Ahmed Sati, M.D. was our family physician from 1971 until a few years ago when he deservedly retired from a busy practise comprised of a patient roster who regarded him as a treasure, as we did.  His personable, caring and sweet personality, aligned with a deep professional knowledge gave assurances to us all that we and our families were in capable, caring hands. 

Not that we visited that often, but when we did, his care of and for us was palpable, reassuring and successful in his ability to discern the origins of a health problem; his diagnostic skills and remedial action were impeccable.

The type of medical professional that this man of Syrian origin and Canadian citizenship exemplified is rarely seen in the new field of the practise of medicine.  General practitioners are far less likely to become as deeply involved in the care of their patients as Dr. Sati was; his was a full dedication, and his office staff reflected his deep commitment to patient care.

Individuals now who enter the medical profession appear to be focused far more on acquiring wealth commensurate with their professional education and practise, even though a busy general practitioner easily out-earns any other high-end profession.  Now, a greater proportion of medical school entrants set their sights on specialization.  General practise is too mundane, too time-demanding, and too relatively unprofitable.

Canada has suffered, in the last few decades, from a lack of general practitioners.  One reason is that insufficient numbers of medical students were accepted into university medical training centres because of a perceived glut in physicians in the country.  Another reason became apparent, when it was understood that many young medical students preferred going into more arcane sections of medical practise requiring specialized knowledge and guaranteeing to earn practitioners handsome payback.

Now, though the deficit in general practitioners opening family practices has eased, partially with an easing of the restrictions imposed on foreign-trained medical immigrants, streamlined into upgrading knowledge and skills to reflect Canadian standards, there still remains a lack of sufficient generalists, particularly in rural areas of the country.

And a study recently released points to the fact that across the nation medical schools are training too many doctors for pediatric specialties while not producing enough medics in other areas of child health care. What pertains to pediatric practise can be interpreted as being reflected in other areas of the medical profession. A clear disconnect, according to the revelations, between physician education and the demands of on-the-ground, real-world requirements.

Comparing numbers of medical graduates in various pediatric sub-specialities with demand in those areas, a close match was revealed in only one of 16 sub-specialties.  Pediatric neurologists were being trained in twice the numbers needed, for example.  The journal Pediatrics and Child Health has stated that University administrators "have a social and moral responsibility to guide the future deployment of pediatricians based on the precise health care needs of this vulnerable population. It is neither ethically or fiscally responsible to train individuals without knowledge of workforce requirements."

The Royal College of Physicians and Surgeons' surveys reveal that one in six doctors completing their residencies find themselves in a situation where they are unable to find a position commensurate with their qualifications.  Some physicians - family doctors and psychiatrists - can simply open their own independent offices and begin their medical practise, then bill Medicare appropriately, thus launching their careers.

Specialists must hope to find a position with a hospital or health region, equipped with expensive, state-of-the-art equipment and support staff.  Unemployment or underemployment has been identified in thirteen specialties: cardiac surgery,neurosurgery, plastic surgery, orthopedic surgery, otolaryngology, urology, gastroenterology, adult neurology, dermatology, general surgery, opthalmology, pediatric infectious diseases and radiation oncology.

For a situation as vital to national public health and service as this situation represents, this is an astonishingly revelation of unforgivably inept planning.