Profile of the cardiovascular specialist physician workforce in Canada, 2004

The Canadian Cardiovascular Society (CCS) examined the demand for cardiovascular care, the supply of specialist physicians to provide that care and physician survey data on human resource issues, including workload, wait times, satisfaction and future intentions. The CCS used data from the National Physician Survey 2004, the CCS Cardiovascular Specialist Physician Workforce Survey 2001, the Canadian Medical Association's Physician Resource Evaluation Template and procedural volumes from the Canadian Institute for Health Information to analyze key human resource planning issues for cardiologists and cardiac surgeons. There are indications in the 2004 survey data that the average workload continues to be very heavy, with an average workweek of between 55 h (cardiologists) and 64 h (cardiac surgeons), and an additional on-call responsibility of between 106 h (cardiologists) and 196 h (cardiac surgeons) per month, of which 38 h (cardiologists) to 45 h (cardiac surgeons) are spent with patients. As a result, many patients are waiting too long for nonurgent referrals. In addition to the toll that this heavy workload exacts from the current workforce and the long wait times for nonurgent referrals, the workload may also compromise the profession's ability to attract physicians into cardiovascular care. Medical graduates, particularly female graduates, tend to consider workload flexibility and predictability when choosing a specialty area. Supply projections already show a decline in the number of cardiovascular specialists per 100,000 elderly population over the next 15 years. If cardiology and cardiac surgery are perceived by female medical graduates (which now make up over 50% of all graduates) as unattractive areas of specialization, the profession may have difficulty attracting needed new entrants in the future. The CCS Workforce Project Team endorses and supports the 2003 Canadian Medical Association's recommendation for the federal government to establish an independent institute for health human resources to foster and conduct research on the supply, mix, distribution and sustainability of Canada's health workforce. The CCS should also renew its commitment to invest in related activities to improve access to cardiovascular care. The CCS Workforce Project Team also believes that the profession's ability to recruit and retain new medical graduates will depend on how well it addresses the identified quality of work life issues.