1. Chartbook | September 2017
Physicians in Canada, 2016

2. The following slides are provided for reuse in your own presentations.
Please cite as follows: Canadian Institute for Health Information. Physicians in Canada, 2016: Chartbook. Ottawa, ON: CIHI; 2017.
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3. Physician supply

4. In 2016, physician supply grew by 2.3% over the previous year
In 2016, there were 84,063 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 2016, there were 84,063 physicians in Canada, representing an increase of 2.3% 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 These increases are reminiscent of the 1980s, which also saw large yearly increases (ranging from 2.3% to 4.6%).
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Canada has sustained yearly physician number increases of more than 2% since These increases are reminiscent of those experienced during the 1980s.
© Canadian Institute for Health Information, 2017.
Source Scott’s Medical Database, 2016, Canadian Institute for Health Information.

5. The number of physicians per 100,000 population reached a record level of 230 in 2016
In 2016, there were 230 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 230 in 2016.
Over the past 5 years (2012 to 2016), the number of physicians increased at a considerably faster rate than the population, resulting in more physicians per population than ever before.
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In 1980, there were 151 physicians per 100,000 population in Canada. The number of physicians per 100,000 population initially peaked in 1993 with 191 physicians. A relative plateau occurred between 1993 and In 2007, a new record of 193 physicians per 100,000 population was recorded. Since 2007, the number of physicians per 100,000 population has increased yearly, reaching 230 in 2016.
© Canadian Institute for Health Information, 2017.
Source Scott’s Medical Database, 2016, Canadian Institute for Health Information.

6. The number of physicians per population has increased in all jurisdictions* since 2012
Across all jurisdictions, except Nova Scotia and Yukon, the physician-per-population ratio in 2016 was the highest ever recorded. Jurisdictions with the highest ratios included Nova Scotia, Newfoundland and Labrador, Quebec, B.C. and Alberta (258, 248, 243, 242 and 241 physicians per 100,000 population, respectively).
The Northwest Territories and Nunavut were excluded from this analysis due to their small physician-to-population ratios.
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Between 2012 and 2016, the number of physicians per population increased in all jurisdictions (the Northwest Territories and Nunavut excluded). In Canada in 2016, there were 230 physicians per 100,000 population, compared with 215 physicians per 100,000 population in 2012.
The breakdown by province is as follows:
Newfoundland and Labrador, 234 in 2012 and 248 in 2016
P.E.I., 183 in 2012 and 187 in 2016
Nova Scotia, 251 in 2012 and 258 in 2016
New Brunswick, 221 in 2012 and 229 in 2016
Quebec, 234 in 2012 and 243 in 2016
Ontario, 203 in 2012 and 220 in 2016
Manitoba, 196 in 2012 and 207 in 2016
Saskatchewan, 179 in 2012 and 197 in 2016
Alberta, 217 in 2012 and 241 in 2016
B.C., 224 in 2012 and 242 in 2016
Yukon, 185 in 2012 and 207 in 2016
© Canadian Institute for Health Information, 2017.
Source Scott’s Medical Database, 2016, Canadian Institute for Health Information.

7. In 2016, 40.6% of physicians in Canada were women
Women represent a growing proportion of the workforce.
In 2016, 40.6% of Canada’s physicians were women, compared with 37.4% in The percentage of female physicians increased in all provinces.
In 2016, Yukon, Quebec and New Brunswick had the highest proportions of women in their physician workforces overall (48.7%, 48.1% and 39.4%, respectively), while P.E.I., Saskatchewan and Manitoba reported the lowest percentages of women in their physician workforces (30.6%, 34.7% and 35.5%, respectively).
The Northwest Territories and Nunavut were excluded from this analysis due to small numbers.
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Women represented a growing proportion of the workforce. In 2016, 40.6% of Canada’s physicians were women, compared with 37.4% in The percentage of female physicians increased in all jurisdictions (the Northwest Territories and Nunavut excluded).
The breakdown by province is as follows:
Newfoundland and Labrador, 34.2% in 2012 and 37.3% in 2016
P.E.I., 29.0% in 2012 and 30.6% in 2016
Nova Scotia, 35.8% in 2012 and 38.6% in 2016
New Brunswick, 36.0% in 2012 and 39.4% in 2016
Quebec, 43.6% in 2012 and 48.1% in 2016
Ontario, 36.1% in 2012 and 39.0% in 2016
Manitoba, 32.2% in 2012 and 35.5% in 2016
Saskatchewan, 32.5% in 2012 and 34.7% in 2016
Alberta, 35.4% in 2012 and 38.1% in 2016
B.C., 34.6% in 2012 and 37.8% in 2016
Yukon, 49.3% in 2012 and 48.7% in 2016
© Canadian Institute for Health Information, 2017.
Source Scott’s Medical Database, 2016, Canadian Institute for Health Information.

