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Better doctor efficiency is the real key to better productivity

The article ‘The feminisation of Canadian medicine and its impact upon doctor productivity’ focuses attention again on the ‘issue’ of women in medicine. Particular attention should be paid to the title’s last word: ‘productivity’. The authors measure productivity by calculating the number of hours doctors spend providing direct patient care. Using this definition, several assumptions are made which result in the ultimate conclusion that doctor productivity in Canada is suboptimal because of the increasing number of female doctors. However, is productivity, as defined in this article, really the best way to measure the provision of medical care in Canada? We believe the answer is no: by assuming the one-dimensional view that number of hours worked equals productivity, the authors fail to consider the significance of quality, efficiency and effectiveness in health care delivery. The cause of Canada’s doctor shortage will not be found in its gender demographic, nor will the solution be achieved by simply increasing medical school enrolment to accommodate the difference in hours spent on patient care by men and women doctors. Rather, we need to reorganise the way in which we deliver health care on a systemic level to improve overall doctor efficiency. Interprofessional collaboration is key to providing optimal medical care, for both doctors and patients. For example, integrated family medicine practices that feature a group of doctors working together with nurse practitioners, nurses, pharmacists, social workers and other allied health professionals provide faster and more efficient and continuous care. If we are to improve patient accessibility to doctors in Canada, we need to transform the ways in which we spend our working hours, not simply the number of hours we spend working.