Physicians Canada

Summary report
Physicians in Canada, 2019

Production of this document is made possible by financial contributions from Health Canada and provincial and territorial
governments. The views expressed herein do not necessarily represent the views of Health Canada or any provincial
or territorial government.
Unless otherwise indicated, this product uses data provided by Canada’s provinces and territories.
All rights reserved.
The contents of this publication may be reproduced unaltered, in whole or in part and by any means, solely for non-commercial
purposes, provided that the Canadian Institute for Health Information is properly and fully acknowledged as the copyright owner.
Any reproduction or use of this publication or its contents for any commercial purpose requires the prior written authorization
of the Canadian Institute for Health Information. Reproduction or use that suggests endorsement by, or affiliation with,
the Canadian Institute for Health Information is prohibited.
For permission or information, please contact CIHI:
Canadian Institute for Health Information

495 Richmond Road, Suite 600
Ottawa, Ontario K2A 4H6
Phone: 613-241-7860
Fax: 613-241-8120
cihi.ca
[email protected]
ISBN 978-1-77109-969-1 (PDF)
© 2020 Canadian Institute for Health Information
How to cite this document:

Canadian Institute for Health Information. Physicians in Canada, 2019. Ottawa, ON: CIHI; 2020.
Cette publication est aussi disponible en français sous le titre Les médecins au Canada, 2019.
ISBN 978-1-77109-970-7 (PDF)
Table of contents
About CIHI’s physician data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
More information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Physician information and COVID-19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Supply, distribution and migration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Physician supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Physician demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
International medical graduates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Physician payments and utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

How much are physicians paid?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Physician full-time equivalents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Types of physician remuneration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Fee-for-service utilization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Appendix: Text alternatives for figures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

About CIHI’s physician data

Collecting and reporting physician information assists decision-makers in health human resource planning, as well
as in the distribution and funding of physicians. Information on the supply, distribution and migration of physicians
from the data sources used for this report is available as far back as 1968, and information on physician service
utilization and payments is published from 1996–1997 onward. The Canadian Institute for Health Information (CIHI)
has collected this information since its inception in 1994, and has been reporting on it since 1997.
The Physicians in Canada release provides readers with a complete set of documents for physician-related data on
the supply and distribution of physicians, their payments and the services they provide.
To ensure that our work reflects priority needs, we invite our readers to join the discussion using CIHI’s
Facebook page (facebook.com/CIHI.ICIS), Twitter account (twitter.com/CIHI_ICIS) or email ([email protected]).
Any questions regarding this publication should be directed to
Program Lead
Physician Information
Canadian Institute for Health Information
495 Richmond Road, Suite 600
Ottawa, Ontario K2A 4H6
Phone: 613-241-7860
Fax: 613-241-8120
Email: [email protected]
Or visit CIHI online at cihi.ca.
4
More information
The following physician products are available on CIHI’s website:
• Physicians in Canada, 2019 (report)

• A profile of physicians in Canada, 2019 (infographic)
• Supply, Distribution and Migration of Physicians in Canada, 2019 (data tables, historical data tables,
methodology notes)
• National Physician Database, 2018–2019 (payments and utilization data tables, historical payments
and utilization data tables, methodology notes)
• Physician Services Benefit Rates, 2018–2019 (data tables, methodology notes)
The following health workforce products are also available on CIHI’s website:
• Nursing in Canada, 2019: A Lens on Supply and Workforce (report)

• A profile of nursing in Canada, 2019 (infographic)
• Nursing in Canada, 2019 (data tables, methodology notes)
• Health Workforce in Canada, 2019 (Quick Stats)
• Canada’s Health Care Providers, 2014 to 2018 (data tables, methodology notes)
Feedback and questions are welcome at [email protected].
5
Highlights
This report contains information on the supply of physicians in Canada, physician service utilization
and payments to physicians that are administered through the provincial and territorial medical care
plans. Data on the supply, distribution and migration of physicians is as of December 31, 2019.
Service utilization and payments data is for fiscal year 2018–2019.
The number of physicians in Canada continues to increase, although growth slowed in 2019.
• 2019 saw the smallest single-year increase in the number of physicians since 2007. In 2019,
there were 91,375 physicians in Canada, representing a 1.8% increase over 2018.
• Growth in the number of physicians kept pace with that of the population, and the number
of physicians per 100,000 population remained unchanged at 241 in 2019.
The proportion of female physicians in Canada is rising, particularly among family

medicine physicians.
• In 2019, 47.5% of family medicine physicians and 38.0% of specialist physicians in Canada were
female. Since 2015, the number of female physicians in the workforce has increased by 19.2%,
while the number of male physicians has increased by 5.8%.
• In 2019, Quebec had the highest proportion of female physicians, at 50.6%, while Prince Edward Island
had the lowest, at 33.1%.
6
Clinical payments to physicians in Canada reached $28.2 billion in 2018–2019.

• Total clinical payments to physicians increased 3.0% over the previous year to almost $28.2 billion.
Total clinical payments to physicians in Canada increased 13.4% over the 5 years from 2014–2015
to 2018–2019.
• Since 2012–2013, the proportion of clinical payments paid through fee for service has gradually
increased from 70.6% to 72.6% of total clinical payments, a level last observed 9 years earlier.
The average gross payment per physician reached $347,000 in 2018–2019.
• The average gross clinical payment per physician increased by just under 1% (0.9%) in 2018–2019 to
$347,000. It ranged from $272,000 in Nova Scotia to $391,000 in Alberta.
• The average gross clinical payment per family medicine physician remained unchanged in 2018–2019
at $280,000. The average gross clinical payment per medical specialist and per surgical specialist
increased 1.5% and 2.6% to $363,000 and $490,000, respectively.
• Some jurisdictions had increases in average payments, while others remained virtually unchanged.
Changes in average payments ranged from an increase of 6.1% in Newfoundland and Labrador
($291,000) to virtually no change in New Brunswick ($294,000) and Quebec ($345,000).
Consultations and visits made up the majority of both services and payments.
• In 2018–2019, the average cost per service paid to physicians was $68.70. Family medicine
physicians billed an average cost per service of $51.01, while medical and surgical specialists
billed an average of $87.60 and $91.88 per service, respectively.
7
Physician information and COVID-19

