Long wait to see dermatologist in Cape Breton frustrates patients, doctors alike

Marianne Gillis started to worry when she noticed three dark spots on her nose and face. Her father, mother and brother all had skin cancer. 

Gillis asked her family doctor to refer her to the dermatologist in Sydney, but she couldn't get an appointment for 10 months.

"I said to my family doctor, 'Well, this is kind of long,'" Gillis said. 

But some patients are waiting even longer than that in the eastern zone, which includes Antigonish and Guysborough counties and Cape Breton Island.

The average wait time to see a dermatologist is about 18 months, according to Nova Scotia Health.

A shortage of dermatologists is the reason for the long wait. There's only one in the zone and one other position that needs to be filled. 

'It's very scary'

Dorothy Best, a patient at Nova Scotia's cancer care centre in Sydney, has a rare genetic mutation — Li-Fraumeni Syndrome — that makes her more likely to get certain cancers. 

She noticed a rash on her legs in November 2021. It might be nothing for some people, but it frightened Best. 

"What can be not really major for somebody else can be very major for me," she said. 

But, even still, she wasn't able to get an appointment in Sydney until January 2023. 

"It's very scary," Best said.

Best is supposed to see a dermatologist every six months as a precaution. But her previous dermatologist retired about 18 months ago.

Dr. Stacey Northgrave has been the only dermatologist in Cape Breton ever since. 

Can't keep up

Northgrave's practice is full, but her office still gets about 80 new referrals each week. She said those with non-urgent conditions may wait 14 to 16 months to see her.

"It's always very stressful to be a health-care provider when you have a long wait list," said Northgrave.

A registered nurse has been brought on to help Northgrave see patients more quickly by taking on paperwork and performing minor procedures.

With her help, Northgrave said they can see 25 per cent more patients each day.

"But it's just the sheer numbers that we can't keep up with," she said. 

Northgrave said patients in the cancer clinic are given priority, especially those with a suspicion of cancer or severe skin disease.

Nova Scotia Health said in a statement that if a primary care provider determines a skin issue is urgent, they would contact the dermatologist and find the next possible appointment. 

Help on the way

Dr. Michael MacGillivary, chief resident of the dermatology program at Dalhousie University, said there have been one or two residents in the dermatology program each year over the past five years. That's an increase from about 10 years ago when only one resident was selected every two years. 

MacGillivary said there are currently seven residents in the program, including himself. 

After he graduates next year, he will return home to Cape Breton in the fall of 2023 to serve as a full-time medical dermatologist. He wants to share some of the patient load with Northgrave. 

He said a backup of referrals is frustrating for patients and doctors alike. 

"We like helping people," MacGillivary said.

"Knowing that people that are out there struggling with their skin and not being able to help them as expediently as we would like … it's challenging on both ends."