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General manpower stock simulator (GMSS) : simulations of possible numbers of physicians in British Columbia… Muir, G.; Stark, A.J. Jul 31, 1979

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GENERAL MANPOWER STOCK SIMULATOR (GMSS) Simulations of Possible Numbers of Physicians in British Columbia to 1993 Report S:6 Division of Health Services Research and Development Health Sciences Centre University of British Columbia July, 1979 ·--------------------------------------GENERAL MANPOWER STOCK SIMULATOR (GMSS) Simulations of Possible Numbers of Physicians in British Columbia to 1993 Report S:6 Division of Health Services Research and Development Health Sciences Centre University of British Columbia Prepared by: G. Muir, BSc. A.J. Stark, Ph.D. -i-LIST OF FIGURES Figures Page 1 GMSS Conceptual Model 1 - ~-------·---__f ------~Jtf Health Manpo~_r Research Unitjjealth Region~---- __ _? __________ _ LIST OF TABLES Tables 1 2 3 LIST OF GRAPHS Graphs GMSS Projections of Total Numbers of Directory Active Physicians B.C., Years 1979 - 1993 GMSS Projections of Total Numbers of Directory Active General Practitioner Physicians in 8.C., Years 1979 -1993 GMSS Projections of Total Numbers of Directory Active Specialist Physicians in B.C., Years 1979 - 1993 6 7 8 1 Simulation of Directory Active Physicians, Projection (88) 14 2 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (88) 15 3 Simulation of Directory Active Physicians, Projection ( 88ATT) 16 4 Simulation of Directory Active Physicians per 1 ,000,000 Population, P~ojection (88ATT) 17 5 Simulation 1of Directory Active Physicians, Projection (120A) 18 6 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (120A) 19 7 Simulation of Directory Active Physicians, Projection (1208) 20 8 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (1208) 21 -ii-LIST OF GRAPHS cont'd Graphs Page 9 Simulation of Directory Active Physicians, Projection --___ _ug_~l ___ --·--- ---------------- -- 22 ----· _. 10 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (120C) 23 11 Simulation of Directory Active Physicians, Projection (120D) 24 12 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (120D) 25 13 Simulation of Directory Active Physicians, Projection {160A) 26 14 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (160A) 27 15 Simulation of Directory Active Physicians, Projection (1608) 28 16 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (1608) 29 17 Simulation of Directory Active Physicians, Projection ( l 60C) 30 18 Simulation of Directory Active Physicians per 1,000,000 Population Projection (160C) 31 19 Simulation of Directory Active Physicians, Projection (.l 60D) 32 20 Simulation of Directory Active Physicians per 1,000,000 Population, Projection (160D) 33 ·- , -1-INTRODUCTION In these analyses the General Manpower Stock Simulator (GMSS)l has been used to simulate the numbers of physicians in British Columbia to the year 1993. The model employs Markovian transitional probabili-ties condit~onal upon location, age and classification (General Practi-tioner or Specialist) of physicians to age the physician population and to investigate the effe_c_t_ o~rious .J)Olicy options upon the stock of -- --- ----- --p ysicians. GMSS, then, simulated those factors known to influence the stock of physicians in British Columbia over time and it is on this ex-perience and selected policy options that the future stock is projected. METHODOLOGY Using four years of data derived from PHYSFILE 2 , the official roster of the College of Physicians and Surgeons of British Columbia, average annual transitional probabilities of movement to and from each state of the system were calculated. The following conceptual model was used: l 2 8 FIGURE 1 8 8 HMRU 75:8 PHYSFILE is a computer-based file of all physicians licensed in the province of British Columbia since April, 1970 by the College of Physicians and Surgeons of British Columbia. The file is maintained by the Health Manpower Research Unit, University of British Columbia. I .. Regfonal Hospital District.s 1 East Kootenay 2 Central Kootenay 2A kootenay Boundary 3 Okanagan-Simil kameen 4 Columbia-Shuswap\------------~----------------6 North Okanagan · 6 Central Okanagan 1 Thompson-Nicola 8 Carfboo I Squamfsh-Lillooet 10 Fraser-Cheam 11 Central Fraser Valley 12 Dewdney-Alouette 13 Greater Vancouver 14 Sunshine Coast 15 Powell River 16 Mount Waddington 16A Central Coast 17 Skeena-Queen Charlotte 18 Kftimat-Stikine 19 Bulkley-Nechako 20 Fraser-Fort George 21 Peace Rfver-Lfard 22 Stikf ne 23 Capital 24 Cowichan Valley 25 Nanaimo 26 Albernf·Clayoquot 27 Comox-Strathcona \ 22 . , ... \...··,_ ----------------·-·· ·-·--•. I ,..-. .-···' l \ ---~ ' ,. ·' . ' t ./ '·.. \ . vv-? ~ . \,...-_, . . \ Fort Nelaon 21 r· --------------~ "'"" ' \,,)I~ • '• •, D Rault• • •._ \ ~- CTHlt . . ' ) .. . -·-·-·-----(; , .. -.1 I '· -- Terrace : 19 t.. "'• 18 '"'""""•"•"t, • \•'°'""'" \ '-I ) I ~ 17 / ~ I ,,· Vanderhoof .... "I ZO '\ ,.-· .. ,// ' .. , ' N - fr1~ '• f . •. ~{ \ 8 I r CENTRAL~----J --• ,-· .. ¥\,. -· ·-; .··tillooet• / 1 9 ,..: I * ! HMRU HEALTH ~EGIONS BORDER EAST - 1 CENTRAL - 2 HORTH - 3 ISLAND COAST , - 4 I GVRD - 5 CAPITAL I - 6 * Regional Htpftal Dfstrfcts have been arbftrarf 1 grouped by the Health Manpower R earch Unf t fn order to provfde su L!cfent base fo~1nalysis of smaller ,...npower groups. I N I -3-For the purpose of these analyses the stock of physicians was grouped into two classifications, General Practitioners and Specialists; and into six regions '{see Figure 2, page 2) which are amalgamations of the Regional Hospital Districts. This grouping of regions provides sufficient numbers for analyses and protects confidentiality. ----- ------- -- --------------- -------- -- ----- --------- ------------OPTIONS The following ten options were simulated. The options are examples of the potential of the model. They are not intended to be all-inclusive and, in fact, none may be current practice or recommended policy in this province at the present time. Readers may wish to offer additional suggestions for options which might be tested. 1.