CMA calls for national review of physician supply, demand
The findings follow numerous warnings and reports of illegal activity linked to Health Canada’s Marijuana Medical Access Regulations initiative. The department has announced a complete reworking of the medical marijuana system in part due to concerns about the risk of criminal exploitation. Under the existing program, to be phased out by April 1, 2014, individuals are issued licences to grow marijuana for their personal use to help ease the symptoms of their medical conditions. More than 30,000 people across the country are authorized to use the drug for medical purposes. The Mounties have long advised that the illegal marijuana trade is a multibillion-dollar industry in Canada. The RCMP report cites case studies that reveal criminal tactics for abusing the federal program, including: Producing marijuana in excess of the quantity allowed under a Health Canada permit in one instance almost 80 kilograms annually, with a street value of more than $650,000; Circumventing federal safeguards by having a family member without a criminal conviction, such as a spouse, obtain a licence; Efforts by organized criminal groups to gain access to a licence through a complex web of associates. “Criminal groups are currently exploiting Health Canada’s MMAR program,” says the report, adding “at least one high-level criminal organization identified as a national level threat is proactively seeking opportunities to exploit future MMAR guidelines currently being developed by Health Canada.” In 2010, the RCMP said a review concluded that 70 licence holders were violating the terms of their agreements. In 40 of the cases, holders were trafficking marijuana. Last month, CBC-TV aired an interview with a man from Nelson, B.C., identified only as Jack, who said he made about $120,000 a year selling the marijuana he cultivated using his medical licence. Under Health Canada’s new medical marijuana program, individuals will no longer apply for licences to grow plants at home. Instead, licensed producers will cultivate marijuana for distribution to individuals whose health-care providers agree it is an appropriate treatment. The government says the licensed producers will be subject to extensive security and quality-control requirements. Those include security clearances for key personnel, alarm systems at growing facilities to detect intruders, and compliance and enforcement measures, Health Minister Leona Aglukkaq said in an opinion piece published Wednesday by the Globe and Mail newspaper. In addition, dried marijuana will be shipped through a secure delivery service directly to the address the client specifies, Aglukkaq said.
The 2013 study is in keeping with earlier studies indicating difficulty in matching training with need. A Royal College of Physicians and Surgeons survey of doctors that it certified in 2011 indicated 14% had not found a position within 4 to 12 weeks of writing their exams. The 2012 National Physician Survey of Residents also indicated more than two-thirds of those surveyed (67%) felt stressed about finding employment at the end of their training. Although doctors at the Calgary meeting generally supported the need to review supply and demand planning, some did so because they questioned whether the anecdotes of under-employment or unemployment are accurate or reflect the reluctance of some graduates to move to more remote underserviced areas. The data on this is somewhat ambiguous, said a delegate from Vancouver, British Columbia. It may not be as bad in unemployment or under-employment as Dr. Pasternaks report suggests. But Pasternak, who suggests a job-matching program and mentorship initiatives may help residents take over a retiring doctors practice, says many of the residents he has spoken to are prepared to move. They just dont have an understanding of where those needs are, he said. Some employment problems exist because hospitals or health regions dont have the necessary resources to hire new graduates, several doctors said. Much of the under-employment doctors identify also relates to difficulty some have in accessing infrastructure, such as the problems that some surgeons have booking operating rooms, the CMA suggested in background documents. The continued existence of long wait times for consultations and procedures suggests that lack of demand is not the key factor that is resulting in underemployment, the CMAs background document states. Psychiatrists are among specialists in short supply across the country, as Dr.