There’s a global crisis in health care and no one is immune

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A paramedic tends to a patient in a hallway at the Humber River Hospital in Toronto on January 25, 2022. The health care work-force crisis is grounded in two global megatrends. First, people worldwide are living longer. Second, COVID-19 decimated the already fragile health systems serving this aging population.Nathan Denette/The Canadian Press

There’s a global crisis in health care and no one is immune. Whether you live in suburban Edmonton, downtown Toronto or rural Nova Scotia, it’s challenging to find and keep a family doctor, access emergency care promptly, or get elective surgery when you want it.

This crisis won’t be fixed by simply funding more beds or with better technology. From Alberta to New Zealand, the crisis takes a very human form: There are not enough qualified health professionals to meet the world’s changing population and needs.

The health care work-force crisis is grounded in two global megatrends. First, people worldwide are living longer. The fastest-growing population in low- and middle-income countries are those older than 65 and, in high-income countries such as Canada, those over 85. This has shifted our primary focus away from communicable conditions, like malaria, to chronic diseases linked to aging – notably heart disease, cancer, and strokes.

Second, COVID-19 decimated the already fragile health systems serving this aging population. The health professional work force, at a breaking point providing care during a global pandemic, also has had to provide continuing care to the constant flow of people with existing or new diagnoses of chronic conditions. Though COVID-19 is now relenting, there is a growing mountain of delayed and unmet health care needs. Combine this with a fatigued and aging health care work force and you have the perfect storm for the current health care crisis.

To address this crisis, health care must change.

Health care needs to be more preventive and less hospital-based. Following the example of Britain 25 years ago, Canada needs to shift decisively and rapidly from providing specialists in metropolitan centres to health care based in communities, family doctors, or other primary-care settings. This care must focus more on the prevention and effective management of chronic disease progression, be more grounded in the communities where we all live and use data to better respond to our diverse communities.

Health care needs to be more team-based. Research over the past 30 years has shown that safe, effective and efficient care can be provided by many different health professional groups — notably specialist nurse practitioners, dieticians and pharmacists. These health professionals can complement our ever-scarce physicians in being the main providers of prevention, rehabilitation and specialized care for very common and costly but often poorly managed conditions such as heart failure, diabetes or heart attack.

Finally, health care needs to be driven by co-operation. Athabasca University educates more nurse practitioners than any other university in Canada, but educators need support from other key stakeholders such as government, health care providers and professional regulators to increase the rate of new professionals entering our health system. Alberta, for example, does not have a chief nursing officer, a role that’s long-established in Europe and, more recently, in Canada at the federal level and in Ontario. Such roles are needed to build smooth and quick pathways to bring qualified professionals into our health system and continue to improve health policy, planning and patient care.

Increasing co-operation to help assess and validate the credentials of internationally educated health professionals is another example. Not only do we need to educate more health professionals in Alberta and other provinces, but we also need to attract and support more international professionals to work in Canada. Protecting patients remains key. But assessing and validating international credentials quickly and when needed can ensure international health care providers receive the right additional education in weeks, not years.

This will benefit overworked health care professionals and underserved patients, and result in better access to primary care, surgery, rehab and other needed services.

The health care crisis won’t change unless we do.

Dr. Alex Clark is president of Athabasca University (AU). He is the former dean of the Faculty of Health Disciplines at AU and former associate vice-president research at the University of Alberta.

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