Finding a family physician in Nova Scotia isn’t easy. Despite the number of Nova Scotians on the Need a Family Practice list having gone down in recent months, there are still over 50,000 waiting for a doctor, and many have been waiting for years.
Andrew Hopper is one of those who put his name on the list as soon as he could.
“I had medications, I had prescription renewals that I required for blood pressure and whatnot, and it’s just very difficult when you live in the country to come in where there’s a walk-in clinic,” he said.
Things got worse after he was in a car crash. He says insurance companies required that a family doctor fill out numerous forms in order for him to get his physiotherapy covered. Last March, he managed to find a doctor who was accepting patients and booked an appointment.
“When I told her what was going on in my life — I’d been in a car accident and I needed forms that needed to be filled in and different things, as well as my prescription refills — she put her hands up and said, ‘Right now I can tell you I do not have time to take you on as a patient,'” said Hopper.
“I was kind of stunned, like it was surprising they have the option of refusing you.”
But the doctor did accept Hopper’s partner, Heather Fraser.
“I was kind of annoyed because my partner had gone to this doctor a week before,” she said.
“For her to flat out tell me, ‘because you’re healthy I’ll take you,’ is counter productive,” said Fraser. “I mean, yes, I’m healthy, I don’t really need a doctor, so why is someone who is desperately in need of a doctor refused because I don’t have time for you? Doesn’t feel fair.”
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According to the College of Physicians and Surgeons of Nova Scotia’s Professional Standard and Guidelines Regarding Accepting New Patients, “physicians may not discriminate against patients at any time including when considering them as new patients in their practice.”
The document says physicians are bound by the Nova Scotia Human Rights Act, which prohibits discrimination regarding numerous provisions including race, religion, sexual orientation or physical disability.
But doctors are not required to accept every patient. The guidelines say “physicians who are accepting new patients into their practices should use a first-come, first served approach. Decisions to accept or refuse new patients must be made in good faith.”
Despite multiple requests over a month, the College was unable to give any further clarification of the guidelines or provide comment surrounding why doctors might refuse a patient.
But Kevin Chapman with Doctors Nova Scotia says there are valid reasons for refusing a patient.
“One of the big ones is narcotics, for example,” said Chapman. “Many family physicians struggle with taking on a patient who is treated through narcotics, both on a comfort level with the patient and also through a regulatory perspective.”
But often it also comes down to workload.
“Every time you integrate a new patient, you have to be able to serve that patient and meet the needs of that patient along with all the rest of your patients,” said Chapman.
Fraser and Hopper say they understand that there are many doctors who are currently overworked, but the couple says something in the system needs to change.
“I’m not the only one being refused care,” said Hopper.
Fraser would like to see a more collaborative approach among doctors accepting patients.
“If they’re going to say, ‘You’re too complicated for me,’ do they have an internal colleague system where they may know someone who has a lighter workload?” she asked. “Say, ‘look, I can’t take you, but I know doctor a,b,c who may take you and have a referral.'”
According to Chapman there are some doctors who will refer patients to others — particularly doctors looking to retire — but it’s not always possible.
“We simply do not have enough primary care providers right now.”
Hopper has recently found a doctor who was able to take him on as a patient and says he is grateful for that, but says for others who are desperately in need, being refused is unfair. He also says the delay in getting a family doctor has had an impact on his health.