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Almost all doctors in Canada support moving to pan-Canadian licensing: survey

Almost all doctors in Canada support changes to medical licensing that would make it easier for health workers to see patients anywhere in the country, according to a new survey.

The Canadian Medical Association online survey of more than 5,000 working and retired physicians and medical learners found 95 per cent would like to see a pan-Canadian licensing program adopted in Canada. The survey was conducted between Nov. 18 and 30, 2022.

A significant majority of respondents agreed that streamlining credentialing of doctors so that only one medical licence is needed to practise medicine anywhere in Canada would improve access to health care in rural and remote communities and would allow for greater use of temporary replacements for physicians, such as locums.

It would also make Canada more attractive for internationally trained medical graduates who may relocate to Canada to practise medicine, the survey found.

With Canada’s health-care system experiencing considerable strain due to a nationwide shortage of health workers, it’s never been more important to find ways to attract more physicians to Canada and make it easier for all doctors to go to where patients need them most, says Dr. Alika Lafontaine, president of the Canadian Medical Association.

“We know we have a challenge with numbers (of health workers). We also know that we have a challenge with distribution,” Lafontaine said in an interview with Global News Monday.

“Pan-Canadian licensure is a direct way of freeing up worker mobility.”

Currently, physicians are required to have individual medical licences in each province or territory in which they practise.

This means they can’t easily travel to another province to help a colleague or provide care for patients in need without obtaining a licence in that province or territory — a process that can be complicated, time-consuming and costly.

As part of its survey, the CMA asked physicians to identify some of the biggest obstacles they face when considering practising in another province or territory.

More than three-quarters cited the complexity of the licence application process and 68 per cent said the length of time to obtain a licence from a jurisdiction outside their home provinces was a major barrier.

Expensive fees associated with these licences were also cited as an obstacle by almost two-thirds of respondents.

Lafontaine said he believes there is momentum for moving to a more streamlined system, pointing to recently proposed changes in Ontario that would allow health-care workers registered in other provinces and territories to immediately start working in Ontario.

The Atlantic provinces have also expressed interest in adopting a regional health-care licensing regime.

Many physicians may consider working somewhere new if it were easier to do so, especially if there is significant patient need or if they were asked by a fellow physician or hospital for help, Lafontaine said.

“For myself, I mean, I live two-and-a-half hours away from Fort St. John (B.C.) and I’d cross the border to help out in the OR (operating room) if pan-Canadian licensure became a thing between Alberta and B.C.,” said Lafontaine, an anesthesiologist in Grande Prairie, Alta.

“I don’t because it takes a lot of effort and resources personally in order to get registered for that licence.”

Adopting a countrywide approach to licensing physicians would be complex, Lafontaine acknowledged, and would involve changing 13 regulatory regimes to be uniform across the country.

But many studies and recommendations have been pointing for decades to the need for better cross-jurisdictional movement of health workers, including the Romanow Commission on the Future of Health Care in 2002, he said.

If provincial and territorial leaders make adopting pan-Canadian licensure a priority, it would go a long way in moving it closer to becoming a reality, Lafontaine added.

“The status quo structure of health systems is not working for anyone right now. Patients are not getting access, providers are not thriving in those environments,” he said.

“If we want to make major change in the system, we’re going to have to change the ways that we structure things. Pan-Canadian licensure is a big part of that.”