This current iteration of CIHI’s Physicians in Canada report is based on supply data as of December 31, 2019,
and on payments and service utilization data for 2018–2019. Although this time period is not directly related to
the COVID-19 pandemic, CIHI is preparing to look at physician activity throughout the pandemic as the data
for this period becomes available.
Some initial work to prepare for analyzing and reporting physician information as it relates to the global
pandemic involves tracking changes to billing rules and billing options for physicians. In response to the
crisis, provincial and territorial governments and medical associations moved rapidly to adapt their physician
fee schedules to meet the emerging needs of physicians and their patients, especially for virtual care services.
CIHI is continuing to track these changes and other impacts of the pandemic in anticipation of reporting
physician information for this period in the near future.
Further information on some of these modifications can be found on CIHI’s COVID-19 resources web page.
8
Supply, distribution
and migration
Physician supply, distribution and migration data includes
active physicians in clinical and non-clinical practice
(e.g., research and academia) who have a Doctor of
Medicine (MD) degree and a valid mailing address.
The data excludes residents, physicians in the military,
and semi-retired and retired physicians. The data also
excludes non-registered physicians who requested that
their information not be published as of December 31 of
the reference year. Data is as of December 31, 2019.
9
Physician supply
Although the pace of growth slowed in 2019,
the physician supply in Canada continued to
increase. For the last 13 years, the growth
rate of the physician population has outpaced
that of the general population, and between
2015 and 2019, the growth rate was twice
that of the general population.
10
The number of physicians in Canada has increased each year since 1997.
Figure 1 Number and percentage growth in the supply
of physicians, Canada, 1978 to 2019
In 2019, there were
91,375 physicians in Canada,
100,000 5%
reflecting a 1.8% increase
90,000
over 2018.
4%
80,000
Percentage change in physician supply

70,000
3%
Number of physicians
60,000 • The increase in physician supply in

50,000 2% 2019 was the smallest single-year
40,000
increase since 2007.
30,000
1% • Following yearly increases in the
number of physicians of more than
20,000
0%
2% since 2007, the slower growth
10,000
rate narrowly outpaced Canada’s
0 -1%
population growth over the
78
80
82
84
86
88
90
92
94
96
98
00
02
04
06
08
10
12
14
16
18
previous year.
19
19
19
19
19
19
19
19
19
19
19
20
20
20
20
20
20
20
20
20
20
Number of physicians Percentage change
Source
Scott’s Medical Database, Canadian Institute for Health Information.
11
Physician supply in Canada continues to outpace population growth.

Figure 2 Number of physicians per 100,000 population,
by physician type, Canada, 1978 to 2019 Between 2015 and 2019,
the number of physicians in
Canada increased at a faster
300
pace than the population.
2019: 241.1
250 2015: 229.1
Number of physicians per 100,000 population
• In 2019, there were 241 physicians

200
per 100,000 population: 122 family
medicine physicians and 119 specialists
1978: 147.1
150
per 100,000.
• The proportion of family medicine
100 and specialist physicians has remained
relatively equal since the late 1970s,
50 with family medicine physicians
representing between 50% and
0 53% of the physician workforce.
78
80
82
84
86
88
90
92
94
02
04
06
08
10
12
14
16
18
96
98
00
19
19
19
19
19
19
19
19
19
20
20
20
20
20
20
20
20
20
19
19
20
Family medicine Specialists All physicians
Source
12
Over the last 5 years, the number of physicians per 100,000 population
has increased in all but 1 jurisdiction.
Figure 3 Number of physicians per 100,000 population,
by jurisdiction, 2015 and 2019 The number of physicians
per 100,000 population in
300
Canada increased by 5.2%
between 2015 and 2019.
250
Number of physicians per 100,000 population
200
• Jurisdictions with the highest number
of physicians per 100,000 population
150
included Nova Scotia and Newfoundland
and Labrador (268 and 260 per
100
100,000 population, respectively).
50 • The number of physicians per
100,000 population in New Brunswick
0 increased by 12.3% between 2015
N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. Canada
and 2019, representing the largest
2015 2019
per capita increase of all jurisdictions
during that period.
Notes
Due to small numbers, data for the Northwest Territories and Nunavut is not displayed individually but is included in the
Canada totals.
The number of physicians per 100,000 population in Yukon includes only those who reside in the territory. If itinerant physicians
were also included, this would provide a more comprehensive estimate of the total physician supply. CIHI has been working with
the Yukon government to this end.
Source
13
Physician demographics
The proportion of female physicians continued to rise,
particularly among family medicine physicians. The average
age of physicians was slightly lower in 2019 than it was
5 years ago.
14
The proportion of female physicians increased across all jurisdictions.

Figure 4 Percentage of female physicians, by jurisdiction,
2015 and 2019
Between 2015 and 2019,
the number of female
60%
physicians increased by
19.2%, while the number
50%
of male physicians increased
by 5.8%.
Percentage of female physicians
40%
30%
• In 2019, 42.8% of physicians were
20% women, compared with 39.9%
in 2015.
10% • Quebec and Yukon had the highest
proportion of female physicians,
0% at 50.6%, while P.E.I. had the
lowest, at 33.1%.
2015 2019
Note
Canada totals.
Source
15
The proportion of female physicians is greater among

family medicine physicians than specialists.
Figure 5 Percentage of physicians, by sex and
physician type, Canada, 1978 to 2019 In Canada, females
represented a larger
proportion of family
100% medicine physicians
90%
than specialists.
80%
70%
Percentage of physicians
60%
• In 2019, 47.5% of family medicine
physicians and 38.0% of specialist
50%
physicians in Canada were female.
40%
• This pattern varies by province.
30%
For example, Quebec had the
20%
highest proportion of female
10%
family medicine physicians (56.6%)
0% and female specialists (44.6%)
in Canada in 2019.
78
80
82
84
86
88
90
92
94
96
98
00
02
04
06
08
16
18
1
1
19
19
19
19
19
19
19
19
19
19
19
20
20
20
20
20
20
20
20
20
20
Family medicine, female Family medicine, male • The overall proportion of female
Specialists, female Specialists, male
physicians in the workforce has grown
from 11.1% in 1978 to 42.8% in 2019.
Source
16
The proportion of female physicians is higher among younger age groups.

Figure 6 Percentage of female physicians, by physician
type and age group, Canada, 2019
Across all age groups,
the percentage of female
100% physicians was higher
90% among family medicine
80% physicians than specialists.
Percentage of female physicians
70%
60%
• In Canada in 2019, 58.5% of family
50%
medicine physicians and 50.0%
40% of specialist physicians younger
30% than 40 were female.
20% • Among physicians age 60 to 69,
10% more than two-thirds (68.9%)
0%
were male; among physicians
Younger than 40 Age 40–49 Age 50–59 Age 60–69 70 and older over age 70, 84.8% were male.
Family medicine Specialists
Source
17
The average age of physicians declined slightly over 5 years.

