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What do new physician contracts mean for Nova Scotians?

By now, you’ve probably heard that Nova Scotia doctors have ratified two new four-year contracts with the provincial government.The new contracts, which are retroactive to April 2019, offer all doctors 2% raises in each of the four years, as well as targeted investments in five key areas, including family medicine, emergency care and psychiatry.

With the new contracts, Doctors Nova Scotia (DNS), the association that represents all physicians in Nova Scotia, made headway on all of the key recommendations outlined in its 2018 report, Road Map to a Stable Physician Workforce.

You’re probably wondering what all of this means for you and your family. Maybe you’re among the more than 49,000 Nova Scotians on the waitlist to be matched with a family doctor. Or maybe you have a family doctor but face a long wait to see a specialist.

Will the new contracts help attract much-needed doctors to your community? Will they improve the care that you receive at your doctor’s office, clinic or local emergency department?

The short answer to these questions is yes, but change won’t happen overnight. It’s taken many years for Nova Scotia’s health-care system to reach this critical point, and it’s going to take time for things to improve.

The investments in these contracts are a step in the right direction. They begin to recognize the value of Nova Scotia’s doctors and to stabilize some key services in our health-care system, so that you’ll have better access to care, when and where you need it.

Boosting recruitment and retention
The contracts address issues that have made it hard to recruit and retain doctors in Nova Scotia, including compensation, physician engagement, physicians’ work environment and physicians’ right to representation.

Family doctors who provide comprehensive care, such as office visits, emergency medicine, inpatient care and obstetrics/maternal care, will see a significant increase in pay, bringing their compensation to the top in Atlantic Canada and making Nova Scotia competitive with other provinces.

There is also a new payment model for rural family doctors who care for patients at community-based hospitals, and money earmarked to create a new blended payment model for family doctors, so they can spend the time they need with patients.

Specialists who practise emergency medicine, obstetrics and gynecology, psychiatry and anaesthesiology will see an increase, which in time will help improve the province’s ability to recruit and retain physicians who provide these essential services.

In addition, enhancements to the rural specialist retention incentive bonus will encourage specialists to live and practise in rural Nova Scotia – so that patients in rural areas don’t need to travel all the way to Halifax for specialist care.

Improving the practice environment
Improving the work environment for doctors is a big part of the new deal. The contracts support succession planning, so a retiring doctor can overlap with the new doctor who’s taking over their practice to ensure a seamless transition for patients.

Doctors who mentor medical students and residents, and were previously not paid (or underpaid) for this work, will now receive a stipend. That’s critical to ensure that our medical learners can train alongside local doctors in a rural or urban setting, and experience what it’s like to live and work in that community.

There is also a commitment to reduce the paperwork physicians deal with, so that they can spend more time doing what they want to do – see patients. And physician audits, which have been punitive and eroded physician morale, will now be educational in nature in the first instance, focusing on how doctors can improve their billing practices.

A positive environment for new recruits
All of these things will help make Nova Scotia a more attractive place to work, not just for family doctors, but also for specialists, who are also in high demand in rural communities across the province.

Ultimately, the new contracts are a step toward a more stable and positive work environment for all doctors in Nova Scotia.

Having more doctors working and staying long term in the province means that you’ll have better access to care: more opportunities to be matched with a family doctor in your community and shorter wait times to see your family doctor or specialist.

The new contracts don’t solve every problem in the system, but they are a step in the right direction and an important investment in the future of the health-care system that will benefit all Nova Scotians.

Dr. Gary Ernest is President of Doctors Nova Scotia. He has been a rural family doctor in Liverpool, N.S., for 37 years and was installed as Doctors Nova Scotia’s President during the association’s annual conference in June 2019. Read more about his work.