Chartbook | August 2016

The following slides are provided to reuse in your own presentations The following slides are provided to reuse in your own presentations. Please cite as follows: Canadian Institute for Health Information. Physicians in Canada, 2015: Chartbook. Ottawa, ON: CIHI; 2016. Additional resources The following companion products are available on CIHI’s website: Summary report Infographic Methodological notes Data tables Public summary Talk to us For data-specific information: physicians@cihi.ca For media inquiries: media@cihi.ca cihi.ca

Physician supply Title page

In 2015, physician supply grew by 2.9% over the previous year © Canadian Institute for Health Information, 2016. In 2015, there were 82,198 physicians — this number was the highest ever recorded. Over the past few years, the number of physicians has increased annually at rates similar to those reported in the 1980s. In 2015, there were 82,198 physicians in Canada, representing an increase of 2.9% over the previous year. Looking back, Canada has sustained yearly physician increases of more than 2% since 2007, with increases of more than 4% in 2009 and 2011. These increases are reminiscent of the 1980s, which also saw large yearly increases (ranging from 2.3% to 4.6%). Source Scott’s Medical Database, 2015, Canadian Institute for Health Information.

The number of physicians per 100,000 population reached a record level of 228 in 2015 In 2015, there were 228 physicians per 100,000 population, which represents the highest physician-to-population ratio ever recorded in Canada. In 2007, the number of physicians per 100,000 population (193) surpassed the previous record of 191 physicians (recorded in 1993). Since 2007, the number of physicians per 100,000 population has increased yearly, reaching 228 in 2015. Over the past 5 years (2011 to 2015), the number of physicians increased at a considerably faster rate than the population, resulting in more physicians per population than ever before. © Canadian Institute for Health Information, 2016. Source Scott’s Medical Database, 2015, Canadian Institute for Health Information.

The number of physicians per population has increased in all provinces since 2011 Across all provinces, except Newfoundland and Labrador and New Brunswick, the physician-per-population ratio in 2015 was the highest ever recorded. Provinces with the highest ratios included Nova Scotia, Newfoundland and Labrador and Quebec (261, 243 and 242 physicians per 100,000 population, respectively). © Canadian Institute for Health Information, 2016. Source Scott’s Medical Database, 2015, Canadian Institute for Health Information.

In 2015, nearly 40% of physicians in Canada were women Women represent a growing proportion of the workforce. In 2015, nearly 40% of Canada’s physicians were women (39.9%), compared with 36.5% in 2011. The percentage of female physicians increased in all provinces. In 2015, Quebec, New Brunswick and Ontario had the highest proportions of women in their physician workforces (47.2%, 38.3% and 38.3%, respectively), while P.E.I., Manitoba and Saskatchewan reported the lowest percentages of women in their physician workforces (31.9%, 34.6% and 34.6%, respectively). © Canadian Institute for Health Information, 2016. Source Scott’s Medical Database, 2015, Canadian Institute for Health Information.

Women represented a larger proportion of family medicine physicians than specialists in 2015 Women represent a larger proportion of family medicine physicians than specialists. Across all provinces, women represented a larger proportion of family medicine physicians than specialists. In Canada in 2015, women accounted for 44.6% of family medicine physicians and 35.1% of specialists. © Canadian Institute for Health Information, 2016. Source Scott’s Medical Database, 2015, Canadian Institute for Health Information.

The average physician age has declined slightly over the last 5 years The average age of physicians has declined slightly over the past 5 years (50.5 in 2011 and 50.0 in 2015). In 2015, the average age of physicians ranged from 47.8 to 52.5 across all provinces. Physicians in Alberta and Newfoundland and Labrador were the youngest (average age of 47.8 and 48.8, respectively), while physicians in P.E.I. and Nova Scotia were the oldest (average age of 52.5 and 51.1, respectively). © Canadian Institute for Health Information, 2016. Source Scott’s Medical Database, 2015, Canadian Institute for Health Information.

One-quarter of physicians received their MD degree outside of Canada in 2015 Approximately one-quarter (25.6%) of Canada’s physicians received their MD degree outside of Canada. The percentage of Canadian physicians trained internationally has increased slightly in recent years, from 24.9% in 2011 to 25.6% in 2015. Saskatchewan, Newfoundland and Labrador and Manitoba had the largest proportions of internationally trained physicians among their physician workforces (52.5%, 36.3% and 34.3%, respectively), while Quebec and P.E.I. had the smallest (9.9% and 17.9%, respectively). © Canadian Institute for Health Information, 2016. Source Scott’s Medical Database, 2015, Canadian Institute for Health Information.

Physician payments Title page

Total gross clinical payments to physicians increased by 3 Total gross clinical payments to physicians increased by 3.7% to reach $25 billion in 2014–2015 Gross clinical payments to physicians reached $25 billion in 2014–2015, an increase of 3.7% over the previous year. © Canadian Institute for Health Information, 2016. Source National Physician Database, 2014, Canadian Institute for Health Information.

