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Challenges for the future of eye care in Canada
EDITORIAL
Challenges for the future of eye care in Canada
T
here are approximately 1100 ophthalmologists practising in Canada. The manpower committee of the Canadian Ophthalmological Society (COS) has recommended an ophthalmologist-to-population ratio of approximately 1:28 000. At present the Canadian average is close to this, but the ratio varies from 1:10000 in metropolitan Vancouver to 1:45000 in Prince Edward Island. Between 1990 and 2000 there was a gradual decrease in medical school places and residency training positions across Canada. As a result, the number of ophthalmology graduates has dropped from approximately 40 to 20 per year. The mean age of the practising ophthalmologist is approximately 55, and with the ageing of the "baby boomer" generation the ophthalmologist-to-population ratio will drop to 1:38000 by 2015 unless there is an increased supply of ophthalmologists. Governments and institutions have recognized this looming problem. Between 2000 and 2015 there will be increased medical school and residency training positions. However, it will take many years for this increase to be translated into an increase in the number of practising ophthalmologists. In the meantime,
Part I: Summary (December 200 I) It is clear that, under the present eye care delivery system, without a substantial increase in the number of ophthalmologists being produced by our training programs, there will be a serious shortfall between the demand for and supply of ophthalmologists' services.
Part 2: Recommendations (May 2002) A. Infrastructure/material resources Recommendation I That capital equipment, information systems, technology and operating costs be matched to patient needs for medical, surgical and diagnostic eye care.
-·. er ,~.. ,~;
the combination of budgetary cutbacks and the ~. ' ageing of the population will produce a ~ \ crisis in vision care. The COS has recommended solutions for this imminent crisis .. to the Commission on the Future of Health Care in Canada (the Romanow Commission). "~ I Following is the execuI' .... tive summary of the COS submission to the Dr. Duncan P. Anderson Romanow Commission, circulated to all COS members last year at this time; the entire submission is available on the COS Web site (www.eyesite.ca). I encourage you to read the submission. If you have new concerns or fresh ideas, speak to me at the annual meeting, in Halifax, later this month or write to me at the COS. Your input and involvement are important to us as we chart our course to meet the challenges of eye care in Canada.
·~·
".J? , ,~
Duncan P. Anderson, MD, FRCSC President Canadian Ophthalmological Society
retirement/emigration, 35 to 40 ophthalmologists per year should be produced by our training programs, considerably more than the 20 per year produced at present.
C. Eye care delivery models Recommendation 3 That multidisciplinary vision care advisory panels in each funding jurisdiction be established.
D. Funding Recommendation 4 That remuneration models that provide incentives for comprehensive patient care, teaching, research and management be developed and assessed.
B. Ophthalmology human resources Recommendation 2
Recommendation 5
That to meet the continuing comprehensive eye care needs of an ageing population and expected ophthalmologist
That the practice of instituting earning caps for ophthalmologists be reassessed in view of patient access to services.
Can J Ophthalmol 2003;38:261
Challenges for the future-Anderson
Fran<;ais it la page 263
261
Challenges for the future of eye care in Canada
T
here are approximately 1100 ophthalmologists practising in Canada. The manpower committee of the Canadian Ophthalmological Society (COS) has recommended an ophthalmologist-to-population ratio of approximately 1:28 000. At present the Canadian average is close to this, but the ratio varies from 1:10000 in metropolitan Vancouver to 1:45000 in Prince Edward Island. Between 1990 and 2000 there was a gradual decrease in medical school places and residency training positions across Canada. As a result, the number of ophthalmology graduates has dropped from approximately 40 to 20 per year. The mean age of the practising ophthalmologist is approximately 55, and with the ageing of the "baby boomer" generation the ophthalmologist-to-population ratio will drop to 1:38000 by 2015 unless there is an increased supply of ophthalmologists. Governments and institutions have recognized this looming problem. Between 2000 and 2015 there will be increased medical school and residency training positions. However, it will take many years for this increase to be translated into an increase in the number of practising ophthalmologists. In the meantime,
Part I: Summary (December 200 I) It is clear that, under the present eye care delivery system, without a substantial increase in the number of ophthalmologists being produced by our training programs, there will be a serious shortfall between the demand for and supply of ophthalmologists' services.
Part 2: Recommendations (May 2002) A. Infrastructure/material resources Recommendation I That capital equipment, information systems, technology and operating costs be matched to patient needs for medical, surgical and diagnostic eye care.
-·. er ,~.. ,~;
the combination of budgetary cutbacks and the ~. ' ageing of the population will produce a ~ \ crisis in vision care. The COS has recommended solutions for this imminent crisis .. to the Commission on the Future of Health Care in Canada (the Romanow Commission). "~ I Following is the execuI' .... tive summary of the COS submission to the Dr. Duncan P. Anderson Romanow Commission, circulated to all COS members last year at this time; the entire submission is available on the COS Web site (www.eyesite.ca). I encourage you to read the submission. If you have new concerns or fresh ideas, speak to me at the annual meeting, in Halifax, later this month or write to me at the COS. Your input and involvement are important to us as we chart our course to meet the challenges of eye care in Canada.
·~·
".J? , ,~
Duncan P. Anderson, MD, FRCSC President Canadian Ophthalmological Society
retirement/emigration, 35 to 40 ophthalmologists per year should be produced by our training programs, considerably more than the 20 per year produced at present.
C. Eye care delivery models Recommendation 3 That multidisciplinary vision care advisory panels in each funding jurisdiction be established.
D. Funding Recommendation 4 That remuneration models that provide incentives for comprehensive patient care, teaching, research and management be developed and assessed.
B. Ophthalmology human resources Recommendation 2
Recommendation 5
That to meet the continuing comprehensive eye care needs of an ageing population and expected ophthalmologist
That the practice of instituting earning caps for ophthalmologists be reassessed in view of patient access to services.
Can J Ophthalmol 2003;38:261
Challenges for the future-Anderson
Fran<;ais it la page 263
261