N.S. physician wait-list matches 10 per cent of patients in first year

Just over 10 per cent of Nova Scotians who registered for the province's wait-list for a family physician were matched with a doctor in the first year of its existence, and the need is about to increase.

The wait-list currently has 37,339 people registered. The Nova Scotia Health Authority said 4,331 people who were on the list successfully found doctors as of Oct. 1. 

But Doctors Nova Scotia estimates, with the help of Statistics Canada, that the number of residents who don't have a family doctor is around 100,000, since some Nova Scotians are not actively looking for a doctor.

"There's no question there are many more Nova Scotians without a family physician than there are names on that list," said Kevin Chapman, director of partnerships and finance at Doctors Nova Scotia.

CBC has confirmed more patients are about to be orphaned by their doctors. Six family physicians in the Halifax Regional Municipality alone will retire by the end of December. Just one of those six has a replacement in line to take on their patients. 

"It's hard to call it a success, but it's a good first step," Chapman said of the wait-list. "There's no question we're in trouble. Things are probably going to get worse as physicians retire, and we can't bring in physicians to replace them. So the gap widens."

People can register for the wait-list by calling 811 or by visiting the website, but CBC notified the health authority that the website has been down since at least Monday.

Short-term solutions needed

Chapman said he's confident that long-term measures such as increasing the number of family physician residency spaces at Dalhousie University and re-establishing a skills assessment program for foreign doctors will be successful in easing the need.

But those steps won't fix the urgent issues overnight, and Chapman said it's critical that those involved with the problem start looking at creative or alternative solutions.

"We need to be flexible in the short term," he said. "If we can get locums in for even two days a week, let's take advantage of that. We need human resources, we need primary care providers, we need family physicians and we need to be as flexible as we possibly can."

Temporary clinic a success

Chapman pointed to a temporary clinic that was tested in Cape Breton. There, physicians worked together to open a clinic specifically for those with chronic illnesses who did not have a family doctor. The physicians took on that work on top of their main practice, offering up a few days a month.

"It was a wonderful testimony to the physicians in that community," he said. "If you got 10 physicians or 15 physicians, maybe they could each work a shift here and there, in addition to their own practice."

Chapman is quick to point out that physicians are currently suffering burnout, and many are nearing retirement.

But he thinks a Band-Aid solution similar to the Cape Breton clinic could be what gets the province through the next few years as it waits for new doctors to earn their licences.

"There's a growing list of patients that can't survive [without continuous care] and we need to figure out what do we do for those individuals because they need a family physician."

International recruitment

The new wait-list numbers arrive as Nova Scotia Health Authority staff return from an international job fair in London, England, to help recruit physicians.

Staff brought along Dr. Simon Bonnington, a family physician in the Annapolis Community Health Centre who immigrated from the United Kingdom himself.

He is confident the recruitment efforts will make a difference. 

"Until we actually get boots on the ground it's impossible to say that there is a definite recruitment. But I think that from the people I spoke with, and some of them at great length and with very significant degrees of interest, I would think that five or six should be fairly certain to want to make the move."

Change of rules

Bonnington said the advantage is that the U.K. system is struggling, and many physicians are feeling disenfranchised like he was when he made the move. For the first time in his career, Bonnington said he found a work-life balance in Annapolis Royal.

"My opportunity to work as a professional here, to get on and do a good job properly without intense scrutiny and excessive bureaucracy and regulation is very very refreshing," he said. "We as physicians in Canada are very much more appreciated than we are, or I was, in the U.K."

Bonnington said the recruitment team will continue to reach out to the dozens of physicians who showed various levels of interest in relocating to Nova Scotia. He said there was an even split between family physicians and specialists who approached the Nova Scotians at the fair.

He said one thing that will work to the province's advantage is that the rules have changed significantly since he arrived in 2010, making it easier for physicians from the U.K. to work in the province.

"It really was a struggle. It really was an uphill venture," he said.

He credits the College of Physicians and Surgeons of Nova Scotia with changing the rules and streamlining the process. 

"The barriers, the hurdles are much less than I had faced eight or nine years ago. I'm hoping that that would give the opportunity for physicians to look at this as a realistic immigration option."

Readers who wish to share their story about searching for a physician can contact Carolyn.Ray@cbc.ca.