When I see my patients I’ve known for years, it’s like seeing an old friend
Planning for the Next Chapter
After practising family medicine for 33 years, Dr. Cathy Connell would be forgiven for thinking about retirement. But hanging up her stethoscope for good was not what the Halifax physician had in mind.
Born on Prince Edward Island, Dr. Connell grew up in Nova Scotia and attended Dalhousie University for her undergraduate degree and medical school. She completed her family medicine residency at the University of Toronto, finishing just in time to welcome the first of her three sons.
Soon after, she returned to Halifax with her family and began working as a family physician at Dalhousie Student Health and Wellness Centre. She stayed there for more than three decades. “That speaks to the collaborative group of colleagues at the centre and the wonderful staff, many of whom have been there since the beginning,” she said.
At the clinic, Dr. Connell served both Dalhousie University students and community members, providing comprehensive primary care, including prenatal, obstetrics and women’s health services. “Over time, my patient population grew,” said Dr. Connell, who saw her roster change to include a diverse community. “Working here has [introduced me to] such a nice cross-section of people from around the world.”
She practised alongside family physician Dr. Katherine Robinson. They met in high school and estimate they have delivered more than 7,000 babies during their time practising together.
By 2019, they were both exploring how to ease out of family practice and pass the torch to new physicians who could continue providing care to their more than 3,500 patients.
For Dr. Connell, it was time for a change of pace. Beyond her family practice, her plate was overflowing with other work, including primary care obstetrics at the IWK Health Centre and administrative roles with Nova Scotia Health and the IWK Health Centre. “It was like I was doing two full-time jobs,” she said.
“Most people would give up the obstetrics because of the hours, but l knew the family medicine component would be much harder to replace.”
With that in mind, she and Dr. Robinson focused on recruiting colleagues to take over their family practices. They knew finding the right people would take time and patience. “We approached it in a problem-solving way and gave ourselves two years to get doctors in place,” Dr. Connell said.
They advertised the positions, worked with Nova Scotia Health recruiters and gave tours of the clinic to potential recruits. “It’s like staging your house,” said Dr. Connell. “It makes a difference when [potential recruits] can see the physical layout and the opportunities for other things they could do.”
It also helps when medical learners spend time at your practice. Dr. Connell regularly hosted medical students at her clinic and mentored family medicine residents in her obstetrics work. “Even if they don’t stay, they may know someone who is looking for an opportunity.”
Ultimately, Drs. Connell and Robinson recruited three family doctors to take over their practices: Drs. Andrew Mikhail, Sarah Massoud and Anna McLean. “All three had done med school or residency at Dal,” said Dr. Connell.
Another selling point was that Drs. Connell and Robinson continued working, mentoring the new recruits as they transitioned into the practice. “Over one and a half years, we supported them in the onboarding,” said Dr. Connell. “We slowly decreased the time we were working, while they increased theirs.”
That meant a smooth transition for patients, particularly older patients who had had their doctor for decades. “There can be a lot of nuances with patients who have complex medical and social histories,” Dr. Connell said. “It can be hard to tease that out just by reading a medical record.”
To help ease the transition, some patients had an appointment with both the outgoing and incoming physicians.
Nova Scotia Health supported the crossover, which mirrored government’s Transition Into Practice, Transition Out of Practice (TIPTOP) program. Drs. Connell and Robinson weren’t part of that program, but they had an agreement with the new doctors outlining the transition process.
The crossover approach doesn’t just benefit patients – it also helps both the outgoing and the incoming physician. Receiving support and mentorship from the outgoing physician helps a new physician adjust to the patients and the practice community, retaining them long term, says Dr. Connell. “We are there as ongoing support, so we can help them with referrals in the city and answer any questions that come up.”
Knowing a colleague is waiting in the wings takes the pressure off the retiring physician, who can evaluate the type and amount of work they may want to continue after retirement. “Perhaps a physician can’t carry on with 2,000 patients and wants to bring on a new doctor to help share the practice. It makes it more enjoyable to continue working.”
Currently, Dr. Connell runs prenatal clinics in Bedford, Regency Park and at the IWK Health Centre, where she also provides primary care obstetrics and delivers babies – about 200 per year. “This is where my passion lies,” she said. “It’s in my family – my mom was an obstetrics nurse, and my sister was a post-partum nurse.”
She also provides primary care to pregnant people in hospital for acute care and to family members of pediatric patients who are receiving care.
She enjoys staying in touch with her former patients at Dalhousie Student Health and still works two half-days a week at the clinic, doing prenatal care, Pap tests and inserting IUDs. “When I see my patients I’ve known for years, it’s like seeing an old friend,” she said.
On the surface, she may not appear to be slowing down – she still works four to five days per week, including “catching” babies days, nights and on weekends.
“I’m working full-time in most people’s eyes,” said Dr. Connell, laughing. “But now I’m able to take longer trips to visit family, which is a treat, and I’m getting back into other passions, like knitting and sewing. I don’t call it retirement – I call it transition.”