Alternative payments as a proportion of total gross clinical payments have stabilized Historically, physicians have been remunerated for clinical services primarily through fee- for-service systems. Over time, there has been a shift toward alternative payment plans in place of fee-for-service payments. However, this trend appears to have stabilized: between 2008 and 2014, fee-for-service payments remained between 71% and 73% of total clinical payments. In 1999–2000, alternative payments totalled $1.0 billion and made up 10.6% of total gross clinical payments. By 2014–2015, alternative payments had reached almost $7.1 billion, which accounted for more than one-quarter (28.4%) of all clinical payments. © Canadian Institute for Health Information, 2016. Source National Physician Database, 2014, Canadian Institute for Health Information.

The average gross clinical payment per physician remained virtually unchanged in 2014–2015 In 2014–2015, the average gross clinical payment per physician was approximately $339,000, virtually unchanged from the year before. The average gross clinical payment per physician ranged from $258,000 in Nova Scotia to $366,000 in Alberta. Notes: Due to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certain smaller jurisdictions relative to larger ones, in an attempt to improve comparability, CIHI has agreed to calculate the average payment per physician using only permanent in-province physicians in P.E.I. and physicians whose total gross payments are at least $60,000 in Yukon. Data for Newfoundland and Labrador is not finalized and should be considered preliminary. © Canadian Institute for Health Information, 2016. Source National Physician Database, 2014, Canadian Institute for Health Information.

Over the last 5 years, average gross clinical payments have increased by 8% Over the last 5 years, average gross payments to physicians have increased 8.2% (from $313,000 to $339,000). Notes: Due to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certain smaller jurisdictions relative to larger ones, in an attempt to improve comparability, CIHI has agreed to calculate the average payment per physician using only permanent in-province physicians in P.E.I. and physicians whose total gross payments are at least $60,000 in Yukon (2010–2011 not reported). Nova Scotia’s 2010–2011 average payment was not available. Data for Newfoundland and Labrador is not finalized and should be considered preliminary. © Canadian Institute for Health Information, 2016. Source National Physician Database, 2014, Canadian Institute for Health Information.

Average gross clinical payments varied by physician specialty in 2014–2015 This year, CIHI combined fee-for-service data with detailed alternative payment data and, for the first time, is able to report comprehensive average payments per physician by specialty. The average gross clinical payment to family medicine physicians in Canada was just more than $271,000, while medical specialists’ average gross payment per physician was $338,000 and surgical specialists’ average payment was $446,000. Ophthalmologists grossed the highest average payment at $669,000 and psychiatrists grossed the lowest average payment at $259,000 per physician. Note: Selected jurisdictions do not include Saskatchewan and Alberta. © Canadian Institute for Health Information, 2016. Source National Physician Database, 2014, Canadian Institute for Health Information.

Average gross clinical payments varied by broad physician specialty and province/territory The average gross clinical payment to a Canadian physician was $339,000 in 2014–2015; however, this value varied based on the physicians’ specialty and location of practice. The average gross clinical payment to family medicine physicians in Canada was just more than $271,000, while medical specialists’ average gross payment per physician was $338,000 and surgical specialists’ average payment was $446,000. Note: Data for Newfoundland and Labrador is not finalized and should be considered preliminary. © Canadian Institute for Health Information, 2016. Note n/a: Not available. Source National Physician Database, 2014, Canadian Institute for Health Information.

In 2014–2015, the majority of services and payments paid through fee for service were for consultations and visits The majority of services and payments in 2014–2015 were for consultations and visits. Of the $25 billion in gross clinical payments, total fee-for-service payments accounted for 72%. The type of services provided by physicians under the fee-for-service model can be divided into 2 broad types: consultations/visits and procedures. Consultations and visits accounted for 73% of services and 66% of payments to physicians, while procedures accounted for 27% of services and 34% of payments (excluding reciprocal billing, imaging and laboratory services, anesthesia services and anesthesiology specialists, and unclassified physicians). © Canadian Institute for Health Information, 2016. Source National Physician Database, 2014, Canadian Institute for Health Information.

The 2014–2015 average cost per service was $62.23 The average cost per service paid to physicians in 2014–2015 was $62.23. Although family medicine physicians perform the greatest number of services and receive the largest proportion of payments, medical and surgical specialists are paid more per service on average. However, services may not always be comparable, as the amount of work required differs depending on the type of service. Family physicians billed an average cost per service of $45.61, while medical and surgical specialists received an average of $79.81 and $87.26 per service, respectively. © Canadian Institute for Health Information, 2016. Source National Physician Database, 2014, Canadian Institute for Health Information.