Nova Scotia doctor shortage needs action, ex-medical dean says

The former dean of Dalhousie University's medical school says Nova Scotia needs innovative solutions to solve its doctor shortage, including helping doctors get used to working in smaller communities. 

Dr. Tom Marrie says doctors and government officials must work together and be creative.

"We have to be innovative. And I don't have all the answers to this. … Whatever we need, it's got to be different than what we have now."

At the end of June, none of the six Dalhousie University obstetrics graduates chose to stay in Nova Scotia to open practices.  

In addition, one of the province's busiest obstetricians, Dr. Charles Hamm, recently decided to close his practice of nine years and 5,000 patients to set up shop in London, Ont. 

Hamm and others cite stressful working conditions and poor government decisions as main reasons for leaving. 

Drawing from experience

Marrie said there are long- and short-term solutions that can help manage the loss of doctors in Nova Scotia. 

Several years ago, when rural Alberta was struggling to retain family doctors, Marrie helped create a program in which third-year medical students would spend a year in a smaller Alberta community. Through the program, students fulfilled their medical requirements.

"The program showed that 50 per cent of the students will spend their entire working professional life in a community like that and it's the only program that's shown to have such a success rate. It's now in its 11th year and it's starting to show major success."

Marrie said a similar program is being developed in Halifax by Dr. Andrew Warren, Dalhousie's associate dean of postgraduate medical education. Through this program, third-year students training in specialities would spend three to six months outside Halifax gaining experience. 

"We think it is likely to be as successful as the program for family doctors." 

Managing working conditions

Marrie said one of the biggest issues facing obstetricians working outside of Halifax is the workload. There are too few doctors, spread thinly across the province.

If Nova Scotia only retains a few new doctors over the next few years, Marrie said the province won't be able to continue paying them as much as they have in the past. 

Conversely, if pay rates dip too far below the national average then Nova Scotia's problem of attracting new doctors will worsen.

To manage this problem, Marrie said residents are given the tools to manage expectations before they graduate.

But, Marrie says the question of money will rule at the end of the day. 

"I think everybody will have to change their expectations in terms of the amount of money we pay," he said.

"Most of the studies now have shown that if you're overtired, then you don't deliver the same quality of care as you do when you're well rested. So, our challenge is to meet that."