Nova Scotia Health Authority creating hiring delays, says Bedford doctor

A family physician in Bedford says the Nova Scotia Health Authority is creating long delays for doctors who want start practising in the Halifax area, even when there are patients waiting to see them.

Dr. Natasha Deshwal said under the previous Capital District Health Authority, hiring a new physician was not a very difficult task.

"It was a much cleaner, much more transparent process than what we have now," Deshwal told CBC News. 

But over the last year, following the amalgamation of nine district health authorities, medical practices have to apply for approval to create the position. Once that's received, they can then advertise for a new doctor. When a doctor has been found, they then have to be approved to take the position.

That's caused some real problems in Deshwal's practice.

"We've been trying to add another family physician, and the application has been completed and submitted since December of 2015," she said.

"When I checked it two weeks ago, the application hadn't even been reviewed yet."

Doctors in demand

Deshwal's practice can receive up to 20 calls a day from people seeking a new doctor. Given it was expecting to be approved for a new doctor, the office made lists of potential patients. But it's had to cancel the list three times so far while waiting for approval. 

"To me that affects patient health care," said Deshwal. 

The Nova Scotia Health Authority admits there are hurdles when creating new positions for doctors.  

"We're already in physician-rich province, we have limited finances, and we have to say, 'What do the people of Nova Scotia need,'" said Dr. Lynne Harrigan, vice president of medicine and integrated health services for the Nova Scotia Health Authority.    

'Too many doctors'

She said it's important that physicians open practices in areas where there is a need for them.  

"We have too many doctors, yet people can't get into family doctors. That's a conundrum," she said.

She said the health authority wants to support physicians who will offer comprehensive primary care and open family practices that see everyone. The authority, she said, doesn't want more of what she calls "boutique physicians."

"A boutique physician is someone who will see, walk-in clinics for instance, who will see people come and go," said Harrigan.

"We have a need for walk-in clinics now because people can't get into a full-service family practice. But over time, if you actually converted those physicians to full-service family practices, everyone would have a family doctor.

"It's like changing the direction of primary care in the province. It will take a long time, but we must do it."          

Vacancies being filled?

Harrigan said the health authority is succeeding in filling doctor vacancies. 

But Deshwal said that's not been her experience. Last September, a doctor in her practice applied for permission to fill in for her on a locum while she was off on maternity leave. By January she had still not been approved for a replacement and she was ready to give birth.

Deshwal said her understanding is part of the rationale for the change is there are not enough doctors in rural areas, and the health authority is trying to encourage doctors to move there. 

"Unfortunately, in my opinion, I don't see that as having actually transpired," she said.

Instead of moving to rural areas, doctors who are faced with long delays in getting approved are moving to other provinces, said Deshwal. 

"It's the patients that are suffering," she said. "The patients have to come first."

Harrigan disputes the claim that doctors are leaving Nova Scotia because they can't get work in the province. 

"I am not aware that there are people leaving the province because they can't get positions in Nova Scotia," she said. "In fact, right now we have 20 vacancies in central zone and they are all over the place: Halifax, Dartmouth, Hammonds Plains, Bedford. Full family practice openings in all those communities."