The unseen human costs of doctor shortages in rural N.L.
On the Baie Verte Peninsula, residents say the wait for a doctor feels endless
The Cure is a CBC News series examining strategies provinces and territories are using to tackle the primary care crisis.
Miranda Penney remembers the moment with chilling clarity. She was standing in the emergency room at the Baie Verte Peninsula Health Centre, watching a screen as a doctor miles away pronounced her father, Terry Penney, dead.
"It's almost cold and dehumanizing to have your loved one there in front of you passed away and you're told that by a doctor on a TV screen," said Penney.
Her dad was 63 at the time. She says he was a smart, hard-working man with a sharp sense of humour. Penney says her father didn't have a family doctor, and was struggling to manage a condition called A1 antitrypsin deficiency for several years without a diagnosis. It's a genetic condition that can lead to lung diseases.
Penney says her dad neglected his health needs because the hour-long travel to his local hospital was burdensome.
"So he would either use his oxygen up or he would be super out of breath to even go there and likely not see somebody in person and only virtually or be told he had to go further," said Penney.
The Penneys' experience paints a portrait of what happens when people can't access primary care.
Roughly 5,000 people live on the Baie Verte Peninsula, along Newfoundland's northeast coast. The area has two full-time family physicians — one of them just added last month — who work out of a new family care clinic.
Residents say the lack of family doctors has led to reliance on virtual care, long clinic and ER wait times, and worse: fear and anxiety. And they're not alone. Across Newfoundland and Labrador about 47,000 people are registered on the provincial primary care waitlist, Patient Connect N.L.
The province says it's working on recruitment and retention, and seeing gains, but for residents — especially in rural areas — it's not happening fast enough.
Kendra Regular, who also lives in the area, had to make that long drive in an emergency. She lives in Woodstock, N.L. with her two children. In October 2023, while her partner was away for work, a dog the family was considering for adoption attacked her then two-year-old daughter, Kali.
"When I turned around, my daughter had blood just running down her face," said Regular.
She says the Baie Verte hospital emergency room didn't have a doctor that day, so patients were diverted to the nearest hospital in Grand Falls-Windsor — over two hours away. She feared an ambulance would take too long to arrive, and packed the kids into the car.
"I was watching her face swell in front of me," said Regular, adding she was worried the dog might have hit an artery, which made the drive harrowing.
"And my son, of course, was traumatized because his sister was screaming."
Kali was treated at the Central Newfoundland Regional Health Centre in Grand Falls-Windsor and received 15 stitches on her face.
As a mother of two young kids living in rural Newfoundland, Regular says she feels helpless.
"There isn't really anywhere to take my kids," she said.
"You know if they have a flu, if they have a fever, if you know there is another emergency, there's nothing like in regards to primary care. It's scary."
'Put the care back in health care'
A little further down the peninsula, Jackie Jacobs lives with her family in La Scie. Jacobs and her husband care for her mother-in-law. But with complex health needs of her own, leaving town is hardly an option.
"You've got to wait weeks just to try to book an appointment. A lot of times people resort to going to the emergency department, which is virtual care for the most part," said Jacobs.
"When you're seeing someone on a screen, it's really hard to describe what's actually going on."
There isn't a doctor or nurse practitioner in La Scie, population about 800. The closest access to care is the 45-minute drive away to the Baie Verte Peninsula Health Centre.
The mayor says eight years ago this wasn't the case.
"Right now, there is no health-care area in the town itself," Mayor Marlene Regular told CBC News.
"[It's] very seldom where you get to see your doctor and in most cases if you do, you got a eight- or 10-hour wait. No matter what your symptoms are, what your age is, you still got to do that."
Over 60 per cent of the town's population are senior citizens on a fixed income and some are without a personal vehicle, the mayor says, adding most can't afford to shell out money on transportation to go to the emergency room for illnesses that could be treated in a family practice.