8. Women represented a larger proportion of family medicine physicians than specialists in 2016
Women represent a larger proportion of family medicine physicians than specialists.
Across all jurisdictions, women represented a larger proportion of family medicine physicians than of specialists.
In Canada in 2016, women accounted for 45.3% of family medicine physicians and 35.9% of specialists.
The Northwest Territories and Nunavut were excluded from this analysis due to small numbers.
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Women represented a larger proportion of family medicine physicians than of specialists across all provinces. In 2016, women accounted for 45.3% of family medicine physicians and 35.9% of specialists in Canada.
The breakdown by province is as follows:
Newfoundland and Labrador, 39.1% family medicine and 35.4% specialists
P.E.I., 35.8% family medicine and 24.4% specialists
Nova Scotia, 43.9% family medicine and 33.4% specialists
New Brunswick, 46.6% family medicine and 30.5% specialists
Quebec, 54.5% family medicine and 42.0% specialists
Ontario, 43.7% family medicine and 34.4% specialists
Manitoba, 38.2% family medicine and 32.5% specialists
Saskatchewan, 38.3% family medicine and 30.5% specialists
Alberta, 41.9% family medicine and 34.0% specialists
B.C., 41.5% family medicine and 33.4% specialists
Yukon, 50.0% family medicine and 40.0% specialists
© Canadian Institute for Health Information, 2017.
Source Scott’s Medical Database, 2016, Canadian Institute for Health Information.

9. 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 (50.4 in and 49.8 in 2016).
In 2016, the average age of physicians ranged from 46.7 to 52.0 across all jurisdictions. Physicians in Yukon, Alberta and Saskatchewan were the youngest (average age of 46.7, 47.8 and 48.0, respectively), while physicians in P.E.I. and Nova Scotia were the oldest (average age of 52.0 and 51.2, respectively).
The Northwest Territories and Nunavut were excluded from this analysis due to small numbers.
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The average age of physicians has declined slightly over the past 5 years in Canada; it was 50.4 in 2012 and 49.8 in In 2016, the average age of physicians ranged from 46.7 to 52.0 across all jurisdictions.
The breakdown by jurisdiction is as follows:
Newfoundland and Labrador, 48.2 in 2012 and 48.8 in 2016
P.E.I., 52.1 in 2012 and 52.0 in 2016
Nova Scotia, 50.9 in 2012 and 51.2 in 2016
New Brunswick, 49.0 in 2012 and 49.3 in 2016
Quebec, 50.1 in 2012 and 49.4 in 2016
Ontario, 51.3 in 2012 and 50.7 in 2016
Manitoba, 50.5 in 2012 and 49.8 in 2016
Saskatchewan, 49.1 in 2012 and 48.0 in 2016
Alberta, 48.4 in 2012 and 47.8 in 2016
B.C., 50.7 in 2012 and 49.8 in 2016
Yukon, 49.8 in 2012 and 46.7 in 2016
© Canadian Institute for Health Information, 2017.
Source Scott’s Medical Database, 2016, Canadian Institute for Health Information.

10. One-quarter of physicians received their MD degree outside of Canada
Approximately one-quarter (25.9%) 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 25.2% in 2012 to 25.9% in 2016.
Saskatchewan, Newfoundland and Labrador and Alberta had the largest proportions of internationally trained physicians in their physician workforces (52.5%, 36.6% and 34.2%, respectively), while Quebec and P.E.I. had the smallest (9.7% and 16.9%, respectively).
The Northwest Territories and Nunavut were excluded from this analysis due to small numbers.
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Approximately one-quarter (25.9%) 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 25.2% in 2012 to 25.9% in 2016.
The breakdown by province is as follows:
Newfoundland and Labrador, 38.5% in 2012 and 36.6% in 2016
P.E.I., 20.1% in 2012 and 16.9% in 2016
Nova Scotia, 31.0% in 2012 and 30.8% in 2016
New Brunswick, 26.2% in 2012 and 24.7% in 2016
Quebec, 10.8% in 2012 and 9.7% in 2016
Ontario, 27.2% in 2012 and 29.0% in 2016
Manitoba, 35.7% in 2012 and 33.8% in 2016
Saskatchewan, 53.0% in 2012 and 52.5% in 2016
Alberta, 32.3% in 2012 and 34.2% in 2016
B.C., 29.5% in 2012 and 29.5% in 2016
Yukon, 32.8% in 2012 and 19.5% in 2016
© Canadian Institute for Health Information, 2017.
Source Scott’s Medical Database, 2016, Canadian Institute for Health Information.