Figure 7 Average age of physicians in Canada,
by jurisdiction, 2015 and 2019
The average age of
physicians in Canada
54 declined slightly from
50.0 years in 2015 to
52
49.4 years in 2019.
50
Average physician age
48
• Overall in 2019, the jurisdiction with
46
the highest average age of physicians
was P.E.I., at 52.1 years, and the
44 jurisdiction with the lowest average
age was Alberta, at 48.1.
42
• Between 2015 and 2019, the average
40
age of physicians decreased in P.E.I.,
N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. Canada Nova Scotia, Ontario, Manitoba and
2015 2019 British Columbia, was virtually stable
in Newfoundland and Labrador
and Quebec, and increased in
Note all other jurisdictions.
Canada totals.
Source
18
International
medical graduates
Canada continues to gain internationally trained
physicians. More family medicine physicians than
specialists received their MD degree outside
of Canada.
19
More than a quarter of physicians in Canada were

internationally trained.
Figure 8 Percentage of physicians with international
MD degrees, by jurisdiction, 2015 and 2019 The percentage of
physicians who received
their MD degree outside
60% of Canada has remained
relatively stable since 2015,
Percentage of physicians with international MD degrees
50% ranging from 25.7% in 2015

to 26.4% in 2019.
40%
30% • Saskatchewan and Alberta had the

largest proportions of internationally
20% trained physicians (50.8% and 35.3%,
respectively), while Quebec and
10% P.E.I. had the smallest (9.0% and
16.1%, respectively).
0%
N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. Canada • Between 2015 and 2019,
2015 2019
the proportion of internationally
trained physicians in Ontario,
Note Alberta and British Columbia
Canada totals.
increased by between 3% and
Source 5%, while it decreased in all
other jurisdictions.
20
In recent years, more family medicine physicians than

specialists received their MD degree outside of Canada.
Figure 9 Percentage of physicians with international
MD degrees, by physician type, Canada, 1978 to 2019 Over one-quarter (26.4%) of
Canada’s physicians received
their MD degree outside
40% of Canada.
1978: 33.4%
Percentage of physicians with international MD degrees
2019: 30.0%
30% • In each of the last 15 years, more
1978: 31.6%
family medicine physicians than
specialists received their MD degree
20% 2019: 22.7% outside of Canada.
• The percentage of internationally
trained family medicine physicians
10% in Canada increased from 28.7% in
2015 to 30.0% in 2019, while the
percentage of specialists remained
0% stable during that period, at 22.7%.
78
90
2
94
96
98
00
02
04
06
6
18
8
1
19
19
19
19
19
19
19
19
19
19
19
20
20
20
20
20
20
20
20
20
20
Family medicine Specialists All physicians
Source
21
More internationally trained physicians received their MD degree

in South Africa than in any other country.
Figure 10 Top 10 countries of MD graduation for
internationally trained physicians licensed in Canada, Physicians from South
by physician type, 2019 Africa, India and the
United Kingdom made up
28.1% of all internationally
trained physicians in
South Africa
Canada in 2019.
India
United Kingdom
Country of MD graduation
Ireland • In 2019, family medicine physicians

United States
accounted for 56.9% of all
internationally trained physicians.
Egypt
• South Africa was the top country
Pakistan
of graduation for internationally
Nigeria
trained family medicine physicians,
Iran
while India was the top country
Poland of graduation for internationally
0 500 1,000 1,500 2,000 2,500 trained specialists.
Number of physicians
Family medicine Specialists
Source
22
Physician payments
and utilization
This section contains information on physician service
utilization and on payments to physicians that are
administered through the provincial and territorial
medical care plans. This data is for 2018–2019.
23
How much are physicians paid?

The cost of physician services in Canada can be understood by examining total
and average clinical payments to physicians, the types of services paid for,
and information about the providers and recipients of these services.
Since 2009, CIHI has reported average gross clinical payments made to physicians
by provincial/territorial medical care plans. These payment amounts are calculated
as the sum of all gross clinical payments (fee-for-service [FFS] and alternative
payments) divided by the total number of physicians reported to CIHI by the
jurisdictions. In addition to total average payments per physician, CIHI publishes
a series of specialty-level payment indicators, including distribution of payments,
standard deviations and average payments with monetary cut-offs.
24
Total gross clinical payments to physicians increased to $28.2 billion in 2018–2019.

Figure 11 Total gross clinical and FFS payments to
physicians, Canada, 1999–2000 to 2018–2019
FFS clinical payments
to physicians reached
$30 $28.2 billion $20.5 billion in 2018–2019,
while alternative payments
$25
reached $7.7 billion.
$20.5 billion
Payments in billions of dollars
$20
$15 • In 2018–2019, total clinical

payments to physicians increased
$10 3.0% over the previous year to
$28.2 billion; this is the second-
$5 lowest increase since 1999–2000.
• Total clinical payments to physicians
$0
in Canada have increased 13.4%
0
9
6
00
00
00
00
00
00
00
00
00
01
01
01
01
01
01
01
01
01
01
00
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
over the past 5 years.
–2
99
00
01
02
03
04
06
07
08
09
10
11
12
13
14
15
16
17
18
05
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Total gross clinical payments ($ billions) FFS clinical payments ($ billions)
Notes
FFS: Fee for service.
Excludes Nunavut. Nunavut does not report to the National Physician Database.
Imaging and laboratory specialists are not included.
Source
National Physician Database, Canadian Institute for Health Information.
25
Average gross clinical payments to physicians have increased 3.4% over 5 years.
Figure 12 Average gross clinical payments to physicians,
by jurisdiction, 2014–2015 and 2018–2019
The average gross clinical
payment per physician in
$400,000 Canada was $347,000 in
$350,000 2018–2019, a 3.4% increase
over 2014–2015. Some
Average clinical payments to physicians
$300,000
jurisdictions saw increases,
$250,000
while others saw decreases.
$200,000
$150,000
• Quebec saw the greatest 5-year
$100,000
increase in average gross payment,
$50,000 from $310,000 to $345,000 (11.2%).
$0 • New Brunswick saw the largest 5-year
decrease in average gross payment,
2014–2015 2018–2019
from $302,000 to $294,000 (-2.7%).
Notes
Due to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certain
smaller jurisdictions relative to larger ones, in an attempt to improve comparability, CIHI has agreed to calculate the average
payment per physician for P.E.I. using only permanent in-province physicians, and for Yukon using only physicians whose total
gross payments are at least $60,000.
Data is not available for the Northwest Territories or Nunavut. Nunavut does not report to the National Physician Database.
Source
26
The average gross clinical payment per surgical specialist was higher
than that per medical specialist and per family medicine physician.
Figure 13 Average gross clinical payments, by physician
specialty, Canada, 2018–2019 By combining FFS data with
physician-level alternative
Ophthalmology $791,000 payment data, CIHI is able
Thoracic/cardiovascular surgery $588,000 to report comprehensive
Neurosurgery $558,000
Urology $500,000 average payments per
Total surgical specialties $490,000
physician by specialty.
General surgery $466,000
Otolaryngology $444,000
Orthopedic surgery $438,000
Anesthesia $437,000
Internal medicine $407,000 • The average gross clinical
Family medicine
Plastic surgery $394,000 payment per family medicine
Obstetrics/gynecology $392,000 Medical specialists
Dermatology $385,000 physician was $280,000.
Surgical specialists
Total medical specialties $363,000
Total medical specialists/
• The average gross clinical
Total physicians $347,000
Neurology $316,000
total surgical specialists payment per medical
Total physicians
Pediatrics $296,000 specialist was $363,000.
Physical medicine $289,000
Psychiatry $282,000 • The average gross clinical
Family medicine $280,000
payment per surgical
$0 $200,000 $400,000 $600,000 $800,000
specialist was $490,000.
Average gross clinical payment
Note
Specialty-level information for Saskatchewan, Alberta and the Northwest Territories at the level needed for this analysis was
not available. Nunavut does not report to the National Physician Database.
Source
27
The average gross clinical payment varies across Canada.

