Pan-Canadian medical licensing ‘more likely than ever’

The Yukon paediatrician who just finished a year-long term as Canadian Medical Association president says licensing changes that could help the North are becoming “inevitable.”

Speaking at a northern medicine conference in Yellowknife, Dr Katharine Smart said the time was coming for provincial and territorial licensing to give way to a national model.

At the moment, most healthcare professionals such as surgeons, doctors and nurses must be licensed by a regulatory authority dedicated to the province or territory in which they are working.

That requirement can be onerous for both the worker and the healthcare system. A licence takes time and often money to acquire, potentially introducing a delay that’s at best frustrating and at worst life-threatening when isolated communities urgently need help.

Dr Smart gave the example of a family physician who had to spend $5,000 and wait six months to receive the necessary licence to work for one week on Newfoundland and Labrador’s Fogo Island.

With the NWT feeling the effects of a Canada-wide healthcare staffing crunch, Smart said the removal of licensing barriers – and introduction of a single, Canadian licensing system – would allow southern professionals to more easily assist northern communities.

“We’re getting closer to the idea of a pan-Canadian medical licence, and we’re not only advocating it for physicians but also for other healthcare professionals,” said Smart in a Saturday speech at the Peer North conference.

“This is something that can be quite impactful, particularly for those of us who work in rural and remote areas. We know how challenging it can be to get locums in, with all the paperwork and administrative burden and barriers.

“It’s very challenging to have the workforce mobility that we need to meet the shifting dynamics of what we require across the country. I think eliminating that can be very helpful and, I think, a key part of retaining physicians in rural and remote communities, because if you don’t know that you can easily get some support or help when you need it, it’s challenging to want to commit to a position full-time.”

Ottawa can ‘show leadership’

The idea of relaxing territorial licensing requirements has in the past prompted concern.

When the territorial government developed legislation that allowed southern professionals to more easily offer virtual care in the North, the NWT Medical Association worried about how to implement such a move in a way that protected the “quality and cultural safety of patient care.”

Any Canada-wide system would be expected to address such issues

In a question-and-answer session on Saturday, Smart – succeeded as CMA leader last month by Dr Alika Lafontaine, the group’s first Indigenous president – said a national licensing model was “more likely now than it’s ever been.”

A pilot program involving a regional licence is taking place in Atlantic Canada, she told delegates at the Chateau Nova Hotel.

Smart suggested a national system would represent a win for the federal government, which she said occupied a “strange position where they’re a major funder of the system but they don’t have a lot of say in the delivery of healthcare.”

“This is an opportunity for them to show some leadership and facilitate something that would be impactful,” said Smart.

“We have to have some flexibility between these lines across our country. It doesn’t really make sense that, if I’m in the Yukon and there’s somebody that can help my patient in Calgary virtually… like, why can’t they do that?

“I don’t think it’s going to come tomorrow but I think … there is a lot more political will. It’s kind-of going down that pathway of becoming inevitable, and the people that are in the way are going to have to start getting out of the way.”

‘A chance to show our strength’

The Peer North conference – Peer stands for patients, experience, evidence and research – is new.

The conference ran from Thursday to Saturday, incorporating a medicine walk along Yellowknife’s Frame Lake Trail and a Friday night social event at The Garden.

In a press release, the NWT Medical Association said Peer North provided a “culturally relevant forum for connecting and strengthening relationships among northern healthcare providers.”

“This is a wonderful opportunity to share medical knowledge, but it is also a chance to show the strength of our medical community and share what it is we love about practising in the North,” stated the NWTMA’s Dr Katherine Breen, who helped to plan the conference.

Topics addressed at Peer North included virtual healthcare, diabetes, alcohol and frostbite. Speakers came from the three territories, northern Alberta and British Columbia.

A second conference is planned for Yellowknife next year, with the possibility of taking the conference to other northern venues like Whitehorse in the years ahead.