This doctor is 71 with retirement on the mind. But there's no one to replace him

A family physician who has practised in the northern Cape Breton village of Neils Harbour for 45 years says he keeps going in part because there is no one to replace him.

"I don't relish the decision," said Dr. Ken Murray, who is one of three doctors in the community. "If I stop or if one of my colleagues stop right at the moment, that would create difficulties for our hospital in our community in terms of maintaining 24-hour coverage."

Murray, who is 71 years old, is one of a growing number of Nova Scotia family doctors inching toward retirement, prompting warnings from politicians and some health workers that the province's physician shortage will likely get worse before it gets better.

This month, CBC Nova Scotia is taking an in-depth look at the doctor shortage, analyzing how it emerged, what's being done to try to fix it and what might be learned from other parts of the country facing a similar challenge.

Last year, there were 672 family physicians in Nova Scotia over the age of 50, representing more than half of all family doctors in the province. Of those, 21 of them were over the age of 75, according to Doctors Nova Scotia. Specialists are in a similar boat.

The bubble of older doctors is putting added pressure on the Health Department and Nova Scotia Health Authority to come up with new ways to recruit physicians before Murray's generation decides it's time to move on.

"Retirement is always on the mind and retirement when the opportunity presents would be welcome," said Murray. "Having said that, I'm still working. I don't mind work. I still like work. I like the interaction. I like the stimulation of work."

Murray's impending retirement is also on the minds of his patients. Many have been treated by him for decades, including Frank Warren. The now 60-year-old first met the doctor in his 20s.

"We've been very lucky here north of Smokey," Warren said. "He's always been one of our family doctors, and always been there when we needed him."

Warren's father, Doug, is 92, and fears he will become one of tens of thousands of orphaned patients in Nova Scotia if Murray leaves.  

Nova Scotia currently has 66 family doctor vacancies. The people who live near Neils Harbour say they've been spoiled up until now, but they know their situation could change soon.  

"It would be a very sad thing to be without a doctor for one thing, especially at my age," said Doug Warren.

Frank Warren said the possibility of his father being without a physician worries him. "We have been very lucky. He has been healthy. If anything did happen, then we'd have concerns."

Murray has put a lot of thought into how to find a replacement. Several doctors have tried out the community over the years, but for personal reasons they've all moved on.

One potential replacement, Dr. Suha Masalmeh, left in October after her husband could not find find work in the community.

The doctors would like to see flexibility for the next generation. Murray said there's a need for four family doctors — one more than the current staffing level — to allow for more time off. That way, they'd be able to take a course, or do a locum in another community.

Another solution, he said, would be to take a page from Northern Ontario, which allows physicians to be brought into smaller communities for months at a time to ensure continuous coverage.

"It would be nice to have four to live here, work here. If that proves difficult or not feasible, an alternative might be a type of arrangement, a type of contract arrangement, that would allow physicians to come in and work in blocks.

"It enables small communities to maintain service if it's hard to attract resident doctors."

He welcomes any physician who might consider moving to the area to get in touch.

"I think in terms of our own community we want exposure, we want people to know about us. We want young physicians to even come and visit, come and see us, maybe come and work for a week, couple of weeks, a month. And try it out, see if it's to your liking. We can easily accommodate that."

Murray said he's already cut back on hours, but will continue to keep seeing the patients he knows so well. Retirement, he said, is likely at least two years away.

"I'm hopeful. For now, I'm going to remain hopeful."

CBC Nova Scotia is taking an in-depth look at the province's doctor shortage. The Search is looking for causes and solutions to the problem. You can send your health-care story ideas to thesearch@cbc.ca.