(88)1 2. ( 88ATT) 3. ( l 20A) a - U.B.C. Medical School enrolment remains at 88 students per year b - Immigration2 remains at 270 physicians per year, present experience c - No increase in the number of post-graduate positions available in B.C. a - As in (88) above b - As in (88) above, but with the addition of an arbitrary attrition3 rate of 15 percent per year for those physicians aged 65 or over. The arbitrary figure of approximately 15 percent maintains the proportion of Directory Active Physicians aged 65 and over at a constant rate throughout the simulation. Use of current trend data tends to increase the proportion of the work force who would be in this age group. c - As in (88) above a - Immigration remains at 270 physicians per year b - U.B.C. Medical School enrolment increases to - 100 in 1979 - 120 in 1980 c - Number of post-graduate positions available increases to - 414 in 1982 - 420 in 1983 - 430 in 1984 1 The bracketed number refers to the title of the simulation. It appears as an identifier in the tables, figures and discussion contained in this report. 2 In this discussion, and in using the model, immigration includes all physicians who became Directory Active in the Province of B.C. in the given study year -whether from other provinces or from other countries. 3 Attrition_ is the loss of practitioners from the system, i.e. those physicians who : emigrate or become inactive. -4-4.(160A) a - Immigration remains at 270 physicians per year b - U.B.C. Medical - l 00 in 1979 - 120 in 1980 -~tt-J--.t.~t- l 981 School Enrolment incteases to ----------c - Number of post-graduate positions available increases to - 414 in 1982 - 420 in 1983 - 430 in 1984 - 450 in 1985 5. (1208) a - Immigration increases 3 physicians per year to 290 (.to account for B.C. Graduates returning to B.C. -- assumes that 75% of graduates who leave will return) 6.(.1608) b - U.8.C. Medical School Enrolment increases as in (120A) c - Number of post-graduate positions available increases as in (120A) a - Immigration increases 4 physicians per year to 311 (to account for 8.C. Graduates returning to 8.C.) ~ b - U.8.C. Medical School Enrolment increases as in (160A) c - Number of post-graduate positions available increases as in (160A) 7.(120C) a - Immigration increases as in (1208) b - U.8.C. Medical School Enrolment increases as in Cl20A) c - Number of post-graduate positions available increases as in (120A) d - Attrition decreases by 2% per year until decrease of 20% in the current attrition rate has occurred 8. (l 60C) a - Immigration increases as in projection (1608) b - U.8.C. Medical School Enrolment increases as in (160A) c - Number of post-graduate positions available increases as in (l60A) d - Attrition decreases as in (120C} I -. -5-9.(120D) a - Immigration increases as in {_1208) b - U.B.C. Medical School Enrolment increases as in (120A) c - Number of post-graduate positions remains constant as in {88) 10 . ('IOOIJ) a - mmigra ion increases as in (1608) b U.B.C. Medical School Enrolment increases as in (160A) c - Number of post-graduate positions remains constant as in (88) RESULTS OF SIMULATIONS Tables 1, 2, and 3, pages 6, 7, & 8 provide a summary of the data generated in the aforementioned simulations. Column labels are as in the Options Section and the body of the table describes total numbers of physi-cians by year. It should be noted that years through 1978 are real data, not simulations. The variables used in the model are described following the tables. INPUT DATA TO GMSS Bl* - Population Data - Population projections used in this model were obtained from 11 British Columbia Population Estimates, 1974 - 1996 11 (B.C. Research). The years between 1981 and 1986, and between 1986 and 1993 are linear projections from these base years. It should be noted that regional populations based on the 1976 census were not available at the time this report was completed. There may then be variations in the population data when more recent information becomes available. Cl - Attrition from Training Program - The attrition rate of 68.7% C8-C37 is inflated due to the fact that a large proportion of the U.B.C. Medical School graduates complete their internship and/or post-graduate work outside British Columbia and then return to this province. For purposes of the model, these persons on return are considered to be immigrant. - Medical School Enrolment - This indicates the number expected to be accepted into the U.B.C. Medical School for each of the projected years. * Bl, C7, etc. are the actual variable names used in the GMSS simulations. ~-----6-Table 1: GMSS Projections of Total Numbers of Directory Active Physicians 8.C., Years 1979 - 1993 -1------ - f- - --- - ·-- ·- --·-----·--- --- -- Pro;!eet1 on-- -- -- ----------Year (88)* (88ATI) (l 2DA) (160A) (1208) (1608) (l 20C) (l 60C). (1200) 1975** 4, 116 4, 116 4, 116 4, 116 4, 116 4, 116 4, 116 4, 116 4, 116 1976** 4,276 4,276 4,276 4,276 4,276 4,276 4,276 4,276 4,276 1977** 4,470 4,470 4,470 4,470 4,470 4,470 4,470 4,470 4,470 1978** 4,639 4,639 4,639 4,639 4,639 4,639 4,639 4,639 4,639 1979 4,817 4,787 4,817 4,817 4,821 4,821 4,823 4,825 4,821 1980 4,955 4,896 4,955 4,955 4,963 4,967 4,976 4,982 4,963 1981 5, 104 5,015 5, 104 5, 104 5, 117 5, 124 5, 145 5,154 5, 117 1982 5,251 5, 133 5,251 5,251 5,275 5,283 5,316 5,332 5,275 1983 5,390 5,244 5,390 5,390 5,425 5,437 5,487 5,505 5,425 1984 5,525 5,350 5,528 5,528 5,579 5,595 5,666 5,687 5,576 1985 5,652 5,447 5,661 5,661 5,729 5,754 5,848 5,874 5,721 1986 5,771 5,539 5,785 5,790 5,866 5,904 6,020 6,063 5,856 1987 5,883 5,625 5,903 5,911 5,994 6,051 6,193 6,254 5,977 1988 5,992 5,709 6,017 6,034 6, 119 6,202 6,370 6,451 6,099 1989 6,095 5,785 6, 128 6,150 6,245 6,344 6,533 6,641 6,221 1990 6,197 5,859 6,233 6,261 6,362 6,480 6,693 6,821 6,332 1991 6,293 5,930 6,333 6,363 6,475 6,609 6,845 6,989 6,441 1992 6,386 5,998 6,430 6,466 6,580 6,738 6,998 7, 157 6,544 1993 6,471 6,058 6,519 6,559 6,679 6,860 7, 136 7,315 6,643 * Refer to oaqes 3,4, & 5 for definition of options included in each projection. ** Historical data for the years 1975 - 1978 reflects real experience and therefore does not change across projections. ----(1600) 4, 116 4,276 4,470 4,639 4,821 4,967 5,124 5,283 5,437 5,592 5,745 5,885 6,022 6, 163 6,293 6,421 6,545 6,665 6,774 t-i T -7-Table 2: GMSS Pro~ections of Total Numbers of Directory Active General Practitioner Physicians in B.C., Years 19 9 - 1993 Projection Year (BB)* (88P.TT) (120A) ( ~~OA \ . l1201U~ 11 i:nn) "-- . . h ?nr \ f1 i:nr \ f1 ?nn' _ t•i:nll}-. _ f-1975** 2122 2122 2122 2122 2122 2122 2122 2122 2122 2122 1976** 2170 2110 2170 2170 2170 2170 2170 2170 2170 2170 1977** 2246 2246 2246 2246 2246 2246 2246 2246 2246 2246 19784'* 2294 2294 2294 2294 2294 2294 2294 2294 2294 2294 ' ' 1979 2309 2295 2309 2309 . 