The COVID-19 pandemic exposed deep, systemic challenges in Canada’s healthcare system. From overwhelmed emergency departments to widespread burnout among healthcare workers, the crisis laid bare vulnerabilities that had long been building. The situation may have quieted, but the cracks are still showing – especially for the millions without access to a family doctor.
Amid ongoing strain, Canada’s healthcare professionals are not backing down. Leaders across the sector are reimagining a more sustainable, people-centered, and integrated system — efforts that were front and centre at Impact Live: Under the scope – Canada’s healthcare workforce crisis. Moderated by Ivey Professor Lauren Cipriano, Canada Research Chair in Healthcare Analytics, Management, and Policy, the panel featured Carol Young-Ritchie (Interim VP of HR, St. Joseph’s Health Care London), Wael M R Haddara (Interim Chair, Department of Medicine, Schulich School of Medicine, London Health Sciences Centre, and St. Joseph’s Health Centre), and Maria Mathews (Professor, Department of Family Medicine, Schulich School of Medicine and Dentistry).
From their conversation, three critical areas emerged – each vital to address in building a more resilient and responsive healthcare system in Canada.
The future is team-based care
Expanding nurse practitioners' capacity to treat primary care patients is one of the leading solutions proposed by industry experts to address the lack of physicians in Canada. While this suggestion is in line with larger shifts that could increase patient access to services, a challenge remains. There are simply not enough nurses to offset the deficit alone.
But as the saying goes, it takes a village.
“We need to rethink when and where we need a family physician,” explains Mathews, who emphasized the fact that many needs of a generally healthy person can be met by a registered nurse.
To optimize time and resources, a team-based model of care is ideal. The hospital system has already seen success in this approach based on improved operational efficiency over the past 20 years – and transitioning to this structure in family care is a promising solution.
In team-based care, working connectedly as an organized network of specialized practitioners enables each player to provide services to their full scope of practice. The result? Increased patient care capacity.
Healthcare providers “recognize that no [single] profession holds the key to a patient’s wellness journey,” said Haddara. “There is a relatively high degree of decentralization in the best teams in hospital care. Professionals make their own assessment as to whether they need to be involved.”
Effectively implementing this model in primary care will require investments in innovative technologies - particularly a successfully integrated patient record system to coordinate communication between hospitals, primary physicians, subspecialists, and the patient.
“When we have team-based care, we see better patient outcomes, better satisfaction, and better cost-effectiveness,” said Mathews.
Rethinking workplace retention
To tackle the depletion of human health resources, Cipriano posed a classic ‘chicken-or-egg’ question to the panel: Which matters more: recruitment or retention?
“It’s about retention first,” Young-Ritchie said. “When we lose somebody in the first year, there’s a cost to that.”
While this strategy is key, there are several societal factors complicating effective retention approaches: a pandemic that pushed workers out of the healthcare sector, industry workplace violence, a new generation prioritizing work-life balance, and women having more career options in medicine.
Because of these compounding influences, Haddara emphasized that short-lived financial incentives are not going to cut it as a means to break through this institutional struggle.
Instead, the three panelists advocated for desirable workplace culture as an effective retention strategy. Young-Ritchie raised necessary questions decision-makers should be prioritizing: “How are we creating workplaces that people want to belong to? And how do they see themselves as contributing to the larger goal of the organization?”
Is Canada’s healthcare system selling out?
Restructuring the current system is not solely in the hands of public policymakers – private equity within the Canadian healthcare system has been evolving in response to inaccessibility.
The panel acknowledged that private investment has always had a presence in Canadian healthcare. But an emerging issue has to do with for-profit players motivating practitioners’ objectives.
Clinic membership fees and upselling treatments are two notable concerns Mathews raised. The Schulich professor explained how these two trends threaten positive patient-practitioner relations and add economic barriers to improving accessible healthcare.
“Even if we move to some forms of private healthcare delivery, we have to be very careful not to simply replicate the mistakes and pitfalls that others have seen,” said Haddara, referring to the example of the United States’ privatized and disparate system.
More concerning is the growing number of nurses leaving public institutions for agency work. Incentives for higher wages and greater flexibility are attracting employees and diminishing commitment to organizations, making non-agency positions harder to fill.
If Canada’s healthcare system is to compete with private entities for necessary human health resources, critical solutions must address the vital needs of the sector’s workforce: flexibility, valued purpose, and strength in teams.
To discover more solution-based insights about resuscitating Canadian healthcare, tune into Impact Live: Under the scope – Canada’s healthcare workforce crisis on Ivey Impact or Ivey’s YouTube channel.
