Physician Resource Plan and Physician Employment

Transcription

1 Physician Resource Plan and Physician Employment A Nova Scotia Approach November 2015

2 Nova Scotia s Communities Challenges Timely access to family doctors Long waits for some specialty services Recruitment and retention issues High rates of chronic disease Ensuring quality and safety Physician Services $720+ million

3 Health System Consolidation From nine District Health Authorities To Nova Scotia Health Authority and IWK Health Center Four Management Zones Acknowledge regional roles in Atlantic Canada Continue population based planning for 950,000 aging Nova Scotians

4 Geographic Population Framework for Planning

5 Physician Resource Planning Partners Dalhousie Faculty of Medicine College of Physicians and Surgeons of NS Recruitment Working Group New MD Appointments Data Working Group Physician Resource Plan Advisory Committee Doctors Nova Scotia Medical Education Working Group PHC/ Physician Services / Health System Workforce Working Group NSHA IWK Planning for Clinical Services Alternate Funding Plan Secretariat Dept of Health and Wellness

6 Consultants Report and Recommendations Environmental Scan and Final Report Change mix and distribution over time Strategic recruitment and retention Change geographic distribution for population need Planning and coordination of services Expand collaborative team-based care Influence supply Training and education National dialogue Identify role for International Medical Graduates (IMGs)

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8 FMEC Postgraduate Project December 14, 2011 Recommendation 1 1. Ensure the Right Mix, Distribution and Number of Physicians to meet Societal Needs Working collaboratively, physicians must address the diverse health and wellness needs of individuals and communities throughout Canada. The Postgraduate Medical Education (PGME) system must continuously adjust its training programs to produce the right mix, distribution and number of generalist and specialist physicians, including clinician scientists, educators, and leaders to serve and be accountable to the Canadian population.

9 The goal of physician resource planning is to ensure the right number, mix and distribution of physicians to meet Nova Scotia's health care needs.

10 Physician Resource Planning Process I The Physician Resource Plannig Model provides a 10 year forecast of needs by discipline Approx 80% of future need driven by retirements and other workforce factors Population aging, although no population growth, contributes about 10% to projected need Policy issue and benchmarks contribute about 10% largely from impact on family medicine by team based care model

11 Forecasting Model Schematic Population Need-Based

12 Physician Resource Planning Process II DHW works with partners To shape post graduate CaRMS entry numbers to match forecast needs Developed Collaborative Primary Care Framework and Teams Began provincial approach to specialty services with orthopedic strategy Implemented Deputy Minister s new MD approval process Initiated Recruitment and Retention Working Group and then Recruitment Action Team Participation in National PRP Task Force & other national meetings All working towards an agreed 10 year plan

13 Physician Resource Planning Process III Recognizes that PG output is into mobile national labour market Goal is to contribute to that pool a number equivalent to forecast needs Training length makes PG capacity an ongoing strategy, not one that can meet short immediate needs Retention and recruitment from the national pool is key to engaging the right number, mix and distribution to meet Nova Scotia needs

14 Principles for CaRMS Recommendations I Total number and mix of postgraduate positions should be structured to meet Nova Scotian communities needs within the Pan-Canadian context

15 Principles for CaRMS Recommendations Maintain sufficient resident positions to permit flexibility Consider other issues and impacts Residency positions would not be maintained primarily for resident service provision Promote generalism while recognizing the need for balance with subspecialization. Encourage distributive learning models Maintain national competitiveness

16 Medical Education Principles for allocation of CaRMS Entry positions Used Forecast to shape 2014 to 2016 CaRMS match & provided information to medical students Established new family medicine community training sites in Annapolis Valley and Southwest Health Multi year quota model for medical and pediatric subspecialty PG positions match Information presentations to medical students

17 Moving From 10 Year Forecast to Current Situation Streamline MD database and real-time access to physician resource planning model Adapt primary care assumptions in consultant s report Move toward equity in distribution Ensure a provincial approach to provincial services with NSHA and IWK Ensure sustainability and include fiscal considerations Consider succession planning and mentoring

18 Physician Resource Planning The goal of physician resource planning is to ensure the right number, mix and geographic distribution of physicians to meet Nova Scotia's health care needs.

19 Questions and Discussion

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