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Advocacy & Health Policy / Défense des intérêts et politiques en santé (continued from page 39)
• There are 1322 full-time orthopaedic surgeons employed across Canada. • 148 of 1322 full-time orthopaedic surgeons are women (11.2%). Interestingly, COA Active membership is comprised of 15% women. • 110 full-time orthopaedic surgeons are over the age of 65. • 81 orthopaedic surgeons currently have operating privileges but only work part-time hours (<70% of a “normal” orthopaedic practice; excludes locums) • In Quebec, locum positions are exceptional, with one or two per year, and usually for less than a year. In all other provinces, the percentage of hospitals which allow locum work ranges from 15% in Saskatchewan to 81% in British Columbia. • In 2016, 69 full-time orthopaedic surgeons were hired across Canada, which is arguably a positive result, as it is greater than the number of residency positions currently offered annually (54 in 2017). • In the next five years, 175 orthopaedic surgeons are expected to be hired across Canada. • In the next five years, if more resources were available in an ideal scenario, 287 orthopaedic surgeons would be hired in order to serve the population. • 24 orthopaedic surgeons will retire in the next year. • 147 orthopaedic surgeons will retire in the next 5 years. • Job sharing examples currently exist in British Columbia, Ontario, and Manitoba. Complete data will be available via the COA web site in July 2018. Government Advocacy and Promoting Access to Care: Arguably the most significant way that the COA can make a difference is by advocating for improved access to MSK care, which not only improves patient care and satisfaction, but ultimately leads to a more efficient system and further job creation. The COA believes that hospital-based resources should be allocated more effectively to better serve Canadian patients. Board members continue to advocate accordingly at various levels of government and the COA has partnered with provincial orthopaedic associations to promote various advocacy initiatives. The COA strongly supports growing provincial initiatives such as the Ontario MSK Strategy as a means for improved access to MSK care. Over the last two years, the COA Access to Care Steering Committee enlisted member support in developing an inventory of dozens of local and provincial innovations which have improved access to timely and appropriate MSK care. Important themes were brought forward such as improved surgical screening and centralized intake of referrals, use of digital innovations and improved flow of communications. We continue to build this database of models of care and share them with members through the COA Bulletin. Steering Committee members met with several federal agencies including Health Canada to promote Canadian MSK innovations and offer our members as collaborative resources to the government. We are continuing our advocacy efforts this year by further partnering with champions from the provincial orthopaedic associations, to encourage provincial Ministry collaboration on piloting improvements in access to care, drawing on models that are successful locally. This initiative will be further develCOA Bulletin ACO - Summer / Été 2018
Full-time Orthopaedic Surgeons 69 Hired in 2016 40
40
35 30 25 20 15 10 5
7
4
2
2
BC
AB
SK
MB
0
8 ON
QC
3
1
1
1
NB
NS
PEI
NL
oped at the June 2018 Board meeting, including a call for provincial champions and revision of the COA Access to Care Position Statement. Direct patient and citizen advocacy directed towards governments and health authorities will also be an important tool in the future of the COA’s advocacy platform. Education: The COA leadership encourages all members to remain aware of the impact of underemployment and to initiate steps throughout various career stages and in local settings to contribute to solutions. Inappropriate use of locums is of paramount importance. Trauma work performed by new graduates in locum positions should be linked to scheduled surgical resources. The COA strongly encourages orthopaedic surgeons to prohibit locum positions that do not allow for safe and highquality continuity of patient care, and to acknowledge the risks to new graduates that serial fellowships and chronic locum positions pose to skillset and practice readiness. For the Board’s complete list of recommendations, please refer to the Orthopaedic Graduate Unemployment Position Statement. Late Career Transition Planning and Job Sharing: The COA encourages senior members to consider job-sharing models and the addition of junior surgeons to a group practice, when moving towards retirement. Decreased surgical activities could be linked to meaningful participation in other aspects of surgical practice, including patient assessment, mentoring, assisting, teaching, research and administration. Please refer to the COA Guidelines for Late Career Transition. Reduction in residency spots: At the COA’s recommendation, orthopaedic residency positions nationwide have decreased from 81 in 2011 to 54 in 2017. Given the lengthy training process required to recruit and train orthopaedic surgeons, the COA Board must continue to monitor these changes. We recognize that the needs of the population and the training programs are not necessarily best met by reduction in resident numbers, but the unfortunate reality is that public funding for new permanent positions, as well as the hospital-based resources required to support them, are inadequate in many regions. Free Job Board for Members: The password-protected membership portal offers a Job Board, where members can post and seek available locum and full-time positions at no charge. We encourage all hospitals to maintain a transparent hiring process by widely circulating opportunities. To post a position, please email cynthia@canorth.org.