Winnipeg Free Press

Winnipeg Free Press (Newspaper) - April 11, 2024, Winnipeg, Manitoba THINK TANK COMMENT EDITOR: RUSSELL WANGERSKY 204-697-7269 ● RUSSELL.WANGERSKY@WINNIPEGFREEPRESS.COM A7 THURSDAY APRIL 11, 2024 Ideas, Issues, Insights Gaining more doctors requires team effort D OCTORS Manitoba commends the Manitoba government’s pledge to add 100 physicians to the province this year. This is an ambi- tious goal and would be the largest single-year increase in our province. Over the last five years, Manitoba has added an average of 60 doctors per year. The best year ever saw a net increase of 83 doctors. Last year, Manitoba added just 44. This begs the question: how could the govern- ment achieve this desperately needed, but never achieved, goal? Before I answer that question, it’s important to reflect on where we are, and how we got here. Today, Manitoba has 215 doctors per 100,000 residents, the second lowest rate in the country. It would take 445 more doctors to reach the national average and that’s a record high for our doctor shortage. It hasn’t always been this way. Twenty years ago, Manitoba had among the most doctors per capita in Canada. So what changed? Several factors have contributed to the current shortage, including population growth outpacing physician numbers, freezes on medical school training seats and chronic change and instability in the health-care system that long predated the pandemic and marginalized physician input and feedback. Fortunately, recent initiatives, such as expand- ing class sizes at the University of Manitoba and increasing medical residency spaces offer promising steps toward cultivating local talent. However, these efforts will take six to 10 years to yield results. What would help this year? The answer is focus- ing on improving both recruitment and retention. Despite an average annual influx of 213 new physicians, the loss of 153 to other provinces or retirement dampens the net increase to a mere 60 per year. Increasing the number of physicians who enter practice in Manitoba by 10 per cent while reduc- ing departures by the same margin could realize the target of adding 100 doctors this year. This goal is achievable and the answer lies in the recommendations Doctors Manitoba has offered to the government. Effective recruitment strategies must ad- dress both retaining graduating physicians and attracting qualified international candidates. Simplifying immigration and licensure processes, alongside financial support and referral programs for doctor-to-doctor recruitment, could be pivotal. The increase to the rural doctor recruitment fund in the provincial budget is a great start, but more is needed. To put it simply, the best doctor recruiters out there are other doctors. We want to see the gov- ernment support and empower them to succeed. Recruiting physicians is complicated, especially in a highly competitive environment with a global shortage. Manitoba has to punch above its weight. The only way to do this is a true “all-in” partner- ship with all the players working together, in- cluding the government, Shared Health, regional health authorities, the College of Physicians and Surgeons, the University of Manitoba and Doctors Manitoba. This work has to be done in partner- ship, with doctors at the table. It’s important to involve other players who can help too, such as local municipalities and the business community. We have to not only recruit physicians, but their families, too. This was a key recommendation coming out of the Rural Health Summit we hosted over a year ago in partnership with the Manitoba Chambers of Commerce. Once doctors arrive in Manitoba, we hope to see more of them stay. Doctors Manitoba is launching a new program to support physicians as they start their practice in Manitoba, with funding from the provincial government. Retaining doctors, however, needs a focus at all career stages. When we look at the doctors we do have in Manitoba, half plan to retire, relocate, or reduce their clinical hours in the next three years. This is a major risk to health care in our province. The top reasons for these plans are fixable: burnout, feeling undervalued or unheard, frustration with a complicated and under-resourced health system and excessive administrative burdens and paperwork. Some foundational actions are now in place that we believe are improving retention. A new physician services agreement is bringing more predictable funding and support for physician practices, making Manitoba more competitive with other provinces. The government has com- mitted to continue the focus on reducing unnec- essary paperwork. This is critical, as we know administrative burden is a top cause of burnout. The current state of siloed, disconnected re- cords means doctors are repeatedly logging in to multiple apps for each patient visit to piece togeth- er vital information. Patients don’t have access to their own chart or results. We are encouraged the budget sets aside significant funding to improve electronic records in the province, however this will only help if doctors and other providers are a partner in planning, selecting, and implementing new integrated electronic systems. All too often, in countries around the world, electronic record