Canada’s Health Care Providers About the Canadian Institute for Health Information Since 1994, the Canadian Institute for Health Information (CIHI), a national, independent, not-for-profit organization, has been working to improve the health of Canadians and the health system by providing quality, reliable health information. The Institute's mandate, as established by Canada's health ministers, is to develop and maintain an integrated approach to health information in the country. To this end, CIHI provides information to advance Canada's health policies, improve the health of the population, strengthen our health care system, and assist leaders in our health sector to make informed decisions. As of September 2001, the following individuals serve on CIHI's Board of Directors: • Mr. Michael Decter (Chair), • Mr. Terry Kaufman, Director General, Lawrence Decter Investment CLSC Notre-Dame de Grâce Counsel Inc. • Dr. Cameron Mustard, Scientific • Mr. Tom Closson (Vice-Chair), Director, Institute for Work and President and CEO, University Health Health Network • Dr. Brian Postl, CEO, Winnipeg • Mr. Richard Alvarez (Ex-officio), Regional Health Authority President and CEO, CIHI • Mr. Rick Roger, CEO, • Mr. Daniel Burns, Deputy Minister, Capital Health Region Ontario Ministry of Health and • Dr. Tom Ward, Deputy Minister, Long-Term Care Nova Scotia Department of Health • Dr. Ivan Fellegi, Chief Statistician of • Ms. Sheila Weatherill, President and Canada, Statistics Canada CEO, Capital Health Authority • Mr. Rory Francis, Deputy Minister, • Ms. Kathleen Weil, Chair of the Prince Edward Island Ministry of Board of Directors, Régie régionale Health and Social Services de la santé et des services sociaux • Mr. Ian Green, Deputy Minister, de Montréal-Centre Health Canada • Dr. Michael Guerriere, Chairman and CEO, HealthLink Clinical Data Network Inc. iii Contents About The Canadian Institute For Health Information . iii Acknowledgements . vii Highlights . ix Introduction . 1 About This Report . 2 For More Information . 3 Part A: The Health Care Team Chapter 1: Who's Who in Health Care . 9 Nursing . 9 Physicians . 10 Other Health Professions . 10 Caring for Ourselves . 11 The Other Members of the Team . 12 For More Information . 14 Chapter 2: Becoming a Health Care Provider . 17 Part One: Learning to Provide Care . 17 Tomorrow's Health Care Providers . 18 Types of Graduates . 19 Demographic Shifts . 20 Where Students Train Matters . 21 Paying for Health Care Education . 21 Location of Programs . 22 Part Two: Beyond Schooling . 23 Regulating Health Professions . 23 Understanding Regulation . 24 Setting Professional Standards . 25 Moving Within Canada . 25 Moving to Canada from Abroad . 25 Part Three: Life-Long Learning . 26 Information Gaps . 27 For More Information . 29 Chapter 3: Planning for the Future: The Supply of Health Care Providers . 33 The A-B-Cs of Modeling . 35 The Challenge of Planning: Some Examples . 37 The Health of Canadians . 37 Health Care in Canada . 38 The Geographic Distribution of Providers . 39 An Aging Workforce . 39 The Sex Divide in Health Care . 40 Full-Time, Part-Time and Casual Work . 41 Migration and Immigration . 42 Crossing the Border . 43 Information Gaps . 46 For More Information . 47 Part B: Working in Health Care Chapter 4: Teamwork in Health Care . 53 What is a Health Care Team? . 53 Forming Health Care Teams in Canada . 54 Members of the Team: Who Does What in Health Care? . 54 The Current Skill Mix . 58 Making Working Together Work . 60 Primary Health Care: Are Teams the Future? . 61 Inside Doctors' Offices . 61 Experiences with Teams of Providers . 61 Information Gaps . 63 For More Information . 64 Chapter 5: Working in Health Care . 69 Changing Jobs in Health Care . 69 The Work Day for Health Professionals . 71 Focus on Physicians . 71 Paying Those Providing Care . 73 How Doctors are Paid . 73 Salaries for Health Professionals . 75 Job Satisfaction in Health Care . 76 What Nurses Think . 76 What Physicians Think . 77 In More Detail . 78 Information Gaps . 79 For More Information . 81 Chapter 6: The Health of Health Care Workers . 85 How Healthy Are Health Care Workers? . 86 Injury and Illness at Work . 87 Musculoskeletal Injuries . 88 Stress and Burnout in Health Care . 90 Hazards in the Work Place . ..