We need a national licensing system for Canadian doctors

Open this photo in gallery:

The Eastern Premiers have agreed that there will be a single medical license needed for physicians to work in the four Atlantic provinces. The Atlantic Physician Register will be in place as of May 1.

Ontario, in new legislation, has promised that health workers licensed anywhere in the country will be able to work in that province without first completing all the onerous paperwork.

These are great initiatives. But why exactly are they happening in a piecemeal fashion?

Why can’t the 13 provincial and territorial premiers agree to implement pan-Canadian licensure of physicians and other health care professionals?

Virtually every large medical organization in the country, including the Canadian Medical Association, Resident Doctors of Canada and the Canadian Federation of Medical Students, has been pushing for a single license. Many of the provincial regulatory bodies have welcomed the change.

It is not clear who, if anyone, opposes streamlining the process for physicians who want to move around the country to work.

Becoming a doctor in Canada requires you to graduate from medical school. Graduates then receive a Licentiate of the Medical Council of Canada, followed by a certificate from a professional college, such as the College of Family Physicians of Canada.

Finally, doctors must be licensed within their province, for example by the College of Physicians and Surgeons of Ontario. This process requires a lot of documentation and costs $1,725, a fee that is paid annually.

All that is fine. The licensing of physicians should be thorough and rigorous.

The problem is that if a physician wants to practise in another province or territory, even for a short period or to fill in for a colleague during vacations, they have to register with the provincial regulator.

The paperwork for doing so is onerous, and the process can take months. You need copies of your diploma, a review of your qualifications, a police check and more. And you have to pay an additional provincial fee.

This makes no sense, especially if a doctor is making a short trek across the border, say from Nova Scotia to New Brunswick, or from Alberta to Saskatchewan.

Those who are harmed the most by this red tape are patients, especially in rural and remote parts of the country.

If a physician goes on holiday, or on maternity leave, a replacement is required. Those short-term contracts are known as locums, and they are usually filled by young doctors.

In fact, it’s a good way for physicians, especially family physicians, to pay off debt and to shop around for permanent work.

But it’s hard to move around the country if, each time you want to check out a new province, you have to do months of paperwork and spend thousands of dollars.

Newfoundland and Labrador Premier Andrew Furey (who is also an orthopedic trauma surgeon) spoke eloquently about this issue at a recent meeting of the Council of Atlantic Premiers, saying the process is unnecessarily onerous and costly.

The solution was also remarkably simple. The four provincial licensing bodies have agreed to create a single registry and any physician can opt in if they want to practise in another Atlantic province outside their home jurisdiction.

The Eastern Premiers, to their credit, recognized that tackling the health human resources challenges that exist today requires more collaboration, not more barriers.

It is a myth that a single medical licence would lead to the poaching of physicians from rural and remote areas.

First of all, only a small percentage of the 93,998 doctors who have a licence in Canada will move around the country, but they play an invaluable role.

Mobility can also be a great recruitment tool. The best way to attract physicians to small communities is to give them a taste of local life during a locum, a point well illustrated in the delightful 2003 Québecois movie La grande séduction (Seducing Doctor Lewis).

Nova Scotia Premier Tim Houston called the Atlantic Physician Register “the first step in a bigger discussion that needs to happen.”

Ontario Premier Doug Ford, in announcing his province’s “As of Right” rules, which will allow health workers to move more easily to the province, also said it was “a first step toward a pan-Canadian portable registration model.”

But enough with the baby steps, already. Let’s get on with the pan-Canadian licensure of all health professionals, without delay.

How are we ever going to implement the reforms needed to bolster Canada’s crumbling health system if we can’t even do the simple, non-controversial stuff?

Editor’s note: An earlier version of this article stated incorrectly that locums usually filled by medical residents as well as young doctors. This version has been corrected.