systems are planned by consultants without front line input, resulting in complicated systems that take doctors and nurses away from patient care. We want to ensure that doesn’t happen here. To put this all together, achieving a record increase of 100 doctors in Manitoba by this time next year demands co-ordinated efforts and proactive measures. While the goal is ambitious, solutions are within reach, and physicians stand ready to collaborate towards a healthier future for all Manitobans. Dr. Michael Boroditsky is the president of Doctors Manitoba. Critical thinking for democracy IN an era of rapidly changing technology, the ways in which we engage with media and acquire information continually evolves. Being informed about political updates is no longer limited to local radio, newspapers and television. The emergence of the internet and cellular devices have revolu- tionized how we become informed of local and global developments. There are myriad benefits to these technolog- ical advancements, including being exposed to pluralistic voices, hearing diverse and contrast- ing perspectives on contentious topics and having speedy access to new information. However, despite the benefits of digital media, there are certainly various concerns. Topical discussion regarding the proliferation of conspiracy theories, disinformation and fake news are all relevant in our 21st century society. Public distrust has only been further eroded as a former U.S. president has repeatedly proclaimed free media as “the enemy of the people.” There is evidence that our electoral processes, the heart of social democracies, are becoming increasingly interfered by adversarial, autocratic governments. Social media audiences are partic- ularly vulnerable to such concerted manipulation efforts and are perhaps at the crux of the disin- formation issue. As social media technologies have become so readily accessible and routinely utilized, we are highly vulnerable to purposeful disinformation by unregulated entities. This is particularly true for younger generations, as reports suggest that youth heavily rely upon social media platforms for their daily news and political updates. Further, the rise in artificial intelligence and understanding what impact this new technolo- gy may have in influencing our consumption of daily news, remains largely unknown. Coupling these developments with the escalating distrust in public institutions and electoral processes raises genuine alarm for the vitality of our social democracies. Now more than ever, acquiring literacy and critical thinking skills are of paramount im- portance. Ascertaining truth from fact can be a difficult task for adults and the challenge is understandably more pronounced for children and youth. Our public schools must continue to prioritze pedagogies that cultivate critical think- ing capacities among young people. The United States education department concluded in a 2017 national review that approx- imately 130 million Americans read at, or below, a sixth-grade level. While this statistic may be shocking, there are numerous articles since published sharing how low national literacy rates impact the U.S. economy by trillions of dollars annually. Literacy rates in Canada are general- ly higher, but efforts to improve literacy rates among children and youth are ongoing. High literacy proficiencies may contribute to a strong economy, but more importantly being able to read, write, and critically engage with informa- tion has countless benefits to individuals, groups and our collective society. Not only do students need to develop strong lit- eracy rates to be effective in their future employ- ment opportunities, they also deserve a quality education to enhance their humanistic growth and potential. As we learn to read, write and engage with text we also learn to tell trustworthy from unreliable. Literacy skills and critical think- ing skills are not quite synonymous, but they are strongly correlated with one another. As such, in the era of “fake news” and concert- ed efforts to disseminate disinformation, our public schools need to further prioritize pedago- gies to foster critical thinking skills among young people. Although we may be unable to prevent the proliferation of disinformation on social media, we may ameliorate these challenges through edu- cational interventions. Teachers and parents alike should encourage youth to question the credibility of their sourc- es of information, to analyze authors’ levels of education and/or experience related to the topic and to consider multiple sources before arriving at conclusions. We should respect perspectives from authority figures, those that study various fields, such as medicine, law, ecology, education and so forth. Understandably, all humans are subject to falli- bility, so we should corroborate experts’ positions with others studying the discipline. In short, the rise in disinformation is a genuine threat to the social functioning of our democ- racy. Recognizing critical thinking skills to be important may be somewhat axiomatic. However, considering the growing public distrust of the media, cultivating such skills among youth is timely. We should engage in explicit dialogue with youth over the credibility