There was a glimmer of hope during the provincial Baie Verte-Green Bay byelection in May 2024. Premier Andrew Furey, Infrastructure Minister Fred Hutton and then Health Minister Tom Osborne met with the town at the old clinic with a promise of restoring primary care.
The mayor says the province promised a medical professional, like a nurse practitioner, for a few days a week through a partnership with local virtual care provider Medicuro.
Marlene Regular says there has been nothing but silence since.
She says she has emailed Furey, who is stepping down as premier, hoping for a sign of progress, but says she hasn't received an answer with a timeline. In a response in September, former Health Minister John Hogan — who's now running for provincial Liberal leadership — pointed to virtual care.
"Virtual care is an invaluable resource for many across the province including those who live in areas with no primary health care clinics, for seniors, and for those with mobility or transportation issues," wrote Hogan.
"I assure you that we continue to work with NLHS to improve access to primary health care in your region."
Family care team taking patients
The ongoing efforts bore fruit last month. A new family physician arrived in Baie Verte and has begun onboarding patients.
The doctor is working as part of a collaborative care team that was slated for the Baie Verte and Springdale region, according to the 2024-2025 provincial budget.
Craig Davis, chief operating officer with Newfoundland and Labrador Health Services central zone, says as of February one full-time physician, one licenced practical nurse, one registered nurse, a social worker and a clerk are operating the new practice.
A spokesperson from the province's health authority told CBC News the clinic had rostered 224 new patients as of March 5. Before the new doctor joined the family care team in mid-February, the Baie Verte Peninsula Health Centre had one full-time physician providing primary and emergency care to the thousands of residents, with temporary, rotational physicians serving the population on a contractual basis.
However, the health authority won't confirm if the new doctor was specifically recruited for Baie Verte or reassigned from another part of the province.
According to the Department of Health, Newfoundland and Labrador has hired 140 physicians and over 970 nurses since April 2023. The province also offers some of the most competitive incentive packages in the country — including bonuses of up to $650,000 for doctors who are willing to practice in the province.
But the Newfoundland and Labrador Medical Association says financial incentives alone won't solve the crisis.
"You can recruit people. You need to make sure that when they come and they work … they're going to stay," says Dr. Steve Major, the association's president.
"So you can get someone for two years and you can give them a big bonus for coming, but will you be able to get them to stay?"
Auditor General Denise Hanrahan recently examined the bonus program. While it is still early days, she wants to see a detailed analysis of the program going forward to inform future decision making.
"Overall, it appears that the physician incentive programs may be having some degree of impact, in this early assessment," the report reads, but that the number of practicing general physicians was still below 2022 levels.
Competition is tough. An estimated 6.5 million Canadians don't have a family doctor or nurse practitioner. According to a 2025 Health Canada report analyzing the health-care workforce, the country is currently short 22,823 family physicians.
Until the recruitment and retention efforts show more results, virtual care is the stop-gap.
Dr. Desmond Whalen is the senior medical director for the NLHS central zone. He says virtual ER physicians may cover multiple hospitals at once, providing care to more than one community during a shift.
"One of the things that we have seen with virtual care is an extreme reduction in the amount of times that we've had to close the door," said Whalen.
NLHS CEO Dr. Pat Parfrey agrees. He says it's the only viable option to maintain emergency services in some areas.
"If you've got a nurse in the emergency room who can communicate directly [and] virtually with a doctor two hours away and can get the advice to give to the patient, and the patient is there, that's a good solution," Parfrey told CBC News.
"Otherwise, you close the emergency room. So which would you prefer?"
Penney says despite it being cold or dehumanizing in situations like the one her family experienced, she's grateful that rural communities can access virtual care. However, she still wishes full access to care would return.
"I know my mom will put off going to the doctor because she knows there's not going to be an actual doctor out there for her to see, and she thinks it might be a waste of time," said Penney.
"So then she puts off her health care and even I do. It's like it trickles down."
ABOUT THE AUTHOR
