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http://umanitoba.ca/outreach/evidencenetwork/archives/4956
However, the 1990s saw a perception of widespread physician shortages though only a handful of provinces had declines in the per capita number of physicians (Ontario, BC, Alberta, PEI and Nova Scotia), and by 2010 these declines have turned into marked increases in most of these provinces. Moreover, after a short pause, health-care spending still continued to mount, driven also by drugs, diagnostic technology and public-health initiatives. The recent increase in physician numbers more than makes up for the small decline of the 1990s but is being accompanied by expenditure increases. While physician spending is an important cost driver, the drivers of public health-care spending are also a complex interaction between physician decision-making, new diagnostic and drug technologies, population growth and aging, and the cost and deployment of other health human resources used in treatment. Indeed, a positive correlation between physician numbers and health spending is not automatic. In other words, a high per capita number of physicians is not always associated with high per capita health spending. Quebec, for example spends the lowest amount per capita on public health care spending and yet has one of the highest number of physicians per capita. Manitoba, on the other hand has the second highest per capita public health spending in the country but is one of the lowest in terms of physicians per capita. Two lessons emerge from this. First, public health-care spending is complex and care needs to be taken that costcontrol approaches to health-system sustainability use a balanced approach rather than setting simplistic goals that target only one aspect of the health care system. Although physicians are a health cost-driver, they are not alone but operate as part of a system that also drives costs. Second, the federal government needs to coordinate information sharing and exchange amongst the provinces so that they can learn from each other on a best practice basis how to balance any increases in physician numbers and access to services with measures to keep health spending costs under control. Livio Di Matteo is professor of economics at Lakehead University. He is also an expert advisor to EvidenceNetwork.ca.