The push to ease interprovincial trade barriers in response to U.S. tariff threats could also bring more mobility to Canada’s health care providers, a move advocates have long called for.
On Wednesday, federal, provincial and territorial governments announced in a statement that there is agreement to move quickly to take down internal trade barriers and labour mobility.
B.C. Premier David Eby said part of that goal to eliminate barriers between the provinces is so that professionals “whether teachers, doctors, or nurses, are able to move seamlessly between provinces.”
The shortage of primary-care providers in Canada is among the central concerns for the country’s health care system, and it’s estimated that five million Canadians lack access to a family doctor or nurse practitioner. While flexibility around where health care providers can work could be a part of the solution, it’s currently expensive and burdensome for a doctor to obtain approval to practise across provincial lines.
The tariff threats from the Trump administration have “provided impetus” for Ottawa and provincial ministers to take a united approach to decrease these types of internal barriers, said Internal Trade Minister Anita Anand.
Joss Reimer, the president of the Canadian Medical Association, told The Globe and Mail that doctors would welcome this change, which they’ve long called for. “We want to be able to move around the country,” she said.
Dominik Nowak, the president of the Ontario Medical Association and a family physician at Women’s College Hospital in Toronto, echoed this sentiment. In an interview earlier this week, he said building a strong Canadian health care system involves “breaking down the barriers that exist to people practising and serving their communities all over the country.”
Dr. Nowak added that slashing restrictions would allow Ontario doctors to practise in jurisdictions where “bureaucratic barriers actually prevent people from serving communities fairly close nearby.”
As it stands now, Dr. Reimer said if a hospital in Kenora, Ont., were to theoretically need to shut down temporarily because of a staff shortage, doctors from Winnipeg – only 200 kilometres away – would not be able to immediately go in to help. In this case, a Manitoba doctor would have to apply for an annual licence from the College of Physicians and Surgeons of Ontario, which costs $1,725, or a 90-day licence for $431.25. In both cases, the paperwork and approval process acts as a barrier.
Dr. Reimer said she does not believe reducing mobility restrictions will completely solve the shortage of physicians in Canada, but it could be a step in a positive direction. Other solutions the CMA has called for include reducing the onerous amount of administrative tasks currently burdening depleted health care providers, and for the publicly-funded system to support virtual care.
The country’s health care shortage is enormous. In February, Health Canada released its findings on education, training and distribution of the Canadian health work force. The report, completed by chief medical work force adviser Geneviève Moineau, said the country needs tens of thousands of additional health care workers, including nearly 23,000 family physicians.
The CMA, a voluntary association of physicians and medical learners which advocates on national health matters, released a statement last month urging policymakers to improve health care access to Canadians by changing what it called the current “fragmented approach” and instead develop a “pan-Canadian licensure.” They also advocated for making requirements for licensing international doctors the same across provinces.
Since health care delivery in Canada falls to the purview of the provinces, medical colleges exist in different jurisdictions that regulate physicians. Dr. Reimer said this approach dates back to 1867, the year of Confederation. More than 150 years later, with individual health care providers able to move quickly between regions of the country, Dr. Reimer said greater flexibility can address gaps in health care.
In 2023, health ministers said they wanted to address the issue of physician mobility, Dr. Reimer added. “We were really optimistic at that time that we were going to see some movement,” she said.
With discussion about tariffs and reducing interprovincial trade and mobility barriers, Dr. Reimer questioned: “If not now, then when?”