2312 2312 2313 2315 2312 2312 1980 2322 2297 2322 2322 2329 2329 2334 2338 2329 2329 . 1981 2333 2296 2333 2333 2343 2344 2354 2361 2343 2344 * ** 1982 2344 2296 2344 2344 2362 2364 2382 2391 2362 2364 1983 2358 2301 2358 2358 2384 2389 2416 2425 2384 2389 1984 2375 2309 2377 2377 2411 2420 2455 2466 2409 2418 1985 2388 2312 2394 2394 2434 2448 2492 2507 2430 2444 1986 2399 2316 2407 2410 2452 2474 2527 2552 2446 2464 1987 2408 2319 2418 2424 2467 2502 2566 2600 2459 2486 1988 2419 2323 2430 2441 2484 2532 2605 2653 2475 2512 1989 2429 2327 2444 2457 2504 2559 2640 2701 2493 2535 1990 2438 2329 2454 2469 2519 2586 2674 2744 2506 2558 1991 1992 1993 2449 2334 2466 2481 2534 2608 2703 2780 2520 2580 2457 2338 2475 2492 2546 2631 2734 2817 2531 2599 2464 2340 2483 2502 2559 2654 2761 2853 2543 2616 Refer to pages 3,4, & 5 for definition of options included in each projection. Historical data for the years 1975 - 1978 refi\ects real exper1ence-aricf:therefoee··does -- not ~chanqe across projections. --8-Table 3: GMSS Pro~ections of Total Numbers of Directory Active Specialist Physicians fn B.C., Years 1979 - 1 93 -. ~ ·------- -·- ----·----- ---·---- .. Prie;leet~eil --------· --- .. - ----- ---- - --- - __ ______,..._ -Year (88)* (88ATT) (120A) (160A) (1208) (1608) (120C) (160C) (1200) (1600) 1975** 1994 1994 1994 1994 1994 1994 1994 1994 1994 1994 1976** 2106 2106 2106 2106 2106 2106 2106 2106 2106 2106 1977** 2224 2224 2224 2224 2224 2224 2224 2224 2224 2224 1978** 2345 2345 2345 2345 2345 2345 2345 2345 2345 2345 1979 2508 2492 2508 2508 2509 2509 2510 2510 2509 2509 1980 2633 2599 2633 2633 2634 2638 2642 2644 2634 2638 1981 2771 2719 2771 2771 2774 2780 2791 2793 2774 2780 1982 2907 2837 2907 2907 2913 2919 2934 2941 2913 2919 1983 3032 2943 3032 3032 3041 3048 3071 3080 3041 3048 1984 3150 3041 .3151 3151 3168 3175 3211 3221 3167 3174 1985 3264 3135 3267 3267 3295 3306 3356 3367 3291 3301 1986 3372 3223 3378 3380 3414 3430 3493 3511 3410 3421 1987 3475 3306 3485 3487 3527 3549 3627 3654 3518 3536 1988 3573 3386 3587 3593 3635 3670 3765 3798 3624 3651 1989 3666 3458 3684 3693 3741 3785 3893 3940 3728 3758 1990 3759 3530 3779 3792 3843 3894 4019 4077 3826 3863 1991 3844 3596 3867 3882 3941 4001 4142 4209 3921 3965 1992 3929 3660 3955 3974 4034 4107 4264 4340 4013 4066 1993 4007 3718 4036 4057 4120 4206 4375 4462 4100 4158 * Refer to pages 3,4, & 5 for definition of options included in each projection. ** Historical data for the years 1975 - 1978 reflects real experience and therefore does not change across projeetions. C50 -9-Distribution of Graduates - This indicates that all U.B.C. Medical School graduates who remain after the attrition rate {C7) has been applied become post-graduate students. This total includes those in internships. C300 Distribution of U.B.C. Medical School Graduates becomingPost-=---------~gur;;g;a:!.t!cH&tt.t$j;;e-~~s - - This indicates that 825 of each 1 ,ooo graowf+.t~es-----­becom1ng post-graduate are in internships of one year and 175 of each 1,000 graduates are entering specialist training. C350 C401 Age Distribution of Medical School Graduates - This gives the model the age distribution of medical school graduates by class-ification of study program. {General Practitioner or Specialist). C501 Historical Data - This gives the model historical data for the years 1975 through 1978. These data are not used in projections but are included in the summary tables as they reflect actual past experience. Dl DlOO Dl02 D20l D260 D300 Directory Active Physicians - This supplies to GMSS the present number of Directory~ctive Physicians by specialty {General Practitioner/Specialist) by age group by region. Annual Immigration into Director* Active Physicians - This vari-able includes in the study all p ysicians entering British Columbia. These may be U.B.C. Medical School graduates who leave the province and then return to British Columbia. Distribution of Immigrant Physicians in Number per 1,000 Directory Active Physicians - This variable distributes the number of immigrant physicians specified in DlOO by age group by region of destination by specialty, based on past experience. Re~ional Transitions in Number per 1,000 Directory Active Physicians -This variable gives the rate of intra-provincial migration by specialty {General Practitioner/Specialist) of Directory Active Physicians. Classification Transitions in Number per 1,000 Directory Active Physicians - These data give the model the rate of transition between General Practice classification and Specialty classi-fication by region. Index of Attrition - This variable allows the research to in-dicate whether the data given in D301 will change during the simulation and how it will change. {e.g., decrease the attri-tion rate during the simulation). -10-D301 Present Attrition Rate of Directory Active Physicians - These data give the present attrition rate of Directory Active Physi-cians by age by region by classification {General Practitioner/ Specialist). D500 - Index of Transition to Post-graduate Education - This variable allows the researcher to indicate how the data given :i--1-1-n--!Dn.S~O+l----­will change during the simulation. D501 Present Rate of Transition to Post-graduate Education - The current rate per l,000 Directory Active Physicians of transi-tion from Directory Active to Port-graduate education is read. D531 Distribution of New Post-graduates - This is the distribution of Directory Active Physicians going to Post-graduate education by present classification by classification of study program and by year of study. D560 - Distribution of New Post-graduates - This is the distribution of Directory Active Physicians going to Post-graduate education by region of origin by location {region) of Post-graduate school Greater Vancouver Regional District (G.V.R.D.) is the only region* offering Post-graduate education and therefore all practitioners in this category will show in this region. D700 - Historical Data on Directory Active Physicians - These data are used in the graphs (Appendix A) to show the real experience for the years 1975 through 