11. Physician payments

12. Alternative payments as a proportion of total 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 2015, fee-for-service payments remained between 70% and 73% of total clinical payments.
In 1999–2000, alternative payments made up 10.6% of total gross clinical payments. In 2015–2016, alternative payments accounted for 27.9% of all clinical payments.
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Over time, there has been a shift toward alternative payment plans in place of fee-for-service payments. This trend appears to have stabilized between 2008 and 2015, with fee-for-service payments remaining between 70% and 73% of total clinical payments. In 2015–2016, fee-for-service payments made up 72.1% of total clinical payments, while alternative payments made up 27.9%.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

13. Most physicians receive compensation through multiple payment models
Most physicians receive compensation through multiple models, which could include both fee-for-service and alternative payments.
While the proportion of clinical payments has maintained close to a 70/30 split between fee-for-service and alternative payments over the last several years, in 2015–2016, 97% of all physicians received some payments through fee for service and more than two-thirds of all physicians (69%) received some payment through alternative payment plans.
With the exception of Nova Scotia and Saskatchewan, more than 88% of physicians in each jurisdiction are paid through fee for service.
The proportion of physicians receiving payments through alternative plans varies greatly for all jurisdictions, ranging from as high as 93% in Nova Scotia to only 16% in Alberta.
Data for Newfoundland and Labrador is not finalized and should be considered preliminary.
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Many physicians receive compensation through multiple models, which could include both fee-for-service and alternative payments. While the proportion of clinical payments has maintained close to a 70/30 split between fee-for-service and alternative payments over the last several years, in 2015–2016, almost all physicians (97%) received some payments through fee-for-service and more than two-thirds of all physicians (69%) received some payment through alternative payment plans.
Note that the number of physicians in Saskatchewan and Alberta may include radiology and laboratory specialists.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

14. Younger physicians and female physicians were more likely to receive payments through alternative payment plans
Younger physicians and female physicians were more likely to receive the majority of their payments through alternative payment plans, compared with their older and male colleagues across the country.
29% of female physicians and 23% of male physicians received more than half of their total clinical payments through alternate payment plans.
Physicians age 60 and older are more likely to be paid through fee for service (79%).
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Note that Saskatchewan, Alberta, the Northwest Territories and Nunavut are not included.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

15. Physician specialty was a strong indicator of payment model
Overall, family medicine physicians are more likely to be paid through alternative payment plans than medical specialists and surgical specialists.
In Canada, 35% of family physicians, 17% of medical specialists and 8% of surgical specialists received more than half of their total clinical payments through alternate payment plans.
When looking at physicians who did not receive their payments predominantly through a single method, there was a considerable difference between family medicine and surgical specialists.
Almost half of all family medicine physicians (48%) received a mixture of both fee-for-service and alternative payments, and approximately one-third of surgical specialists (31%) received the same.
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In Canada, 35% of family physicians, 17% of medical specialists and 8% of surgical specialists received more than half of their total clinical payments through alternative payment plans.
Note that Saskatchewan, Alberta, the Northwest Territories and Nunavut are not included.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

16. Total gross clinical payments to physicians increased by 3
Total gross clinical payments to physicians increased by 3.4% to reach $25.7 billion in 2015–2016
Gross clinical payments to physicians reached $25.7 billion in 2015–2016, an increase of 3.4% over the previous year.
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Gross clinical payments to physicians reached $25.7 billion in 2015–2016, an increase of 3.4% over the previous year. Fee-for-service payments reached $18.5 billion that year.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

17. The average gross clinical payment per physician increased 0
The average gross clinical payment per physician increased 0.8% from the previous year
In 2015–2016, the average gross clinical payment per physician was $339,000, a 0.8% increase from the previous year.
The average gross clinical payment per physician ranged from $262,000 in Nova Scotia to $380,000 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.
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In 2015–2016, the average gross clinical payment per physician was approximately $339,000, an increase of 0.8% from the year before. The average gross clinical payment per physician ranged from $262,000 in Nova Scotia to $380,000 in Alberta.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

18. Over the last 5 years, average gross clinical payments have increased by 3.4%
Over the last 5 years, average gross payments to physicians have increased 3.4%, from $327,000 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 (2011–2012 not reported). Nova Scotia’s 2011–2012 average payment was not available.
Data for Newfoundland and Labrador is not finalized and should be considered preliminary.
Data is not available for the Northwest Territories or Nunavut
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Over the past 5 years, average gross payments to physicians have increased 3.4% (from $327,000 to $339,000).
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