type and jurisdiction, 2018–2019
Canada
FM: $280,000
Family medicine (FM) • The average gross clinical payment per
MS: $363,000
SS: $490,000
Medical specialists (MS) family medicine physician ranged from
Surgical specialists (SS) $217,000 in Newfoundland and Labrador
to $310,000 in Ontario.
N.L.
Y.T.
FM: $217,000 • The average gross clinical payment per
MS: $346,000
FM: $274,000 N.W.T. Nun. SS: $475,000 medical specialist ranged from $283,000
MS: $230,000 FM: n/a
P.E.I.
SS: $591,000 MS: n/a
FM: n/r FM: $327,000 in Nova Scotia to $404,000 in Quebec.
MS: n/r MS: $429,000
SS: n/a SS: n/r
B.C. SS: $590,000 • The average gross clinical payment per
FM: $221,000
MS: $338,000 Alta. Man. Que. surgical specialist ranged from $400,000
SS: $487,000 FM: n/a FM: $309,000 FM: $274,000 N.S.
MS: n/a Sask. MS: $388,000 MS: $404,000 FM: $225,000
in Nova Scotia to $512,000 in Manitoba.
SS: n/a FM: n/a SS: $512,000 Ont. SS: $478,000 MS: $283,000
MS: n/a FM: $310,000 SS: $400,000
SS: n/a MS: $344,000
SS: $489,000 N.B.
FM: $227,000
MS: $342,000
SS: $422,000
Notes
n/a: Specialty-level information for Saskatchewan, Alberta and the Northwest Territories at the level needed for this analysis was not available.
n/r: Nunavut does not report to the National Physician Database.
Due to cell suppression at the specialty level, the average payment for medical specialists in Yukon includes only payments to pediatric specialists.
Due to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certain smaller jurisdictions relative to larger
ones, in an attempt to improve comparability, CIHI has agreed to calculate the average payment per physician for P.E.I. using only permanent in-province
physicians, and for Yukon using only physicians whose total gross payments are at least $60,000.
Canada figures exclude Saskatchewan, Alberta, the Northwest Territories and Nunavut.
Source
28
Physician full-time equivalents
Another metric that can be used to analyze physician payments and supply is the
full-time equivalent (FTE). The FTE is used to adjust the total count of physicians
to reflect their activity based on their clinical payments.
Historically, CIHI published an FTE indicator based on FFS payments only. Since the
late 1990s, there has been considerable migration from FFS to alternative payments.
As a result, CIHI has developed an enhanced FTE indicator that focuses on a physician’s
full clinical payments by including both FFS and alternative payments to physicians and
replaces the former FTE indicator that used only FFS payment data.
The aim of the FTE indicator remains the same: to produce statistics that are
comparable in 3 dimensions — over time, across jurisdictions and across specialties.
A full description of the FTE indicator methodologies is provided in the National

Physician Database Methodology Notes document in appendices C and G.
29
Average gross clinical payment per FTE physician includes

both fee-for-service and alternative payments.
Figure 15 Average gross clinical payment per FTE physician,
by physician type and jurisdiction, 2018–2019 The FTE methodology uses
payments as a proxy for
activity and computes FTEs
$800,000
that reflect clinical activity
for each given specialty.
$700,000
Average clinical payment per FTE physician
$600,000
$500,000 • The average payment per

$400,000
family medicine FTE in Canada
in 2018–2019 was $327,000.
$300,000
• The average payment per
$200,000
medical specialist FTE in Canada
$100,000 in 2018–2019 was $400,000, and
$0 the average payment per surgical
N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Canada specialist FTE was $568,000.
Family medicine Medical specialists Surgical specialists
Notes
FTE: Full-time equivalent.
Saskatchewan and Alberta FTEs are based on fee-for-service payments only.
Data is not available for Yukon, the Northwest Territories or Nunavut. Nunavut does not report to the National Physician Database.
Source
30
Types of physician
remuneration
Since the introduction of the public medical care system in the 1960s,
most physicians in Canada have been compensated through FFS
payments. Alternative payment plan (APP) programs first became
prevalent in the mid-1990s and have become an increasingly
popular method of remuneration to physicians in the last 2 decades.
Payments through alternative methods have shown a slight decrease
from nearly 30% of total clinical payments in 2012–2013 to 27.4%
in 2018–2019.
Alternative methods of paying physicians include salaries, sessional

and hourly rates, capitation models and contract-based payments.
Many physicians receive compensation through multiple models,

which could include both FFS and alternative payments; however,
funding through the different payment models varies significantly
across jurisdictions.
31
The proportion of APP clinical payments stabilized between

2008–2009 and 2018–2019.
Figure 16 FFS and alternative payments as a percentage
of total clinical payments to physicians, Canada, A shift toward APPs in place
1999–2000 to 2018–2019 of FFS payments has been
stable for 10 years; since
100% 2008–2009, FFS payments
have made up between
80% 72.6% FFS 71% and 73% of total
clinical payments.
Total clinical payments
60%
40% • In 2018–2019, alternative payments

accounted for 27.4% of all gross
20% 27.4% APP clinical payments, compared with
10.6% in 1999–2000.
0% • For the sixth consecutive year,
20 000
20 002
04 4
20 005
20 008
20 010
20 011
20 012
20 013
20 014
20 015
18 8
9
20 06
alternative payments as a
00
00
00
00
01
01
20 01
01
0
0
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
–2
99
00
01
02
03
06
07
08
09
10
11
12
13
14
15
16
17
05
19
20
20
20
20
20
20
20
proportion of total clinical

