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The study cohort consisted of 6,579 primary care doctors who bill on a fee for service basis (as opposed to a minority of physicians who collect salaries); 2,469 were female and 4,110 were male. Fourteen per cent of the doctors were over age 65, according to the study published in Health Affairs, a major international health policy journal.

The feminization of medicine — surging numbers of female doctors who generally work less because of family responsibilities — is one factor in the shrinking productivity phenomenon as is the fact that, just like the general population, the proportion of older doctors is growing. But while feminization and the aging physician workforce are both contributing to the decline in services per physician “neither change was as influential as the reduction of per physician activity levels over time. That’s the primary driver,” lead author Lindsay Hedden said.

Asked if medical schools should start accepting fewer females, she said that would be a terrible idea, especially since patients appear to have more favourable opinions of female physicians.

“Patient satisfaction surveys show this. Female doctors spend more time with patients, they have different practice styles,” Hedden said.

The situation is dire not only because so many people don’t have a regular family doctor but also because of the growing population; it increased by about 350,000 during the duration of the study alone. The B.C. situation is far from unique as demand for physician services all across North America is growing faster than the supply of doctors. But Hedden and her co-authors noted it’s possible the shortage of doctors will hit Canada even harder than the US because Canada has a paucity of nurse practitioners and physician assistants providing primary care services.