19. Average gross clinical payments varied by physician specialty in 2015–2016
By combining fee-for-service data with physician-level alternative payment data, CIHI is able to report comprehensive average payments per physician by speciality.
Ophthalmologists grossed the highest average payment at $714,000 and psychiatrists grossed the lowest average payment at $266,000 per physician.
Note: Selected jurisdictions do not include Saskatchewan, Alberta, the Northwest Territories and Nunavut.
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The average gross clinical payment to family medicine physicians in Canada was just more than $275,000, while medical specialists’ average gross payment per physician was $347,000 and surgical specialists’ average payment was $461,000. Ophthalmologists grossed the highest average payment, at $714,000, and psychiatrists grossed the lowest, at $266,000 per physician.
The average gross clinical payment for all physicians in Canada was $339,000. The breakdown for the other reported physician specialties is as follows:
Cardiology, $578,000
Thoracic/cardiovascular surgery, $569,000
Neurosurgery, $520,000
Gastroenterology, $515,000
Urology, $457,000
General surgery, $435,000
Otolaryngology, $424,000
Obstetrics/gynecology, $398,000
Anesthesia, $415,000
Orthopedic surgery, $398,000
Internal medicine, $389,000
Dermatology, $378,000
Plastic surgery, $346,000
Neurology, $304,000
Pediatrics, $294,000
Physical medicine, $274,000
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

20. Average gross clinical payments varied by broad physician specialty and by province/territory
The average gross clinical payment to a Canadian physician was $339,000 in 2015–2016; 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 $275,000, while medical specialists’ average gross payment per physician was $347,000 and surgical specialists’ average payment was $461,000.
Data for Newfoundland and Labrador is not finalized and should be considered preliminary.
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The average gross clinical payment to a Canadian physician was $339,000 in 2015–2016. The Canadian breakdowns were $275,000 for family medicine, $347,000 for medical specialists and $461,000 for surgical specialists.
The breakdown by jurisdiction is as follows:
Newfoundland and Labrador, $213,000 for family medicine, $324,000 for medical specialists, $399,000 for surgical specialists and $276,000 for total physicians
P.E.I., $312,000 for family medicine, $414,000 for medical specialists, $518,000 for surgical specialists and $367,000 for total physicians
Nova Scotia, $220,000 for family medicine, $269,000 for medical specialists, $373,000 for surgical specialists and $262,000 for total physicians
New Brunswick, $252,000 for family medicine, $311,000 for medical specialists, $370,000 for surgical specialists and $290,000 for total physicians
Quebec, $255,000 for family medicine, $381,000 for medical specialists, $456,000 for surgical specialists and $325,000 for total physicians
Ontario, $311,000 for family medicine, $331,000 for medical specialists, $456,000 for surgical specialists and $348,000 for total physicians
Manitoba, $296,000 for family medicine, $364,000 for medical specialists, $486,000 for surgical specialists and $344,000 for total physicians
Saskatchewan, $354,000 for total physicians (data is not available by specialty)
Alberta, $380,000 for total physicians (data is not available by specialty)
B.C., $219,000 for family medicine, $325,000 for medical specialists, $467,000 for surgical specialists and $285,000 for total physicians
Yukon, $274,000 for family medicine, $314,000 for medical specialists and $290,000 for total physicians (data is not available for surgical specialists)
Data is not available for the Northwest Territories or Nunavut.
© Canadian Institute for Health Information, 2017.
Note
n/a: Not available.
Source National Physician Database, 2015, Canadian Institute for Health Information.

21. In 2015–2016, the majority of services and payments paid through fee for service were for consultations and visits
The majority of services and payments in 2015–2016 were for consultations and visits.
Of the $25.7 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 72% of services and 66% of payments to physicians, while procedures accounted for 28% of services and 34% of payments (excluding reciprocal billing, imaging and laboratory services, anesthesia services and anesthesiology specialists, and unclassified physicians).
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Of the $25.7 billion in gross clinical payments, total fee-for-service payments accounted for 72% while alternative payments accounted for 28%. Under the fee-for-service model, consultations and visits accounted for 72% of services and 66% of payments to physicians, while procedures accounted for 28% of services and 34% of payments. Physicians provided 270 million services under the fee-for-service model and received $17.3 billion in fee-for-service payments.
Data is not available for the Northwest Territories or Nunavut.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.

22. The 2015–2016 average cost per service was $64.05
The average cost per service paid to physicians in 2015–2016 was $64.05.
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 $46.96, while medical and surgical specialists received an average of $82.03 and $89.02 per service, respectively.
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The average cost per service paid to physicians in 2015–2016 was $ Family physicians billed an average cost per service of $46.96, while medical and surgical specialists received an average of $82.03 and $89.02 per service, respectively.
Data is not available for the Northwest Territories or Nunavut.
© Canadian Institute for Health Information, 2017.
Source National Physician Database, 2015, Canadian Institute for Health Information.