Percentage FFS Percentage APP
payments decreased slightly.
Notes
APP: Alternative payment plan.
Source
32
Most physicians receive compensation through multiple models,

including both FFS and alternative payments.
Figure 17 Distribution of physicians and clinical payments,
by payment type and jurisdiction, 2018–2019 Over 96% of all physicians
in 2018–2019 were paid
a portion of their total
100% payments via FFS, and 69%
were paid a portion via APPs.
80%
60% • In Ontario and Quebec, almost all

physicians (99%) received some FFS
40% payments. The proportion receiving
APP payments in those provinces
20% differed: 56% in Ontario and 88%
in Quebec.
0% • Alberta had the lowest proportion
FFS clinical payments Percentage of physicians who received any FFS payments
of physicians receiving some
APP clinical payments Percentage of physicians who received any APP payments
payments through APPs, at 17%,
and Nova Scotia had the highest
Notes proportion, at 97%.
Source
33
Family medicine physicians are more likely to be paid through alternative

methods than medical specialists and surgical specialists.
Figure 18 Distribution of physicians, by payment type
and physician type, Canada, 2018–2019 Alternative methods of
paying physicians include
salaries, sessional and hourly
100% 5%
rates, capitation models and
10% 3%
16%
6%
contract-based payments.
80% 26%
19%
31%
60% • In Canada, 34% of family medicine
30% physicians, 16% of medical
40% specialists and 8% of surgical
66%
specialists received more than
52%
20%
36% half of their total clinical payments
through alternative methods
0% in 2018–2019.
Family medicine Medical specialists Surgical specialists
90% FFS 50%–90% FFS 50%–90% APP 90% APP
Notes
Excludes Saskatchewan, Alberta, the Northwest Territories and Nunavut. Nunavut does not report to the National Physician Database.
Numbers may not add to 100% due to rounding.
Source
34
Fee-for-service utilization
The largest payment program as a proportion of total gross clinical

payments to physicians in Canada is still FFS, at about 73% of total
payments in 2018–2019. FFS services provided by physicians can be
split into 2 broad types: consultations/visits and procedures.
The cost and amount of physician services can be analyzed to determine

which types of services physicians who are paid under FFS are providing
and which types of physicians are providing the FFS services, as well as
information on patients who are receiving these services.
Although family medicine physicians perform the greatest number of

services and receive the largest proportion of payments, medical and
surgical specialists are paid more per service on average. Services may
not always be comparable, as the amount of work required differs
depending on the type of service.
35
The types of services provided by physicians under the FFS model can be
grouped into 2 broad categories: consultations/visits and procedures.
Figure 19 FFS services and payments,
Canada, 2018–2019 Although the majority
of services provided by a
physician are consultations
100% and visits, procedures
cost more.
29% 33%
80%
60% • In 2018–2019, consultations and

visits made up 71% of services
40%
71%
delivered and accounted for
67%
67% of payments.
20%
• Procedures made up 29% of
services delivered and accounted
0%
Percentage of services Percentage of payments
for 33% of payments.
provided via FFS paid via FFS
Consultations and visits Procedures
Notes
Excludes reciprocal billing, imaging and laboratory services, anesthesia services and anesthesiology specialists, and unclassified physicians.
Excludes the Northwest Territories and Nunavut. Nunavut does not report to the National Physician Database.
Source
36
Medical and surgical specialists paid through FFS receive more per service
on average than family medicine physicians.
Figure 20 Average cost per service, by physician specialty,
Canada, 2018–2019
• In 2018–2019, the average cost

$250
per service was $68.70.
$200
• Family medicine physicians billed
Average cost per service
$150 an average cost per service of

$100 $68.70 $51.01, while medical and
surgical specialists billed
$50
an average of $87.60 and
$0 $91.88 per service, respectively.
na icine
Ca ne
oe logy
Ps gy
Pe ry
De trics
An ine
sia
dic gy
ry
hth gery
Ob tola logy
gy
log
ica olog
cu rger
er
er
s/g olog
t
Ne rge
olo
olo
hia
ici
the
c
rg
rg
l
dia
io
ro
tho Uro
o
r
d
ed
ed
su
su
su
u
ur
alm
ec
yc
me
rd
Ph rma
es
nte
ls
os
ryn
lm
lm
Ne
yn
lar
tic
a
ur
ly
er
as
pe
mi
str
en
Op
er
Pl
ys
as
tric
O
Fa
Ga
G
Int
iov
ste
Or
rd
ca
ic/
ac
or
Th
Family medicine Medical specialties Surgical specialties Total physicians
Notes
Includes fee-for-service payments only.
Source
37
Appendix: Text alternatives for figures

Figure 1 Number and percentage growth in the supply
of physicians, Canada, 1978 to 2019
Year Number of physicians Percentage change
1978 35,400 1.6%
1979 36,413 2.9%
1980 37,252 2.3%
1981 38,280 2.8%
1982 40,046 4.6%
1983 41,401 3.4%
1984 42,364 2.3%
1985 44,194 4.3%
1986 45,560 3.1%
1987 47,536 4.3%
1988 49,649 4.4%
1989 51,251 3.2%
1990 51,759 1.0%
1991 52,726 1.9%
1992 53,698 1.8%
1993 55,035 2.5%
1994 54,944 -0.2%
1995 54,940 0.0%
1996 54,918 0.0%
38
Year Number of physicians Percentage change

1997 55,207 0.5%
1998 56,163 1.7%
1999 56,914 1.3%
2000 57,803 1.6%
2001 58,546 1.3%
2002 59,412 1.5%
2003 59,454 0.1%
2004 60,612 1.9%
2005 61,622 1.7%
2006 62,307 1.1%
2007 63,682 2.2%
2008 65,440 2.8%
2009 68,101 4.1%
2010 69,699 2.3%
2011 72,529 4.1%
2012 75,142 3.6%
2013 77,674 3.4%
2014 79,905 2.9%
2015 82,198 2.9%
2016 84,063 2.3%
2017 86,643 3.1%
2018 89,772 3.6%
2019 91,375 1.8%
Source
39
Figure 2 Number of physicians per 100,000 population, by physician

type, Canada, 1978 to 2019
Physicians per Family medicine physicians Specialist physicians

Year 100,000 population per 100,000 population per 100,000 population
1978 147.1 74.3 72.7
1979 149.6 75.8 73.8
1980 151.0 76.4 74.7
1981 153.2 76.9 76.3
1982 158.6 80.6 78.1
1983 162.5 82.9 79.6
1984 164.7 83.9 80.8
1985 170.2 87.7 82.5
1986 173.5 89.6 84.0
1987 178.7 93.0 85.7
1988 183.7 96.4 87.3
1989 186.6 98.8 87.8
1990 185.8 98.0 87.8
1991 187.1 98.9 88.2
1992 188.2 99.6 88.6
1993 190.9 101.6 89.2
1994 188.5 98.4 90.2
1995 186.6 97.1 89.5
1996 184.6 94.8 89.8
1997 183.8 93.6 90.3
40
Physicians per Family medicine physicians Specialist physicians