1978. They are not used in simulation. Fl Number of Years of Post-graduate Training - This variable sets the length of Post-graduate educational programs at a maximum of five yea rs. F2 Present Number of Post-graduate Physicians ~ .This is the present number of Post-graduates in the training program by classification of study {General Practitioner/Specialist) by year of study and region. As previously noted all Post-graduates are shown in the G.V.R.D.; the 88 practitioners in first year of General Practitioner classification are interns. The 12 practitioners in the second year of the General Practitioner classification are those in the second year of the Family Practice Program - the number of physicians in the five years of the Specialty classification is shown by year of training towards Specialty certification. F201 Regional Transitions in Number per 1 ,000 Post-graduate Physicians -There are no regional transitions. * The small number of Interns located in Capital Region will not affect the projections. -11-F301 Classification Transition in Number per 1,000 per Post-graduate Physicians - These data indicate that all practitioners in the Post-graduate program in the General Practice classification remain in that classification as do those in the Specialty classification. F400 Index of .Aftr:rtion - This variable indicates to the model that attrition data given in F401 will not change during the simula-tion. F401 Present Attrition Rate of Post-graduates - Present rate of attrition from the Post-graduate education programs by classifica-tion by year of study is shown. F500 - Index of Transition to Directory Active Physician ;- This vari-able indicates to the model that the rate of transition given in D501 will not change during the simulation. F501 Present Rate of Transition to Directory Active Physician -The~e data are the current rate of transition to Directory Active Physician by classification by year of study. The rate is in number per 1 ,000 Post-graduate Physicians. The rate is applied after the anticipated attrition has been calculated and removed. As previously noted, in this model the only way that physicians who have finished their Post-graduate education may return to the Directory Active group is through this variable. It is for this reason that the rate in the final year of training in each classification is 100% allowing all practitioners entry into the Directory Active Group. F551 F575 -F700 -Distribution of Post-~raduates becoming Directory Active Physicians -These data indicate tat all practitimners returning to the Diredtory Active group before completing five years of Post-graduate education will return in the General Practitioner classification. Those who return after the fifth year of Post-graduate training return to the Active group in the Specialty classification. Distribution of Post-graduates becoming Directory Active Physicians -These data indicate to which region the practitioners moving from Post-graduate to Directory Activ.e return. This distribution is shown as number per 1,000 Post-graduates returning to the Active group. Age Distribution of Graduates by Classification - These data indicate the age distribution in number per 1,000 Post-graduate physicians returninq to the Directory Active group by classification (General Practitioner/Specialist). -· -12-F800 - Projected Number of Post-graduate Positions Available - These data are the number of Post-graduate training positions which will be available for each projection year by classification and region. F850 - Number of Excess Post- raduate Positions filled b Immi rant ys1c1ans - - s s e num e o os -g available once those which will be filled from within the system (province) are taken. It assumes that the remainder will be filled by immigrant physicians. The anticipated number of positions which will be filled from within the system either by the last year's U.B.C. Medical School graduates or by move-ment to and from the Directory Active Physicians (B.C.) is determined. The number of excess positions is then determined by comparing this figure to the number of physicians available as given in variable F800. Variable F850 is the number per 1,000 excess positions which will be filled by immigrants. F875 - Distribution of Excess Positions filled by Inmigrants - These data determine the distribution of immigrant physicians filling excess Post-graduate positions by year of training by region by classification of study. The data are shown in number per 1,000 excess positions. F900 - Historical Data on Post-graduate Education - These data are the number of Post-graduates by classification by region by historical year 0975 through 1978). They are not used in the simulation but may be helpful in identifying trends in the projections. In summary, the preceding information has been included for explana-tion of the data. The actual analyses produced are not included in this technical report but Tables l, 2, and 3, pages 6, 7, & B, show the pro-jected total number of physicians in British Columbia arising from the use of this model when the aforementioned variables and options are used. The summary graphs arising from each projection are included com-mencing on page 14. In each case, the first graph (1) displays the actual number of physicians and the second (2) the number of physicians per million population. The graphs by region are of interest both for projected total number of physicians per one million population (T) and for the displayed relationships of number of General Practitioners (G) to Specialists (S) over time. It is noted for example (Graph 88/1) that us1ng projection (88) it is anticipated that in Border East Region there will be, by 1987 virtually equal numbers of General Practitioners and Specialists (approximately 800 of each per l million population (Graph 88/2). A-(ter this time the number of Special-ists in this region is projected to exceed the number of General Practitioners although total number (T) appears to level at approximately 1,600 per l mil.lion ·population. -13-' Alternately, in the region labeled North, using projection (88), the number of General Practitioners continues to exceed the number of Special-ists, with Specialists projected at approximately 300 per l million population and General Practitioners showing a decrease from approximately 600 per million