Nova Scotians rely on health-care services being available when and where they need them. But with more than 56,000 people sitting on the province’s waitlist for a family doctor and over 100,000 people lacking primary care, health care is on unsteady ground across the province.
With the province struggling to attract and retain both family doctors and specialists, there simply aren’t enough doctors to provide the care Nova Scotians need.
“With more than half of practising physicians over the age of 50, with increasing numbers of people without a family doctor, and with many specialty services hanging on by a thread, it’s clear that short- and long-term solutions are needed to ensure Nova Scotians have access to the care they need,” said Dr. Tim Holland, President of Doctors Nova Scotia (DNS).
Without enough physicians to meet the needs of patients, practising physicians are bearing the burden, working long hours to fill gaps in services and taking on excessive patient loads. This difficult work environment is not sustainable and makes it even harder to attract doctors to Nova Scotia.
Doctors Nova Scotia, Maritime Resident Doctors (MarDocs) and the Dalhousie Medical Students’ Society (DMSS) represent physicians at every stage of their career in Nova Scotia. All three organizations worry about how their members can deliver high-quality patient care in a strained health-care system.
The three groups teamed up to release a new position paper, titled “Road Map to a Stable Physician Workforce,” which calls on the provincial government to take immediate action to stabilize the physician workforce in Nova Scotia.
The paper lists six recommendations to create a stable physician workforce.
1. Pay physicians competitively
Nova Scotia’s physicians are among the lowest paid in Atlantic Canada and among the lowest paid in the country. The province must become a leader in physician compensation in Atlantic Canada, with a path to becoming nationally competitive. Not only would this help recruit new physicians to Nova Scotia but it would also help retain the physician talent we current have.
2. Introduce a new blended payment model
Adding a blended payment model for family physicians to support comprehensive and collaborative care, similar to what’s now offered in New Brunswick (Nova Scotia’s main competitor for physicians) would make working in Nova Scotia more enticing to physicians. This would support the province’s recruitment efforts for family doctors and specialists, and halt the tide of physicians leaving Nova Scotia to work in neighbouring provinces.
3. Invest in succession planning
Implementing a Transition into Practice/Transition out of Practice model would improve the work environment for both new-to-practice doctors and retiring doctors. The retiring physician mentors the incoming physician, who learns the ins and outs of the practice before being on their own with a full roster of patients. Providing this peer-to-peer support will lead to successful long-term physician recruitment, particularly for rural communities.
4. Improve physician engagement
Physicians need a say in health system decisions that involve their patients. The Nova Scotia Health Authority and the Department of Health and Wellness must seek the input of the right mix of physicians when making decisions about the delivery of health services. That means involving the organizations that represent physicians, including DNS, MarDocs and the DMSS, as needed.
5. Change the focus of billing audits
Physician audits are meant to be educational and focus on how doctors can improve their billing processes. But in Nova Scotia, aggressive audits contribute to low morale and a national reputation as an unattractive province to practice medicine. The first time a physician is audited, the audit should be for education purposes only, with a commitment to discuss the audit details with the physician. Disciplinary action should only be taken in the rare circumstance of fraud or intentional abuse, or if a physician keeps repeating the error after attempts to educate.
6. Create a “Red Tape Reduction Task Force” for physicians
Nova Scotia physicians are burdened by an incredible amount of paperwork that takes them away from caring for their patients. The mandate of this task force would be to remove unnecessary administrative work and to ensure that physicians are paid for the work they do, which will increase physician capacity and build trust between physicians and the government.
Have your say
Ultimately, we need to make Nova Scotia a better place to practise medicine, which will mean more doctors working here and deciding to put down roots, which will strengthen patient care and access across the province. Immediate action is needed for this to happen.
But we can’t do this on our own. It’s up to all health-care stakeholders to come together and take action on these recommendations. If you believe the government should take action and improve health care for all Nova Scotians, contact your MLA today and share your concerns.