Year 100,000 population per 100,000 population per 100,000 population
1998 185.6 94.2 91.4
1999 186.4 94.3 92.2
2000 187.5 94.4 93.1
2001 187.8 95.1 92.8
2002 188.7 96.1 92.6
2003 187.1 96.5 90.6
2004 189.0 96.9 92.0
2005 190.2 97.6 92.6
2006 190.4 97.8 92.7
2007 192.7 98.6 94.0
2008 195.8 100.9 94.9
2009 201.4 102.9 98.5
2010 204.0 103.5 100.5
2011 210.1 106.5 103.6
2012 215.4 109.4 106.0
2013 220.4 111.8 108.6
2014 224.6 114.6 110.0
2015 229.1 115.8 113.3
2016 231.5 117.1 114.4
2017 235.5 120.1 115.4
2018 240.6 121.8 118.8
2019 241.1 121.7 119.4
Source
41
Figure 3 Number of physicians per 100,000 population, by jurisdiction, 2015 and 2019
Year N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. Canada
2015 242 183 263 220 245 221 204 199 240 227 209 229
2019 260 204 268 247 252 232 216 210 254 250 192 241
Notes
Due to small numbers, data for the Northwest Territories and Nunavut is not displayed individually but is included in the Canada totals.
The number of physicians per 100,000 population in Yukon includes only those who reside in the territory. If itinerant physicians were also
included, this would provide a more comprehensive estimate of the total physician supply. CIHI has been working with the Yukon government
to this end.
Source
Figure 4 Percentage of female physicians, by jurisdiction, 2015 and 2019

2015 37.3% 32.0% 38.2% 38.2% 47.1% 38.3% 34.7% 34.5% 37.6% 36.6% 49.4% 39.9%
2019 40.2% 33.1% 41.0% 40.7% 50.6% 41.3% 37.7% 36.9% 39.2% 40.3% 50.6% 42.8%
Note
Source
42
Figure 5 Percentage of physicians, by sex and physician type, Canada, 1978 to 2019
Year Family medicine, female Family medicine, male Specialists, female Specialists, male
1978 13.8% 86.2% 8.4% 91.6%
1979 14.7% 85.3% 8.9% 91.1%
1980 15.3% 84.7% 9.5% 90.5%
1981 16.1% 83.9% 9.9% 90.1%
1982 17.8% 82.2% 10.7% 89.3%
1983 18.9% 81.1% 11.3% 88.7%
1984 20.2% 79.8% 12.1% 87.9%
1985 21.4% 78.6% 12.9% 87.1%
1986 22.4% 77.6% 13.5% 86.5%
1987 23.8% 76.2% 14.2% 85.8%
1988 24.9% 75.1% 15.0% 85.0%
1989 25.8% 74.2% 15.8% 84.2%
1990 26.8% 73.2% 16.8% 83.2%
1991 28.0% 72.0% 17.5% 82.5%
1992 28.9% 71.1% 18.2% 81.8%
1993 29.6% 70.4% 18.9% 81.1%
1994 30.4% 69.6% 19.6% 80.4%
1995 31.2% 68.8% 20.3% 79.7%
1996 31.9% 68.1% 21.3% 78.7%
1997 32.6% 67.4% 21.9% 78.1%
1998 33.3% 66.7% 22.7% 77.3%
43
Year Family medicine, female Family medicine, male Specialists, female Specialists, male
1999 34.1% 65.9% 23.4% 76.6%
2000 34.6% 65.4% 24.2% 75.8%
2001 35.3% 64.7% 25.2% 74.8%
2002 35.9% 64.1% 26.0% 74.0%
2003 36.2% 63.8% 26.5% 73.5%
2004 37.0% 63.0% 27.1% 72.9%
2005 37.4% 62.6% 27.6% 72.4%
2006 38.2% 61.8% 28.3% 71.7%
2007 39.0% 61.0% 28.5% 71.5%
2008 39.7% 60.3% 29.4% 70.6%
2009 40.7% 59.3% 30.2% 69.8%
2010 41.4% 58.6% 30.8% 69.2%
2011 41.7% 58.3% 31.2% 68.8%
2012 42.5% 57.5% 32.2% 67.8%
2013 43.3% 56.7% 33.3% 66.7%
2014 44.0% 56.0% 34.0% 66.0%
2015 44.7% 55.3% 35.1% 64.9%
2016 45.4% 54.6% 35.9% 64.1%
2017 45.6% 54.4% 36.3% 63.7%
2018 46.6% 53.4% 37.5% 62.5%
2019 47.5% 52.5% 38.0% 62.0%
Source
44
Figure 6 Percentage of female physicians,

by physician type and age group,
Canada, 2019
Younger Age Age Age 70 and
Specialty than 40 40–49 50–59 60–69 older
Family medicine 58.5% 53.4% 46.2% 35.8% 16.3%
Specialists 50.0% 42.5% 35.4% 26.2% 14.1%
Source
Figure 7 Average age of physicians in Canada, by jurisdiction, 2015 and 2019

2015 48.8 52.4 51.1 49.5 49.4 50.7 50.4 48.2 47.8 50.9 47.6 50.0
2019 48.9 52.1 50.7 50.5 49.5 49.6 49.0 49.2 48.1 49.5 49.5 49.4
Note
Source
45
Figure 8 Percentage of physicians with international MD degrees, by jurisdiction,

2015 and 2019
2015 36.3% 18.8% 30.4% 24.9% 10.0% 28.5% 34.6% 52.8% 33.6% 29.6% 25.6% 25.7%
2019 34.4% 16.1% 27.1% 24.7% 9.0% 29.8% 32.4% 50.8% 35.3% 30.7% 20.3% 26.4%
Note
Source
46
Figure 9 Percentage of physicians with international MD degrees,

by physician type, Canada, 1978 to 2019
Year Family medicine Specialists All physicians
1978 33.4% 31.6% 32.5%
1979 32.2% 31.8% 32.0%
1980 31.7% 31.8% 31.7%
1981 31.2% 31.7% 31.5%
1982 30.0% 31.4% 30.7%
1983 29.2% 31.0% 30.1%
1984 28.5% 30.5% 29.5%
1985 27.8% 29.8% 28.8%
1986 27.5% 29.6% 28.5%
1987 26.7% 29.3% 27.9%
1988 26.0% 28.8% 27.3%
1989 25.2% 28.4% 26.7%
1990 24.7% 27.9% 26.2%
1991 24.5% 27.5% 25.9%
1992 23.7% 27.3% 25.4%
1993 23.4% 27.0% 25.1%
1994 23.1% 26.9% 24.9%
1995 22.7% 26.5% 24.5%
1996 22.5% 26.2% 24.3%
1997 22.3% 25.8% 24.0%
1998 22.2% 25.2% 23.7%
47
Year Family medicine Specialists All physicians

