Munter: Come North, Desperate American Health Workers

While the business models of care delivery are very different between the two countries, the practice of medicine is not.

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Because Canadians are so familiar with the culture, people and places of the United States, it is painful for many of us to see society seem to be falling apart. It’s scary, and there’s a good conversation about how to avoid the same kind of division and polarization that now defines the United States.

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But there’s another conversation worth having related to Canada’s long tradition of welcoming Americans in times of turmoil there. United Empire loyalists fleeing the American Revolution. African Americans escaping slavery in the 19th century. And, more recently, young people who refused to participate in the Vietnam War.

It is a time of confusion again. Should we make it much easier for Americans to come to Canada, particularly in fields like health care that are experiencing a shortage of mission-critical staff?

Guns are now the leading cause of death for American children. Life expectancy is in decline. Concealed weapons are constitutionally protected, while women’s control over their bodies is not. A Supreme Court Justice has openly defended criminalize homosexuality and contraception. Even talking about gay people is prohibited in Florida schools.

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For a considerable number of Americans, all of this is deeply painful and disturbing. And a proportion of those people may be willing to consider a job in Canada.

While the business models of care delivery are very different, the practice of medicine is not. And moving to Canada can be closer to home than moving elsewhere within the US Ottawa is closer to Boston than it is to Cincinnati, Chicago or Raleigh. Denver is closer to Calgary than it is to Atlanta.

Recently at CHEO, we’ve noticed a significant uptick in interest from physicians practicing in the United States: expat Canadians who have had enough or Americans who want to get out.

Canada’s health care system is facing severe staffing shortages throughout the care process. We should welcome trained American health professionals with open arms.

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The first priority must be to keep the people we have. End-of-career incentives could delay retirements while we train new professionals. Improving working conditions, wages and new models of care could help curb attrition.

At the end of 2019, more than 40,000 jobs could not be filled in the health sector in Canada. The pandemic has made this much worse. We need to find more people; It’s as simple as that. An American healthcare professional already working in a hospital or community health setting would essentially be job-ready from day one.

Registration and credentialing processes for these professionals must be drastically simplified and expedited, including emergency and conditional licensing.

Ontario Health and the College of Nurses of Ontario recently launched a promising program to help fast-track nursing applicants who may lack language proficiency requirements and are already in the province. We should be able to adapt that for American healthcare professionals who aren’t here yet and for whom language will rarely be an issue. Canadian health care organizations should be funded to conduct large-scale marketing and recruitment campaigns in the US.

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The average American nursing salary is comparable to the average Ontario salary. There are many parts of the US where wages are much lower and benefits markedly lower. Also, swapping school shootings for snowstorms is an option many parents should consider.

But if we are looking, we need the systems in place for these people to come into the country and provide care in days or weeks, not months or years.

A long-awaited comprehensive Health Human Resources Strategy for Canada obviously cannot depend on importing expertise from other countries, but it can be one piece of the puzzle. And it’s a piece of the puzzle infused with compassion: for Americans who want a better future for themselves or their children, and for Canadians who are waiting too long for the care they need.

alex münter He is President and CEO of CHEO, the pediatric health and research center for Canada’s Capital Region.

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