Issue link: http://clhia.uberflip.com/i/206673
must be supported by federal and provincial stakeholders and it will require resources to ensure successful implementation. Another issue discouraging physicians from entering geriatrics is remuneration practices. The standard fee-for-service billing system financially penalizes geriatricians compared to other specialists because geriatricians tend to take more time with each patient to look at the often multiple issues facing a patient in a more holistic and interdisciplinary way. It is important that compensation for physicians working with seniors be comparable to those working in other disciplines. In addition to the physician shortage, there is a looming nursing shortage, particularly in the geriatric specialty. For example, the number of registered nurses that work within the area of geriatrics/longterm care decreased by 3.5 per cent between 2006 and 2010.29 As a result, as the need for nurses increases, including in long-term care, the pool of available nurses has been on the decline. This has been the result of an aging workforce, poor working conditions and heavy workloads. This serves as a disincentive for the retention of nurses. The nursing profession has also experienced inequities in salary and other working conditions between the hospital sector and the home health care and long-term care sectors. When positions come available in the hospital sector, nurses from home care and long-term care are attracted to move because of compensation disparities, including access to benefits like pensions. This contributes to gaps in continuity of care and reduced morale. 30 Finally, there are a large range of paramedical providers that are needed to provide quality care for our elderly in long-term care. This includes specialists such as physiotherapists, chiropractors, and nutritionists. The demand for physiotherapy and chiropractic services has increased in the recent years. This increase is attributed to the effects of the aging of the population and shorter stays in health institutions, among other factors. These services are important to improve the quality of life of Canadians, including the elderly. As Canada's population continues to age, the demand for these services is expected to further escalate. As such, ensuring appropriate enrollment numbers for these professionals and adequate resources will be important. Recommendations The CLHIA recommends that private delivery of long-term care be encouraged and that governments do not regulate price for private delivery of services. This will act as an incentive to a vibrant private long-term care market in Canada. The CLHIA recommends that providers of care be subject to appropriate regulation and that, in particular, adequate resources are put towards the supervision of longterm care providers from a patient quality of care perspective. 29 Canadian Institute for Health Information. Regulated Nurses: Canadian Trends, 2006 to 2010. January 2012. Registered Nurses' Association of Ontario, http://www.rnaoknowledgedepot.ca/strengthening_nursing/rar_the_nursing_shortage.asp. 30 13