persons in 1979 to approximately 425 per million in 1990. Total number of physicians reflects these projections. The difficulties in obtaining accurate population projections have already been mentioned. ~~ It should be reiterated that these projections reflect only past experience and the options included in the model. The reader is encouraged to examine the output from each simulation together with the included options (pages 3 - 5). Finally, these simulations should not be used to project actual numbers of physicians in B.C., but rather to examine the effect various options have on the physician stock in the province. For example, if, as in projection (88ATT), the anticipated 15 percent attrition per year of physicians aged 65 years and over actually occurs, there will be five percent fewer Directory Active physicians in B.C. in 1989 than if all present cond-itions (88) pertain. * 6,095 - 5,785 x 100 6,095 Border East . ~ ~ ~ - - - - ~ ~ -.... ............ ..... 1 ••••••••• 1 ••••••• •• 1 ............................................................ . &•n I ·-· • T . ' •• I 8 ·-· . ' •• ' ' I . T .. T I. 8 I ' ·-· 0 I ' • • T '"'' • • T Island Coast 0 M LID lH 1tO HO HO HI ... 4H Ml •·········•·········•·········•·········•·········•·········•·········•·········•·········•·········• HHI ·-· ..... ·-· 1"1 I ' • Simulation of Directory Active Physicians Projection l!HU_ Central . " - - ~ ~ - - - - -•··········································'······························-·············· Hll I I ·-· I I l•M I I I • . I • I I • ·-· I • I • . I •• 1•H I •• G.V.R.D. 0 ... HO UOO l~O HOO HH ,... NII MM tODi 1 ••••••••• 1 ••••••••• 1 ••••••••••••••••••• 1 ••••••••••••••••••••••••••••••••••••••••••••••••• •••••••••• 1 lt11 I ·-· ltH I ·-· ..... Total • rM lSOO llH hOCI IHI •HO HM 60M •n• nee 1 ••••••••• 1 •••••••••••••••••• • 1 ••••••••• 1 •••••••••••••••••••••••••••••••••••••••••••• - ••••••••••••• 1 HHI .. .. •tel I a I •tet I ·-· ~ North . . - t ~ - - ~ - ~ -• ••••••••• •• ••••••••••• ••••• 1 . ....................... . ...... 1-............... __ ••••••• - ••• •• _ ........ . a•n 1 ' • ' I I 5 Y I • •• i I t 1, ·-· i• .. &•t I I • I I ·-· ..... Capital • ,.. 191 ... ... ... ... ,. - ... ·-•••••••••••••••••••• 1 • •••••• .., •••••••••• 1.-•• - •• 1 ........ _ . .............. --·······-·····---·· l•H I S I T •••I , ... I , .. , I . .... ·. t . ~I . . t. · .. ' i ·: ' . I • I ' . I G = G.P. s Specialist T Total __, ~ I '' .. ,.1 I Simulation of Directory Active Physicians per 1,000,000 Population Projection ~ Border East . - - - - ~ -·- ~ - -..................................................................................................... '"'I ·-· I G ' t•t I I & . .. ' ..... •• . G I ' & I . '"'' Island Coast • ua tOll ~H .oa na U.J ··~ UDD IHU ..... o ................................................... 1 ••••••••• 1 ••••••••• 1 ••••••••••••••••••••••••••••• 1 ltH I ·-· IHI I IMO I '"'' Central . ~ - - - - - - ~ ~ ~ • .... . ..... .. .............. . . . ........... . . .................. 1 ......... ................. _ •••••••••••••• t•H I '"'' I . ' I I . . I I . ' ..... I • ' I • • I . ' •• ' I I . . IMO I I G ' I .. I •• '"'' .. ' G.V.R.D. • no "OO HO 111'10 11'10 noo Uta HOO IHO noo 1 ••••••••• 1 ••••••••••••••••••• 1 ••••••••• 1 ••••••••••••••••••• 1 ••••••••• 1 •••••••• • 1 ••••••••• 1 •••••••• ~ 1 1ort I .... , ·-· ·-· , .. ,, Total • .00 000 1100 UDO JDOO 1400 1100 Hno IWIO .... ........... 1 ••••••••• 1 .......... 1 ••••••••••••••••••• 1 •••••••••••••••••••••••••• • •••••••••••••••••••••• 1 un I ·-· ..... ·-· .. •• O I G I • ... ,.. 1... _ ~rth _ ... _ _ •• ............................. l ... 1 ................................ 1 ................ - •• 1 •••• _ •••••••• •• _ • 1•n I ·-· I I • I 1:· . .... r I I I I I ·-· , .. ,, Capital ~ ....... ~: ....... ~ ... ... ,!~ ...... !~~---... !~-----·~------!~ ...... !~ ...... !~.---·~ ans I 1•0 I ..... ·-· .... , G I I • I I • i • I : I • I • I I I G = G.P. s Specialist T = Total __, CJ1 I "' c "' ..... u ..... "' .c 0... cu > ~ ..... ...... u CXl c:c CXl s.. c 0 0 ...... ..... u ...... cu u s.. cu ..... c 0 s.. ...... 0... 0 c 0 ..... ...... "' ..... :::J e ..... Vl q =1 :i ';;; s.. . ...... c cu ~~ u :l . ·- -:1 . t: n "' LL.Is.. cu -0 s.. 0 :a a.! ; 1 ~ ~ i !j UI H II '" U " u u " u - - - - -l . .. £1 ~1 e.! -•-= ~ 1 :1 ~ i ge: c ~1-:-: ~ 2 ! C!I ;1 !"i ~ . . . . . . . -~~du .. " u u cu~ u u" u u" u u c i1 !1 . ..: - - - - - - - - - - - - - - - -~ 1 !1 i1 ...... !1 ~ ~L 0 u I : ..... -0 c "' "' -:r r ·- -n ~ i ll .. :;-; ....I:~ . "' . : ...... : 0 : I- 8.; ~ ! 51 ~1 a.! --16-...... "' ..... ..... "' ..... ,.... u "' 0... cu ...... c.. 0 C!I Vl I-II II C!I Vl I-' • ·'! Simulation of Directory Active Physicians per 1,000,000 Population Projection (88ATT) Border East • 100 '11"5 •10 IG.l lttG'J U'i' 1'1101 U..MI ti.JO 1 11 .J.I 1 • •• •••••••••••••••• 1 • •••••••• 1 . . ..... ...................... 1 •••••••• • 1 ...... . ..... ........... ...... 1 I•" I ..... l•H I , ... I '"'' ' . • < .. • s . . 's Island Coast . ~ - - - ~ - - ~ ~ ~ ····················•·········•·········•·········•·····························t---················· 1a11 I ·-· I ..... att1 I nu I s. s • •• Central 0 1"111 ta~ 'll'IG t.llO f"l>J •oa l"''I U.l:J II"" 1"1 ... 1 •••• •••• • • • •••••••••••••••••• 1 ••••••••••••••••••• 1 ••••••••••••••••• ••••••• ••••••••• • ••••• 1 •••••••••• UH I noto I IU~ I .... . , ... ,, . . s • • • .. .. s. " G.V.R.D. • ,.. """ nn IQOlt IUD noa 11'1 ,,,n 11''M l'lOI ...................................................................................................... 1cn I ,_, ,_, ·-· • .. , I Total • •a •oo UQO HOO ian l\~ l'"' .,Z)ll U.20 •3.W ..................................................................................................... t•n I ·-· t•H I ·-· .. .. • s . . • s North a ta .-. rk111 .aa--= .- ••• ... ._ IA ... :·········· ··············r ··········-·--···"·····-··-·····"-·-············"········· ·-· ..... ·-· ... ,, I I I I . I "40 'UGI I 16CO laOI ,..._ ,901 .i.- MOI WllM t Capital ............................... ·········•·········•······-·•···················•·········•······  1•n I ~ I f I I I s • s l•M I 1: ••HI ·-· ,. . '"'I r G G.P. s Specialist T = Total ....... ........ I -. "' c "' u ..... "' .c 0... Cl.I > ..... ...... u ~ s.. 0 ...... u Cl.I s.. ..... q '+-0 c 0 ..... ...... "' ...... ::s 5 .... V1 ~ i ii ..... "' s.. ...... c Cl.I u ...... "' "' I.LI s.. Cl.I "C s.. 0 CCI . . . .. .... " ........ ..... -J ~ ·----~---------,,. 11 .,.:. - - - - - -:1 !1 ·-!1 :i -· " .. . , :1 . 11 i1 ·- -~ £ 11 '1 -18-a1 !1 :~ :L .,.. . : "' : u ti ...... "' ';;; ..... ..... a: u ,:g Cl.I c. 0 C.!l Vl I-~ -,.I- ~~----~-~-----------·-, 1- . --- ______ t2_~--'='----- -! .. l1 !1 .. .: -!1 i1 ~1 !1 ? c il -~ ~1 C.!l :j: i1 jl .,.: - - - - - -. ! ~1 --: 1 =1 rt ...... !i "' -"' 0 u ·-" c "' ...... ~1 VI . !1 !i . ·-·- - - - - - -. ! ... !1 r! ~i ~1 ~1 · :1-0 :: I- . 1 :1-.-!1 !1 .,.: - - - - - -Border East " Z..U •lhl •<o111 -.i,;, l.t.N Ul.I ""l"JJ l•.t" IUll lJ"J 1 ....................................... 1 ••••••• • • •••••••••••••••••••••••• •••• • • •• •••••• •••• •••• •••• 1 UH I ltM I ' I ' I ' I .. ..... ' ' I .. . . .. I ·-· .. I ' . I IHJ I Island Coast • m - - - ~ - ~ ~ 1m -1 . .......... ............................ 1 ••• •• •••• 1..................... ........ 1 ................... . ltltl &Me I Hiii ·-· '"l I ., ~ •'[ i Simulation of Directory Active Physicians per 1,000,000 Population Projection (120A) I Central I North : ....... !~ ......... !~ .......... 1: ......... :::t ........ ~~-······~-······!~ ........ ~ ........ ~ .... _~ l•H I '- 5 I I G I I . - ~ - - - - - ·~ ·- -1 .............................. 1 ....... ............. 1 ••••••••• 1 ••••••••• 1 ••••••••• 1 ••••••••• 1 .......... 1 • .,, I I ' ..... ·-· I I I .... ' ·-· I . ' ·-· . ' ·-· I . 'I " . ., ... . .... G.V.R.D. Capital " no WW l1olil '""'" Jl,0 l'!llJol I IW 1.Hhf UM IW. • ••••••••••••••••••• 1 ••••••••• 1 ................. . ...... ........ 1 .......... 1 •••••••• • 1 ••••••••• 1 •••••••••• t. ....... ::: ....... :: ...... !!fi ...... ~~ ...... :-::: ........ !:t ...... !~ ........ !!~ ....... ~ ...... = 11111 I 111rt t ~ I " 1 ·-· ·-· HH I ·-· I : ·-· ·-· &HSI .... ). Total I WQ •Jtl llU.111 IWo1 .!1hU l•.J.J IC.Joi II.Joi U.o1.1 • .I.I.I ...................... 1 ••••• •• • • 1 .......... 1 ................................. 1 • •••• • •• • 1 . .. ....... 1 ........... . 1 1'9HI UCUI .. I .. I G = G.P. I __, S = Specialist 1110. . ' I U) j T = Total I . I . . I I l'f'fUI Border East . - - - - - - - ·- ·- -................................................... ......................................... 1 .... . ..... . l~hl ltlHI ,._,I ..... '. '. \HJ I Island Coast o H - ~ - - - ~ - - -l•••••••••l•••••••••l•••••••••loo•o•••"oloo•oooo oolo•••••••••••••••ooolooouoooolooooooo•olooooooooo l 1tH I ·-· 1Nt I ,_, "'' . ' " Simulation of Directory Active Physicians Projection (1208) Central • • • • - - - ~ - m -1............................ ... 1 .............................. 1 .......... 1 •••• •••• • 1 •••••••••••••••••••• .. ,,. &HG I ..... I . . . ' I • ' . &•'N I . ' I '. I• UH I G.V.R.D. II ,..,... otJW IJ.,hJ IW.t '"""' l•..1..1 l•,i,,, """ fW"' '""'"'" ·················•·········•·· ······•·········•·················································· l'#O I lo t. I 1'1140 I &tn I ,,._.,, IHI I Total .i Ou ,._,,,, .r.!'H• ,:..,11 ''""' .:...., ,,.,., .. ~., .nv n...i 1 .................................... ...... . .... . .... 1 .................................. . ............. .. ..... 1 &•I> I l•11t1 I .... ". 1no1 ,, . . , •j ' North i ......... ~t ........ ::: .... ····Ii ........ ~: ......... ~!"': ........ !:": ..... ..... !!~ ........... ~~ ...... -.!!: ........ _ .. ~ HH1 I i. CO I _: ~ l . . 1·. ·-· 1 · I ·-· lft&I • ... '"' t w. Cap~~al ... ... ... ..... • ... 1 ............................................................................................................... . lHS I • ' I I ., ' I .. . ' l'IW I 5 l'HS I &•'N I ...... G = G.P. s Specialist T Total I N 0 I - --....------- -c 0 ..... .... "' .-;:J 0 a.. 0 8 . 0 0 0 ..... I-Q.I Ill c "' ..... u _. Ill -C a.. CIJ > ..... .... u Cl: I-0 .... u Q.I I-..... c <+-0 c 0 ..... .... "' .-;:J E ..... VI ~ ~ .... Ill "' LL.I I-CU -a l-o al r~ --;~ ~1 :l: ~ ~ 31 • .! :J -.. .. ... j1 11 11 !1 ~~- :r "' j~ ~ -1 l~ • a.. ~ -21-.... Ill ..... .-"' ..... .-u "' CIJ .... Cl. 0 Vl ...... Vl ...... T --------------- ---------- ------- ------.... Ill "' 0 u -a c "' .-"' ~1 :L _ ---i !1 ~i ~ ~ ~1 ~1 ~i . !1 :1 . :1 ~ ! .. ~ -~I . . . !1 ;~ ~ ~ ~ i ~1 21 ~1 t il . .: :J Border East " 1;11 '""' "'Jo" wu '~" 'IJ.i 1.1 ·.11 llau lt'I.. 1-..14.I 1 ••••••••• 1 ••••••••••• •• ••••• • ••••••••••••••••••••• • ••••• • ••• • •••••••• 1 ••••••••••••••••••••••••••••• 1 01111 &tu I . . ,.,.,I ' . ..... . . '""I Island Coast 11 1111 U" 1•11 l•U t.IJ U,., ""' "tJ 'lo \" • o11 loooooooooloooooo o ool oooooo o oo l o ••••••••lonooo oool o oooooo oo l oooo oooooloo•• • •• oo l o o••n•••I•••• • ••••• ,,.,, I ..... INS I ........ , ...... " Simulation of Directory Active Physicians Projection (120C) Central Q tol "'°' .. II &111 IW llol UU '"'" Uu 1o.H 1 .... . . . ... . .................. 1 ••••••••• 1 ...... .... . . . ...... 1 •••••• • •• 1 ........................ . .... . '"''' .... UH I . ..... '"'' G.V.R.D. o1 ""°' •.w U.111 tw.a l.J~ h.1.1 l•.111 Ull• U.1u '°""' ·········•········'1} ·················································•·········•···················· "'°"I at•.J I l't•t I n~ I ... 01 Total ol hol hJ.1 11 .. 11 J w.,t4 JO.I •\.lot ,, .. _, t.v.• t.l'loot l'loiJ• .............................................................................................................. ... ,, .. 1"99 I l'l•!tl I I ,..,.,, . . . . . . . . . I . I . ~ 1 North :. ....... :t ........ ~---···-~t-·····-~·-·····'.-:t ....... '.:: ....... '.~ ....... :'.'; ....... !:: ....... -::t l•rto I ~ 1 5 I I ·-· ... ,. ·-· ... ,. Capital i ....... !~ ....... !:': ....... 1 ......... ~ ......... -:-:: ....... ~ ....... !:: ........ ~~------·~----·-~~. IHt I G a I I IO• I I • . . . 1•u I iO hit I ·-· , ... I ~ I• 1. I • 1 · I I G = G.P. S = Specialist I N T = Total N I ~ ~ Simulation of Directory Active Physicians per 1,000,000 Population Projection (120C) Border East o1 IW.J ..W aoltol ...... I.IV.I II.I" "'""" . .. .,.,. ...... /,J.,1,. loo•ooooooloo•oo••••l••••••••oloooooooulo o • • o•ooolooOOo • ooolooo •ooooolooooo•oooloooooooooloooooooool ... ,,. ·-· ·-· I • • • ·-· . ' ...... Island Coast • '°° wie ... •• llHHI UIW hChl IMMI uoa lQQQ ........................................................ - •• 1 •••••••••••••••••••••••••••••••••••••••• HH I ·-· I ·-· ·-· '"'' Central ol .,.. loN ...... ...,,, ,,_, IU l.i... l/ol.. 11~ l'hool ····················•······ •·········•·······•·········•······································· , .. ,,,, , ... ,, , ... .,I l'l'U I . . . . . . G.V.R.D. II 4"10 ...W I'll 1 ... 11 UW l'),W I t\11 111~11 111'0 11'0 .. .. ........•.........•.........•.........•.............................•.........•.........•.........• HHI ·-· 1111 I ·-· , ..... Total <I "''" •'" l/wol 1•111 , .. ,,, ,.,,. ''""' Ull.1 l•ll.1 .,,. 1 ••••••••••••••••••••••••••••••••••••••••••••••••• 1 •••••••••••••••••••••••••••••••••••••••••••••••••• "''' ....... I . . I , .. , I . . I I . . I I . ' I ....... , North . - - ~ - - - - - - -lo••••••o•l••o••••o•l••••••o••i•••o•••••lo••o•••ooloooo.roo oot • • • •• o•ooloo•oo•••otooooooooo l oo•oooooo • '"' ... ·-· &•t I ·:1 . ·-· ...... : I · 1 Capital : .••..•• ~ ••...•. ~ ••.••• !!:1. ..... !~ ...... !-::t .••••. !:t ...... !::i ...... :!":i ....... !~ ...... :::-r 19" I ·-· I•• I ·-· lffl I . . .. ,I I I • • . G = G.P. S = Specialist I N T = Total w I Border East .. o.. .....,, <o'UI Wol ·~.. ., ,,,,. IJ'>" ,,,.... 1nu ..... ... ·········•········•·········•·········•·········•··· ············•·········•·········•········· un 1 1 .. 0 I ... ,, ·-· ...... . .. . . •• ... .. .. . . Island Coast 11 W Ill II• 1•• IN IW "''" ... ,, "°' ... ., •············································•·······················• ················ '"' I .. ·-· "'"' IH• I ....... .. Simulation of Directory Active Physicians Projection (1200) Central _. 1J W •II Ur.I lW IW 'IU '"'" llu l.U ··················•·········•···············································•···················· • .,, I ....... ·-· . . ... ,,, . ' IMl I G.V.R.D. 111 Wll llu.I 11.u I Wot I~ '"°"' II# llol" ....,.., ..OJiU l•••••••·•l•••••••••••••••••••l•••••••••l••·••••••l•••••••••l••··•••••l•••••••••l••••-•••l•••··•••·I Uh I ..... ,,.,, ...... , ,..,. , Total • 1~11 I~~;, ll~" JCW., JI~" <o'Uol ~IW • .,,_,,, •IW lw.i 1 ••••••••• 1 ••••••••••••••••••••••••••••• 1 ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 1 no 1 .. 1'110 I .... ,. . . • I . . ' ' . . ' l'nol I .~1 I North 1 ........ ~ ......... :i ........ i ....... !!~ ....... !'!1 ••••..• !:: ....... !!: ....... !:i' ....... !!i ........ ~ 1•n I ' I ~ ' I ' ! ·-· • .. , I ·-· ...... I I , , Capital ..... , .. 1· ........ ~ ....... -·-. .... . ........... ........... ......... . . . .. . ................... .......... . ............ -...... . ,.,,., :0 .. • ' " ' . I ; I G ·-· IMI I ·-· ..... . . ' . . · 1 ·I"· ' 1• I i I • I I I G = G.P. S = Specialist I N ~ T = Total I .. ~ ,, . ' Simulation of Directory Active Physicians per 1,000,000Population Projection (1200) Border East Central 11 l.fO "'""" •·hi IWol l.U.1 &U" U.hl • • .,, .. ,...., lJ.111 1 ••••• • ••• 1 ••••• ••• • • • • • •••••••••••• • ••• 1 ••• ••••• • •••••••• •••••••••••••••• • ••• • ••• • • ••• • •••• •• ••••• • , .. .,,.. J- .... " ...... ,...., ...... ,.,,.," ,,.... ...,.. .~ .. l• • •••••••l••• •• •• •·l • • • • • •• ••l•••• •• ••• l• ••• •• • ••l• • •• • • • ••l• • •• • • • ••l••• ••••••l•• ••••••• l • · ••• • ••• I &•n I &•I~ I ·-· 1 .. 1 I &ffO I '"JI Island Coast G.V.R.D. e IH JOO UC 400 IW ,.o,a IOMI IUQ UM I M O •·········•·········•·········•·· ···•·······•·········•········•·········•·····h······--' M .IW WV l>ti luJ\I U'W o .iu .,...., I W.I l l 'M I W. l • ••••••ool o••••••uloo•• ••• •• l••• •••• •••• ••••• •• •• • • • ••• •••• • •• •• ••• • l • • •• ••• • • •• ••••• • oo l •••• •• •• • I &•H I l'ltU I ·-· ·-· ..... , . .,, ..... ·-· &ttl I ...... !otal 11 ...... •.N U.1<1 IWll I U.J h.Jll U.M U .J.. IMIQ UOll ...................................................................................................... nh I .. ·-· .. ..... ...... l North • ·~· ,,. ·+. ...... ..... ...., ,_ ..,,.. ... ·-·~'" :················-·········:·r·····--····-·-·-······--··············:···········-··········--·: _: I . . l•t I :'I • I ·-· • I ' I ! ...... Capital ; ....... ~ .. ...... ~ ...... !:tt ...... !~ ....... ~~ ....... ~ ........ !:!: ...... !!~ ...... !:: ...... ~ ~I <l\ I ,J: ·-· lMt> I ·-· . .,. .. I ~ I: . I • I . i I I I I I I I G G.P. s Specialist T Total I N U'l I VI c .., .,.... u .,.... VI ..c c.. cu > .,.... ...... u < "-0 I ...... u cu "-.,.... Cl '+--0 c 0 . ,.... ...... .., ..... :::i E .,.... Vl ~ I ii ..... .., "-...... c cu u ...... VI .., LL.I "-cu ~ lo-o al :1 !1 ~1 !1 :1 . '1 . J1 ] - - - - - - -~ ! .. ... .. -! . ~ . £ ...... VI .., 0 u ~ c .., ..... VI J1 !1 :1 ~1-~] ~ ! . ~1 !r ·-,_ - - - - -.. -26-...... VI .,.... ..... .., .,.... ,_ u .., c.. cu ...... Q. 0 t!J Vl I-II II t!J Vl I------------------------~I ~1 ~1 ~1 ~1 :1-j ... ~1 s1 . !1 .~ • j ~.: -. < •'1 Simulation of Directory Active Physicians per 1.000.000 Population Projection (i60A) Border East Central • ,.. _.. ~ ..... ·~ '"'" t 11o.-.i l iw.J ...... ,.,,. .. 1 . ................ ... . ... . ...... . ........ . . .. . . . .... . .... . . . . 1 .. .................. 1 . . . .. . .... ......... . .1 .,., '°"" , ,,., w a ,.,,. "N.1 a.n.. "- 11~ o ~ . ................................. ...... ........ ... ....................................... .......... . UH I t••~ I ·-· ·-· ·-· '"'' Island Coast G.V.R.D. . - - - - - - ~ ·- ·- ~ 1 • •••••••••••••••••• 1 •• •••• •• • 1 • •• •• • • •• 1 ••••• •••• • •• • • • •• ••• • • • • • • • • •••• •• • • • •• 1 • • • ••• ••• 1 ••• ••• •••• " t\11 """" '"" IN.I 11 .. .1 l'I·"' llW l .iJJ tlW l ~.U 1 . . . .. ..... . .. . . ..... . .. . ..... . .... . ..... . ....... . . 1 ••••• • ••• •••••••••• • •••••••• •• • ••• ••• • ••••••••••• • '"" ' .. , .. t ·-· ..... ..... ... ,, ·-· ·-· '"'I ....... . Total ,. w• ..... u.... fW,. I .. ~ ,,_,. 11.-, U>IW u,,.,, ..,,.,,, 1 •• • •• • •••••• •••• • •• 1 •••• •• ••• 1 . . ..... .... ..... . .. . . . .. . . ........ .. . . .............. . . ...... . ... ...... . Uh I ..... . ' .. . I t•t I . . I . ...... North : •..•... !~- ------ !'!i ........ r· ·--- - --~---- -- -=:: ....... :'!: ....... !~ ...... .. ~-- --·- -~---- .. !..~ un 1 ~ 1 I O I I ' ' ·-· ~· ·-· J ·-· "'' ·-· : .. ...  '.':': ....... ~ ...... !t ...... !:..~.~-~!~.~- -.. !~: ...... !~ ..... !~ ...... ~ ...... ~ Hh I • i t I • I . . ' 1: 1· . ! • ·-·· I • i I • ·-· ..... I I 6 = G.P. I I N S = Specialist ...., I T = Total < Border East u U• ~ Hol ..,.. rw V.M U).,1 Uu.I uu IW~ ........... 