1999 22.2% 24.6% 23.4%
2000 22.3% 24.1% 23.2%
2001 22.6% 23.5% 23.1%
2002 23.2% 22.9% 23.0%
2003 23.6% 22.1% 22.8%
2004 23.5% 21.8% 22.7%
2005 24.0% 21.6% 22.8%
2006 24.4% 21.2% 22.8%
2007 24.6% 21.7% 23.2%
2008 25.6% 21.6% 23.6%
2009 26.2% 21.9% 24.1%
2010 26.1% 22.7% 24.4%
2011 26.8% 23.0% 24.9%
2012 27.5% 22.9% 25.2%
2013 28.1% 22.5% 25.3%
2014 28.6% 22.5% 25.6%
2015 28.7% 22.7% 25.7%
2016 29.4% 22.4% 26.0%
2017 30.3% 22.6% 26.5%
2018 30.0% 22.7% 26.4%
2019 30.0% 22.7% 26.4%
Source
48
Figure 10 Top 10 countries of MD graduation

for internationally trained physicians
licensed in Canada, by physician
type, 2019
Country Family medicine Specialists
South Africa 1,911 741
India 1,021 1,083
United Kingdom 1,057 883
Ireland 840 670
United States 590 578
Egypt 693 424
Pakistan 595 425
Nigeria 519 334
Iran 405 338
Poland 296 246
Source
49
Figure 11 Total gross clinical and FFS payments to physicians,

Canada, 1999–2000 to 2018–2019
Total gross clinical payments FFS clinical payments
Fiscal year (billions of dollars) (billions of dollars)
1999–2000 $9.7 $8.6
2000–2001 $10.2 $8.9
2001–2002 $11.0 $9.2
2002–2003 $11.6 $9.6
2003–2004 $12.4 $10.0
2004–2005 $13.0 $10.4
2005–2006 $14.1 $11.1
2006–2007 $14.9 $11.6
2007–2008 $16.3 $12.2
2008–2009 $17.9 $12.9
2009–2010 $19.3 $14.0
2010–2011 $20.5 $14.7
2011–2012 $22.0 $15.7
2012–2013 $22.8 $16.1
2013–2014 $24.0 $17.1
2014–2015 $24.8 $17.8
2015–2016 $25.7 $18.5
2016–2017 $26.4 $19.2
2017–2018 $27.3 $19.8
2018–2019 $28.2 $20.5
Notes
Source
50
Figure 12 Average gross clinical payments to physicians, by jurisdiction, 2014–2015 and 2018–2019
Fiscal year N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. Canada
2014–2015 $277,124 $363,464 $258,264 $302,123 $310,438 $357,271 $340,900 $363,999 $365,765 $279,437 $266,956 $336,043
2018–2019 $290,748 $391,162 $272,238 $293,862 $345,250 $347,966 $362,596 $359,933 $390,899 $292,397 $294,711 $347,353
Notes
Due to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certain smaller jurisdictions relative to larger ones,
in an attempt to improve comparability, CIHI has agreed to calculate the average payment per physician for P.E.I. using only permanent in-province physicians,
and for Yukon using only physicians whose total gross payments are at least $60,000.
Source
51

specialty, Canada, 2018–2019
Specialty Average gross clinical payment
Family medicine $280,000
Psychiatry $282,000
Physical medicine $289,000
Pediatrics $296,000
Neurology $316,000
Total physicians $347,000
Total medical specialists $363,000
Dermatology $385,000
Obstetrics/gynecology $392,000
Plastic surgery $394,000
Internal medicine $407,000
Anesthesia $437,000
Orthopedic surgery $438,000
Otolaryngology $444,000
General surgery $466,000
Total surgical specialists $490,000
Urology $500,000
Neurosurgery $558,000
Thoracic/cardiovascular surgery $588,000
Ophthalmology $791,000
Note
Specialty-level information for Saskatchewan, Alberta and the Northwest Territories at the level needed for this
analysis was not available. Nunavut does not report to the National Physician Database.
Source
52
Figure 14 Average gross clinical payments, by physician type

and jurisdiction, 2018–2019
Jurisdiction Family medicine Medical specialists Surgical specialists
N.L. $217,000 $346,000 $475,000
P.E.I. $327,000 $429,000 $590,000
N.S. $225,000 $283,000 $400,000
N.B. $227,000 $342,000 $422,000
Que. $274,000 $404,000 $478,000
Ont. $310,000 $344,000 $489,000
Man. $309,000 $388,000 $512,000
Sask. n/a n/a n/a
Alta. n/a n/a n/a
B.C. $221,000 $338,000 $487,000
Y.T. $274,000 $230,000 $591,000
N.W.T. n/a n/a n/a
Nun. n/r n/r n/r
Canada $280,000 $363,000 $490,000
Notes
n/a: Specialty-level information for Saskatchewan, Alberta and the Northwest Territories at the level needed for this analysis was not available.
n/r: Nunavut does not report to the National Physician Database.
Due to cell suppression at the specialty level, the average payment for medical specialists in Yukon includes only payments to
pediatric specialists.
Due to the greater proportion of short-term, visiting and locum physicians and their lower associated payments in certain smaller jurisdictions
relative to larger ones, in an attempt to improve comparability, CIHI has agreed to calculate the average payment per physician for P.E.I.
using only permanent in-province physicians, and for Yukon using only physicians whose total gross payments are at least $60,000.
Canada figures exclude Saskatchewan, Alberta, the Northwest Territories and Nunavut.
Source
53
Figure 15 Average gross clinical payment per FTE physician, by physician type and
jurisdiction, 2018–2019
Physician specialty N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Canada
Family medicine $288,406 $312,368 $301,296 $337,382 $363,927 $299,288 $362,666 $318,152 $392,180 $304,398 $327,502
Medical specialists $383,077 $393,538 $340,309 $410,142 $420,933 $371,231 $422,401 $437,072 $443,587 $425,322 $400,181
Surgical specialists $531,702 $618,451 $536,921 $566,065 $569,350 $511,635 $641,511 $656,644 $714,335 $622,958 $568,439
Notes
FTE: Full-time equivalent.
Saskatchewan and Alberta FTEs are based on fee-for-service payments only.
Data is not available for Yukon, the Northwest Territories or Nunavut. Nunavut does not report to the National Physician Database.
Source
54
Figure 16 FFS and alternative payments as a percentage of total clinical

payments to physicians, Canada, 1999–2000 to 2018–2019
Fiscal year Percentage FFS clinical payments Percentage APP clinical payments
1999–2000 89.4% 10.6%
2000–2001 87.1% 12.9%
2001–2002 83.9% 16.1%
2002–2003 83.2% 16.8%
2003–2004 80.6% 19.4%
2004–2005 79.7% 20.3%
2005–2006 79.0% 21.0%
2006–2007 77.4% 22.6%
2007–2008 74.7% 25.3%
2008–2009 72.1% 27.9%
2009–2010 72.6% 27.4%
2010–2011 71.8% 28.2%
2011–2012 71.2% 28.8%
2012–2013 70.6% 29.4%
2013–2014 71.2% 28.8%
2014–2015 71.7% 28.3%
2015–2016 72.1% 27.9%
2016–2017 72.5% 27.5%
2017–2018 72.5% 27.5%
2018–2019 72.6% 27.4%
Notes
Source
55
Figure 17 Distribution of physicians and clinical payments, by payment