of internet and social media sources, to critically interrogate texts and to investigate the strengths and limitations of our public institutions. A critically reflective society is conducive not only to the vitality in our demo- cratic infrastructures, but also to our individual and collective humanistic growth. Jordan Laidlaw is a public school teacher and a Ph.D. candidate in educational administration at the University of Manitoba. Good first steps in education funding AFTER years of provincial austerity bud- gets that put school divisions under financial strain and failed to provide the necessary funding to support students, the 2024 budget signals a hopeful change. However, the budget falls short in some respects and we are left with questions about specifics in the plan for education moving forward. Public schools should be cornerstones of every neighbourhood, inclusive spaces that support the well-being of children, families and communities. We want a budget that makes this a reality. One of the highlights of the current budget is the $30 million designated for a universal K-12 nutrition program in every school across the province. In a province where 27.2 per cent of preschoolers and 24 per cent of school- aged children live in poverty, this funding has the potential to improve the health, well-being and success of countless children. However, more must be done to holistically address poverty inside schools and in com- munities. For example, in its report released in February 2023, the Poverty and Education Task Force outlined a range of recommenda- tions that included mental health initiatives, addressing racism, improving access to trans- portation, supporting Indigenous students and children in care and more. Schools need to be community-oriented spaces and parts of the budget reflect this. The two new schools that will be built will in- clude dedicated spaces for childcare centres, which demonstrates consideration for the needs of families and communities. However, given the current lack of child- care spaces and the shortage of early child- care educators, more must be done in this area. We hope that more attention will be given to supporting our province’s youngest students, with more access to full-day kinder- garten and pre-kindergarten programs across the province, many of which have been lost after years of underfunding. The aim to reduce class sizes is a move in a positive direction, where early years learners can receive more teacher attention and support. The province has allocated $3 million to reduce class sizes, which seems like a paltry amount compared to the new $10.9 million dollars allocated to private schools in this budget, a decision which does not serve the greater public. It remains to be seen whether the $3 million is a sufficient amount of money and how specifically class size reduction will be addressed. Inadequate funding can lead to unintended consequences, such as larger class sizes in older grades or a shifting of resources away from other vital areas. Is the province committing to creating class size policies, hiring more teachers and expanding school infrastructure? If the province is committed to smaller class sizes, there needs to be a plan to address the teacher shortage. There are now hundreds of teaching posi- tions filled by non-certified teachers, many teaching positions are not being filled and the substitute teaching pool has been drained. In rural and northern communities, this is a longstanding problem that needs action. In addition, recent reports from the New- comer Education Coalition and the Winnipeg Indigenous Executive Circle indicate a signif- icant underrepresentation of racialized and Indigenous teachers in schools. The province needs a plan to recruit, educate and retain more teachers and also find pathways into teaching for racialized and Indigenous people. Importantly, the province is revising the education taxation credits and rebates, removing the education property tax rebate and replacing it with a homeowners afford- ability tax credit of up to $1,500, which is more progressive. The province claims this will generate $148 million of tax revenues. As well, the province recently gave permission to trustees to raise property taxes, giving school divisions back some local control over their own funding. These funds are badly needed and these are good first steps. Manitoba schools need a new funding model that mandates equitable, robust, consistent and predictable funding. This will allow school divisions to plan for the long term and to develop community-responsive program- ming to best support their schools’ students and families. The 2024-25 budget shows a promising shift towards treating education not as an expense, but rather as an investment in our communi- ties and in our province’s future. However, this budget is only the first step. More long-term, community-oriented plan- ning is needed going forward, along with greater government transparency in the process. Ellen Bees and Melanie Janzen are members of People for Public Education. ELLEN BEES AND MELANIE JANZEN JORDAN LAIDLAW MIKE DEAL / FREE PRESS FILES The 2024-25 provincial budget promises more doctors — but where will they come from? DR. MICHAEL BORODITSKY ;