1 ................. . ....... . ... 1 •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 1eH I ·-· Island Coast . - - ~ - - - - - - -.................................................. .......... 1 •••••••••••••••••••••••••••••••••••••••• 1en1 ·-· .... , ·-· .... , ·~ Simulation of Directory Active Physicians Projection (1608) Central It Ill Mt 'tU II.. I- l•.I 1111 IW 119 u.1 • ............................................................ 1 ....................................... . .. . .. 1 Uf) I ...... 1¥1111 . . • ..... , ...... G.V.R.D. w w11 lloW ll-'t.1 IW• IJol.,1 Ill.Hi l•M UM k.~ ~ •···· ··································•·········•··········· ···············•················· IHtol ttll I ... ,, U..WI t.,.u I Total If ,... l\00 11'•11 ""°'" Hw •1v..o 'llW . ... .,., •IW l\Uol •••••••••••••••••••••••••••••••••••••••• 1 • • ••••••• 1 .................................................. . llllltol "" .... .,. I ' . I I . . I Ud I ' ' . . I ........ North : ...... ..... . :t .......... . ':t .... l .. ~~t .......... ~:T .......... !":": .......... ~~ .......... !':i ............ !:r ..... -· !:":' ........... . '"'"I ·-· ·-· ·-· 19.S I I • I ' I '. i ·1 I > I ' I t. ... :;... .!::.. l .. :; ......  :.:~::..'. ... ::: ...... :; ....... :; ....... :0.-. ,.,~ t c I • t •• • • ·-· ..... '""' l'hl I I I G = G.P. I N 5 = Specialist (X) I T = Total I I ,"I ~ •, • Simulation of Directory Active Physicians per 1,000,000 Population Projection (1608) Border East Central W 10..t 00 MO "-Ill hl.N I U.1 ''°°'°' Hllll I tu.I IWll ...................................................................................................... , 11 '"" "'" o• ..,., 1w ..u u~ u:1a ,,,. tt..ao looOOOOOOOlo o o•oHOOloooooooooloooooooooloo o o o oooolooOOOOoool.ooOoooo o loooooooooloooooooooloooooooo•I l•H I ... ,,, ·-· a•t I ·-· '"'I Island Coas-t G.V.R.O. . - - - - ~ - ~ ~ ·- ~ ............................... 1 ••••••••••••••••••• 1 ................................................. 1 If ou ,,,., rw 1""'"' ll\11 l1JJ 11w l w"u ,,,u lw• l•••••••• • l• •··••·•·•··•••••••l•••••·•·• l ••·•·•••• l·•••·····l··· ····' ····•·•••••••••••••l••••••••·I un 1 l~U• I ·-· ..... , .. , I ... ,. ·-· .... , UUI '"JI Total If W.I ·~ II.JU IWU 1.i.1.1 l" J ' fl.U lluw .. ....,,.,, W .J,. 1 ............................... 1 ••••••• ••••••••••• • •••••• ••• •••• •• ••••• 1 •••••••••••••• ••••• 1 ••• •• ••••• ,.,, I '"'"'I .. I . . I I . . I UH I . I I I • ' I ....... . North " ·- ,_ I Mil ..... ~ •U ,... ... -.. •• ·········· ' · ··············~···•·····························•········· · ·· · · · ··· · · ···· ·· · ·· •· ... ····  ,.,, I ·-· , .. , I ·-· . .,.., I I • I • 1 • :· i: 1. r ! Capital u W.,\ ...,., I"" lW• 1.-"U l~ ,.,,. H.W ......, .. ....................................................................................................... ltH I IG • ' I I .. ' ' . . ·-· ..... ·-· lftJ I I • I I I I I I I G = G.P. S = Specialist T = Total I N •.o I ... --- --"' c "' .,.. u .,.. "' .c 0.. CIJ ~ > ~ u ~ I '-• 0 ~ u CIJ '-.... 0 . " .... 0 c 0 .,.. ~ "' ,.... ::I e ..... V') ,.... "' '-~ c CIJ u ~ "' "' l..LJ r-CIJ 1: 0 ca ... l 11.! - - - - -'1 :j !l t1 :1 . i1 ] - - - - -- - - - - -! ! ! ~ ! . 0 ~ > . (!> 11 11 ~1 ~1 ~1-~1 !1 !1 11 • ] ____ _ j1 11 :j ~ !1 ~ a1 ~ 11-ll :i ~ .r ] ____ _ . . . ... --- --------- -------~I .. . . . ~-: ~ ~ $1 ~1 ~1 ~1 -~1 11 sl ~ £ !1 .~ :L -30-~ "' ';;; .,.. ,.... n: u "' CIJ ~0.. 0 (!> V') I-II II (!> V') I-... /' ~ ... Simulation of Directory Active Physicians per 1,000,000 Population Projection ~ Border East 11 lolol U.I ""'" -..o1 IJJ .. UJJ a.Joi I~ ,..,,, l.1.lol •·········•·················•·········•····· ···········•··· ····•··················•·········· &H~ I ·-· ..... ·-· '"'' . . .. .. • I • I .. Island Coast e NG ... ..... N.1 IJllO IU.1 h;>O IWlll l~.J f.Ml.1 •.........•.........•.........•.........•.........•.........•.........•.........•.........•.......... Urt I ·-· ·-· ·-· H•t I Central .. ,,... ..... .. ,.. ..... ,,... •;N , .. _ ''"'° •• ,... '""' ··········•·········•·········•·········•·········•·········•·········•·········•·········•·········· ,.,,. I '(_ '• ....... , .. , I ...... IWl I G.V.R.D. • .f')ol ~ l\U l.Wol UW l'W.1 llW I W<H ll'lll IW<il •·········•·········•·········•·········•·········•·················································· &•I\ I 19N I ..... ·-· lftil Total .. ....... ·~ ''"" · ·~ .. ,,,. , .. ,, ...... .,,.. .. ... .., .. ., .............................. 1 ................... 1 ..... ... ..................... 1 ......... 1 ......... 1 ...... .. l't•ll I ''ljl""' • •'i North • •- ~ I .._ - - - ,_ - - ... ······················1· •·········•·········•···--································-········ .. '""' ·-· ... , I ·-· IMi I . Capital . - - ~ - - - ~ - - -.... : ·····•·········•·····t···:········•·················;·•·········•··-·····•····-············ I I • • I • I ·-· I ..... . .... ...... G = G.P. s Specialist T = Total I w __, ;j .~ ~ i ! !1 ii l1 :1 . . . . . . . . . . .  : l =i - r i1 11 .~ - - - -- - - - - -~ ! :1 Ill c: "' ~1 .,.. u .,.. Ill >, .~ .r:. ~ ~ c... CIJ > ~ !1 .,.. .... u ~ :j ,_ ~ ~ "' r... 0 .... .... c: u CIJ . . CIJ u . r... .,.. c .> ~ 11 0 . c 0 :i .,.. .... "' ,_ :i e:= LI') - - - - - - - - -- ! !1 ~i :1 .... ~1 Ill "' LL.I !1 r... .. CIJ "'C -r... 11 0 cc ~i ~ . . . . .• " 11 . :1 - - - - - - - - - - - - -~ ! ! I . . . . . . . -- -- --- -- -· - - -! ! c "' > c.!i - -~ ! .... "' "' 0 u "'C c "' ,_ . <II ~ . . -- - -! ! Ji ! -32-•1 !1 11 '1 -. . .... Ill .,.. ,_ "' .,.. ,_ u :I c... CIJ Q, 0 ~ LI') I-II ~ LI') I-. . . :l -~~----'°-" _!._ _______ --- --- -- - - -------- ·- --------- - -- - ------ --. !1 11 .~ -E J1 !j ~i ![ 21 -~1 :i . ~1 31 -11 !1 =1 :~ 11 :1 -; i . :1 =~ . ! ] -. ~I u .... ,, .. ' ' .ll u .. ., .... ~1 ~1 .~ i l ~1 ~1-~1 ~] ~ ! l i '.]__ ___ _ 'Report 5:6 GENERAL MANPOWER STOCK SIMULATOR {GMSS} Simulations of Possible Numbers of Physicians in British Columbia to 1993 Division of Health Services Research and Development Health Sciences Centre University of British Columbia July, 1979 ·Report S:6 GENERAL MANPOWER STOCK SIMULATOR {GMSS} Simulations of Possible Numbers of Physicians in British Columbia to 1993 Division of Health Services Research and Development Health Sciences Centre University of British Columbia July, 1979 

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