Months after trial project, still no word on future of family practice anesthetists in N.S.

Health-care officials say a trial project last spring that tested increased access to anesthesia services was successful, but it's unclear if or when the program could be expanded.

Last March, Yarmouth Regional Hospital brought on two family practice anesthetists to work in its operating rooms, under the watch of a Royal College of Physicians and Surgeons of Canada-certified anesthesiologist for two months.

A family practice anesthetist, or FPA, is a family doctor who has additional training and certification in anesthesia. They can administer local and general anesthetics for cases that do not require a subspecialist.

"It was a good opportunity," Dr. Blair MacDonald, a general surgeon at Yarmouth Regional who also works in the hospital's ICU, said in a recent interview.

"Certainly from the surgery side of things, it was good to have the opportunity to do it and to work with these providers."

'We've certainly had an improvement'

FPAs have long been used in Ontario, British Columbia and other western provinces. While it has been a difficult sell in Nova Scotia, a national shortage of Royal College anesthesiologists presents an opportunity for FPAs to buttress and even expand surgical services.

Yarmouth Regional has struggled for years to maintain its full complement of anesthesiologists, and MacDonald said that has often resulted in the same person being responsible for scheduled, elective cases and for providing emergency coverage.

"Before, we would have to stop elective cases if there was an emergency."

During the trial project, the surgical team was better able to meet demand because there were more people to share the workload, said MacDonald. 

"Having the capacity in house to kind of give the care and do the cases that we want, we've certainly had an improvement in both our waitlist and our access, which are quite good for our elective cases at this time," he said.

"We've been able to have safe, effective, timely anesthesia care for the appropriate cases."

Health authority still evaluating program

The FPAs worked on ear, nose and throat procedures, obstetrics and gynecology cases, general surgery and other elective cases. They did not work on emergency cases.

Months after the trial concluded, however, it remains unclear what the next step will be.

Officials with Nova Scotia Health declined an interview request for this story. In a statement, the medical executive director for Western Zone said early indications suggest the pilot was a success.

"The goal of the initiative was to assess how family practice anesthetists might contribute to our overall anesthesia resource needs," Dr. Cheryl Pugh said in the statement.

"We will continue to evaluate the program to determine if it makes sense to expand the program, and if so, what supports are needed for a long-term sustainable model."

Pugh said the health authority is working on a "multi-year, multi-pronged plan" to improve access to surgical care, reduce waitlists and help achieve wait-time targets.

"Investing in new roles and fully leveraging the skills of various health-care providers to support care is key to this plan."

An option to address demand

At Yarmouth Regional, one of the FPAs from the pilot program is still providing anesthesia services along with three Royal College anesthesiologists.

There are currently openings for anesthesiologists around Nova Scotia in Antigonish, Bridgewater, Halifax, Sydney and one post in Yarmouth.

MacDonald, who saw FPAs in action while he was doing his surgical training at hospitals in Ontario, said the extra hands provide peace of mind.

For years, surgeons at Yarmouth Regional have had to rely on extra help in the form of visiting anesthesiologists, or else face situations where they could not do as many elective cases as they wanted to.

"I think it can return us to kind of the full function of both our [operating room] and our surgical program that we want to provide," he said.