on the province. This reduction in patient volume contributes significantly to the perceived shortage.
Physician Numbers vs. Hours Worked
UBC professor Paul Kershaw highlights a paradox: while Canada's population has grown by 75% since 1976, the number of physicians has increased by nearly 200%. Yet, total physician hours have not kept pace. Kershaw notes that doctors today work fewer weekly and annual hours than in the 1970s, driven by expectations for better work-life balance and a rising share of physicians in dual-earner households.
Changing Demographics and Work Patterns
The demographic shift in the medical profession is notable. Currently, 54% of physicians under 40 are women, compared to about 15% four decades ago. Researchers refer to this as 'workplace feminization,' but the trend reflects broader lifestyle choices among both female and male doctors. Many now prioritize balanced lifestyles, including time with family, and seek to avoid burnout that was common in previous generations.
Two generations ago, family physicians often operated under a 'cradle-to-grave' model, providing office, hospital, and emergency care, and were available on weekends and for house calls. In 1990, male physicians worked an average of 55 hours per week; today, that figure has dropped to just under 48 hours.
Implications for Policy
Addressing the doctor shortage requires acknowledging these work-hour trends. Simply increasing the number of physicians may not suffice if individual work hours continue to decline. Policies that support efficient practice models, reduce administrative burdens, and promote sustainable work schedules could help maximize the capacity of the existing workforce.
