Report finds Atlantic doctor registry has had little impact on access to care

A new report looking into the effectiveness of the Atlantic Physician Register since its launch two years ago says it has not substantially improved access to health care in the region.

The registry was designed to make it easier for doctors to work across the four Atlantic provinces by allowing them to practise anywhere in the region without additional licensing requirements.

Doctors can opt into the registry at an annual fee of $500, which gives them more freedom to cross provincial borders to work.

However, the report — requested by the Federation of Medical Regulatory Authorities of Canada (FMRAC) and conducted by researchers at Laurentian University — found that only about 417 of the more than 5,500 physicians who were eligible signed up.

On Prince Edward Island, just 36 doctors participated.

The report described this level of uptake as "modest."

Impact on physician mobility

Dr. George Carruthers, registrar for the College of Physicians and Surgeons of P.E.I., acknowledged that the registry did achieve co-operation among the region's medical colleges by streamlining licensing processes and building trust.

However, he said that when it comes to physician mobility within Atlantic Canada, the region is a closed system.

"There's only X number of physicians in the Maritimes, in Atlantic Canada, and so moving them around — if you're working in Charlottetown, you decide to go to Amherst, then you're not working in Charlottetown," said Carruthers, who's also president of FMRAC.

"It proved the point of co-operation and trust and understanding, simplifying process, reducing fees, but from a mobility point of view, and extra care, [it] probably didn't show as much as some people had hoped."

P.E.I. has about 500 licensed doctors, and about 20 off-Island physicians obtained licenses through the registry to practise here. Carruthers said he's not aware what those 20 people specifically do — ER shifts, specialty work or virtual care.

"If you're a patient who is receiving care from somebody, it's significant. But I don't think it was the numbers that we wanted to see, you know, in terms of bigger numbers," he said.

In total, 35 doctors from outside P.E.I. practised in the province during the time studied by the researchers, though some had already been working locum shifts before the registry was introduced, he added.

Administrative barriers remain

The report also found that while the registry simplified the licensing process, it did not eliminate other administrative hurdles for doctors moving to a new province.

Some of the physicians said they withdrew from the process after learning it merely streamlined licensing, calling it "false advertising."

Carruthers said that beyond licensing, doctors still need to go through a number of steps.

"Through the health authority, through Health P.E.I., they have to get privileged, credentialed, they have to get their Medicare numbers, their billing numbers, they have to get their positions. So there's many layers," he said.

Additionally, the report shows that many physicians invited to participate in the survey were unaware the registry even existed, despite promotional efforts by medical colleges, medical societies and provincial governments.

Improvements proposed

The report makes a number of recommendations, such as reducing administrative and cost burdens for doctors seeking to work in multiple provinces, as well as creating a centralized hub for information about the registry.

"We've got work to do, and we're not going to scrap it, but I think we just grow on it," Carruthers said.

In a statement, the P.E.I. Department of Health and Wellness acknowledged that while the Atlantic registry is a step toward streamlining physician licensing, further improvements are necessary.

We're a fixed number, whether it be the Atlantic provinces or nationally. So we just need other options to bring more health-care providers into the system.— Dr. George Carruthers

"We are actively engaged in discussions about potential options for other professions regarding interprovincial licensure and registries," the statement reads.

"We are grateful to our medical regulatory bodies for their ongoing efforts and expertise, and we will continue to work closely with them to ensure the Atlantic Registry evolves to meet the needs of both physicians and patients."

Carruthers said while there may be interest in a national approach to multi-jurisdictional licensing, improving access to health care requires more than just streamlining mobility.

"We're a fixed number, whether it be the Atlantic provinces or nationally. So we just need other options to bring more health-care providers into the system."