RN, or PN -- not everyone can do, not everyone should do, not everyone would do.
IF you are not the person, do not do.
回复
南山秀才
2007-03-11 00:02
举报
0
Does Canada have too many doctors?
The question of how many doctors are available to the system is vital to determining
whether the effects of the various systems for remunerating them are being accounted
for. It is possible that countries with a salary system have simply compensated with very
large numbers of doctors in order to mitigate the problems associated with reduced
output from salary payments. It is also possible that countries with appropriate incentives
for physicians have regulated the supply of physicians to an extent that has diminished
the positive aspects of increased quantity that would result from this system of
payment. Further, increased numbers of doctors have been strongly and significantly
associated with lower mortality over the last 25 years (Or, 2001).
There are some health policy analysts who deny that the Canadian system is
experiencing a shortage of physicians and point to the increase in doctors per capita
since the introduction of taxpayer-funded health care as proof. Indeed, the number
of doctors in Canada has risen from one for every 950 Canadians in the 1960s to
one for every 550 in 1999 (Rachlis et al., 2001; Barlow, 2002). However, the fact that
the number of doctors per capita in Canada has risen does not, in itself, prove that
Canada has no shortage of doctors. There must also be some accounting for the
increased demand for medical services on the part of patients, which is not possible
in Canada where no marketplace for physicians’ services exists. What is possible is
a comparison of Canada’s experience with that of other OECD countries where consumers
of health are able to determine, through parallel private systems or market
mechanisms in the public system, what the growth in the number of physicians per
capita should be.
Since many of these countries have a larger proportion of the population over
the age of 65 than does Canada, it is likely best to compare the number of physicians
after some adjustment for the age of the population. Like health expenditures, where
the elderly consume far more resources than other proportions of the population,
medical professionals are likely to be needed at a higher rate as the population ages.
Since there are no documented studies quantifying the increased use of physicians as
the population ages, it seems most logical to apply the same proportional increase in
spending used above to the adjustment of physicians (from box 2 above, this means
that (ρ + 1) is now multiplied by the number of physicians instead of the health expenditures),
since increased use of physicians is likely to rise roughly proportionally to
increased use of all health services. Unadjusted ratios of physicians to population are
given in appendix B.
In 2003, Canada ranked twenty-fourth out of 28 OECD countries in a comparison
of age-adjusted doctor-to-population ratios . That year, Canada had 66,583
doctors (OECD, 2006). In order to rank with equally developed countries, Canadawould have needed a significantly larger number of doctors. For example, in order for
Canada’s 2003 ranking to equal that of first-ranked Iceland, the number of doctors
would have had to be higher by approximately 57,071—an 86% increase.
Although the number of doctors per capita has increased over time, it is important
to consider the rate of growth of doctors (age-adjusted) in other countries. In 1970,
Canada had an age-adjusted ratio of 1.8 doctors per 1,000 people, the second-highest
ratio among 20 OECD countries for which data were then available. Since 1970, however,
all but one of these countries have bettered Canada’s growth in doctors per capita.
While the age-adjusted proportion of doctors in Canada grew by 31% over the period,
the average increase in the proportion of doctors in the other 19 countries was 149%.
In the 33 years between 1970 and 2003, Canada’s doctors-per-capita rank fell from
second of 20 countries to twenty-fourth of 28 countries. This is particularly remarkable
given that in 2003, Canada’s age-adjusted health spending as a percent of GDP was
higher than all other developed nations with universal access health care programs
save Iceland. Comparatively, the health care sector should have enough resources to
provide for many more doctors than we now have. The long and growing waiting lists
suggest that we could certainly employ more physicians to our advantage.
Answer: Canada has too few doctors by comparison with other similar countries, and ranks
twenty-fourth in this respect in the OECD.
The fact that there are more doctors per capita in Canada now than in the past is not a
decisive argument against claims of doctor shortages. Every OECD country has more
doctors now than in 1970. What is clear is that Canada has a relative shortage of doctors
compared to other, equally developed, OECD countries and, in fact, compared to
many less developed countries. It is also clear that the ratio of doctors to population
is, comparatively, much lower than it was 30 years ago when the current medicare
system was launched.
(source: Fraser Institute Digital Publication
December 2006)
How Good is Canadian Health Care? 2006 Report:
An International Comparison of Health Care Systems
Publication Date: December 2006
Publication Format: Digital Publications
see here:
http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id=877
I have the same situation with you.The same background .The hardest time is the first one or two months,after that you will be better and better!Trust yourself.Good luck!
学习护士专业，我相信这是正确的选择