type and jurisdiction, 2018–2019
Percentage of physicians Percentage of physicians
APP clinical FFS clinical who received any who received any
Jurisdiction payments payments FFS payments APP payments
N.L. 33.1% 66.9% 94% 39%
P.E.I. 36.4% 63.6% 91% 75%
N.S. 56.5% 43.5% 61% 97%
N.B. 32.3% 67.7% 92% 63%
Que. 20.7% 79.3% 99% 88%
Ont. 35.6% 64.4% 99% 56%
Man. 27.4% 72.6% 91% 71%
Sask. 38.2% 61.8% 66% 46%
Alta. 12.5% 87.5% 92% 17%
B.C. 19.7% 80.3% 96% 67%
Y.T. 42.7% 57.3% 96% 67%
Canada 27.4% 72.6% 96% 69%
Notes
Source
56
Figure 18 Distribution of physicians, by payment type and

physician type, Canada, 2018–2019
Physician specialty 90% APP 50%–90% APP 90% FFS 50%–90% FFS
Family medicine 16% 19% 36% 30%
Medical specialists 10% 6% 52% 31%
Surgical specialists 5% 3% 66% 26%
Notes
Excludes Saskatchewan, Alberta, the Northwest Territories and Nunavut. Nunavut does not report to the National
Physician Database.
Numbers may not add to 100% due to rounding.
Source
Figure 19 FFS services and payments, Canada, 2018–2019

Percentage via FFS Consultations and visits Procedures
Services provided 71% 29%
Payments paid 67% 33%
Notes
Excludes reciprocal billing, imaging and laboratory services, anesthesia services and anesthesiology specialists,
and unclassified physicians.
Source
57
Figure 20 Average cost per service, by physician specialty, Canada, 2018–2019

Group Physician specialty Average cost per service
Family medicine Family medicine $51.01
Medical specialties Internal medicine $85.50
Cardiology $82.51
Gastroenterology $112.27
Neurology $112.30
Psychiatry $102.49
Pediatrics $82.98
Dermatology $46.70
Physical medicine $88.50
Anesthesia $140.71
Surgical specialties General surgery $128.55
Thoracic/cardiovascular surgery $206.56
Urology $84.87
Orthopedic surgery $122.52
Plastic surgery $112.13
Neurosurgery $233.92
Ophthalmology $64.48
Otolaryngology $70.32
Obstetrics/gynecology $87.89
Total physicians Total physicians $68.70
Notes
Includes fee-for-service payments only.
Source
58
[email protected]
CIHI Ottawa CIHI Toronto CIHI Victoria CIHI Montréal
495 Richmond Road 4110 Yonge Street 880 Douglas Street 1010 Sherbrooke Street West
Suite 600 Suite 300 Suite 600 Suite 602
Ottawa, Ont. Toronto, Ont. Victoria, B.C. Montréal, Que.
K2A 4H6 M2P 2B7 V8W 2B7 H3A 2R7
613-241-7860 416-481-2002 250-220-4100 514-842-2226
cihi.ca
22956-0920

Physicians Canada

Uploaded by

Copyright:

Available Formats

Physicians Canada

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Physicians Canada

Uploaded by

Copyright:

Available Formats

Summary report

Physicians in Canada, 2019

All rights reserved.

For permission or information, please contact CIHI:

Canadian Institute for Health Information

ISBN 978-1-77109-969-1 (PDF)

© 2020 Canadian Institute for Health Information

How to cite this document:

Physician information and COVID-19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Supply, distribution and migration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Physician payments and utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Physician full-time equivalents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Appendix: Text alternatives for figures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

About CIHI’s physician data

Any questions regarding this publication should be directed to

Or visit CIHI online at cihi.ca.

• Physicians in Canada, 2019 (report)

• Nursing in Canada, 2019: A Lens on Supply and Workforce (report)

Feedback and questions are welcome at [email protected].

The proportion of female physicians in Canada is rising, particularly among family

Clinical payments to physicians in Canada reached $28.2 billion in 2018–2019.

The average gross payment per physician reached $347,000 in 2018–2019.

Physician information and COVID-19

Percentage change in physician supply

60,000 • The increase in physician supply in

Physician supply in Canada continues to outpace population growth.

• In 2019, there were 241 physicians

Family medicine Specialists All physicians

The proportion of female physicians increased across all jurisdictions.

The proportion of female physicians is greater among

The proportion of female physicians is higher among younger age groups.

The average age of physicians declined slightly over 5 years.

More than a quarter of physicians in Canada were

50% ranging from 25.7% in 2015

30% • Saskatchewan and Alberta had the

In recent years, more family medicine physicians than

Family medicine Specialists All physicians

More internationally trained physicians received their MD degree

Ireland • In 2019, family medicine physicians

Family medicine Specialists

How much are physicians paid?

Total gross clinical payments to physicians increased to $28.2 billion in 2018–2019.

$15 • In 2018–2019, total clinical

Total gross clinical payments ($ billions) FFS clinical payments ($ billions)

The average gross clinical payment varies across Canada.

Physician full-time equivalents

A full description of the FTE indicator methodologies is provided in the National

Average gross clinical payment per FTE physician includes

$500,000 • The average payment per

Alternative methods of paying physicians include salaries, sessional

Many physicians receive compensation through multiple models,

The proportion of APP clinical payments stabilized between

40% • In 2018–2019, alternative payments

proportion of total clinical

Most physicians receive compensation through multiple models,

60% • In Ontario and Quebec, almost all

Family medicine physicians are more likely to be paid through alternative

90% FFS 50%–90% FFS 50%–90% APP 90% APP

The largest payment program as a proportion of total gross clinical

Figure 2 Number of physicians per 100,000 population, by physician

Figure 6 Percentage of female physicians,

Figure 8 Percentage of physicians with international MD degrees, by jurisdiction,

Figure 9 Percentage of physicians with international MD degrees,

Figure 10 Top 10 countries of MD graduation

Figure 11 Total gross clinical and FFS payments to physicians,

Figure 13 Average gross clinical payments, by physician

Figure 14 Average gross clinical payments, by physician type

Figure 16 FFS and alternative payments as a percentage of total clinical

Figure 17 Distribution of physicians and clinical payments, by payment

Figure 18 Distribution of physicians, by payment type and

Figure 19 FFS services and payments, Canada, 2018–2019

Figure 20 Average cost per service, by physician specialty, Canada, 2018–2019