International comparisons of manpower in gastroenterology.

Health-care systems vary among countries and we were interested in how this might impact on gastroenterology manpower. We assessed the number of gastroenterologists in Canada and compared this with four countries where data were available over the Internet in either French or English. The number of gastroenterologists per 100,000 of the population was 3.9 in the United States, 3.48 in France, 2.1 in Australia, 1.83 in Canada, and 1.41 in the U.K. This variation in number of gastroenterologists was not reflected in the overall number of specialists per 100,000, which was similar in all five countries. Furthermore, the difference in gastroenterology manpower did not correlate with the amount of gross domestic product spent on health care. Countries with a low number of gastroenterologists per 100,000 all had a strong primary-care gatekeeper system, although this observation may be coincidental, as only five countries were studied. Canada had the most equitable distribution of gastroenterologists across the country with only modest differences among provinces. The United States had the most variation in the number of gastroenterologists per 100,000 of the population among states.