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Doctor shortages a key election issue in Nova Scotia

Click to play video: 'N.S. seeing rise in temporary emergency departments closures' N.S. seeing rise in temporary emergency departments closures
The list for those in need of a family doctor in Nova Scotia continues to grow and as of July the list sat at just over 69 thousand people. As the province deals with doctor shortages it is also seeing a rise in temporary closures at emergency departments in rural communities. Alicia Draus reports. – Aug 10, 2021

In 2018, Nova Scotia’s 811 Need a Family Practice Registry reached a peak of 59,225 names. Three years later, the list keeps growing — and as of July 1, just over 69,000 people were on the wait list for a family physician.

The need is greatest in the Northern and Western health zones, where over 13 per cent of the population are in need of a doctor. The community most in need is Middleton, N.S., where 27.8 per cent of people are on the list.

Read more: Eastern Shore physician discusses impacts of rising emergency department closures

“Everyone’s just really stressed. They say, ‘I really need a doctor,’ and I’m like, ‘We all need a doctor,'” said Middleton resident Katrina Kellough.

Kellough’s family doctor retired three years ago and she says that left her in a difficult situation.

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“I have a long list of health issues, so I didn’t have the regular weekly appointments with my doctor and ended up having a migraine-induced stroke and landed in the hospital,” said Kellough.

Katrina Kellough walks through Rotary Park with her family in Middleton, N.S. Alicia Draus / Global News

To make matters more challenging, the hospital wouldn’t discharge her without a family doctor. She says that situation helped her find a doctor to take her on but she says it should have never come to that.

“You shouldn’t get so sick that a doctor needs to be there for you,” Kellough said. “You should have a primary care doctor follow you so you don’t get that sick.”

The shortage of family physicians is not the only challenge when it comes to accessing medical care in rural parts of Nova Scotia. In the past three years there’s been an increase in how often emergency departments have to temporarily shut down, often due to staffing shortages among doctors and nurses.

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“There are limited number of bodies and when people get to the point where they can’t work anymore, then there’s nobody there to work and shifts go uncovered,” said Heather Johnson, president of Doctors Nova Scotia.

In 2018, emergency departments across the province were temporarily closed for a total of 12,567 hours. That more than doubled in 2019 with 26,258 hours of temporary closures, and then in 2020, emergency departments say over 33,000 hours of temporary closures.

Click to play video: 'Nova Scotians feeling pressure with health care crunch' Nova Scotians feeling pressure with health care crunch
Nova Scotians feeling pressure with health care crunch – Oct 3, 2019

Johnson says while doctor shortages are not a problem unique to Nova Scotia, it’s especially challenging in rural areas.

“Living in (a) rural community requires that somebody from outside is taken into the community,” said Johnson.

“It’s hard to come and be a solo care provider, so people are looking for multiple providers and maybe a collaborative practice team to come and work. So that’s one challenge is to get those teams set up.”

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All three provincial parties say they’re looking at ways to improve health care across the province.

Zach Churchill, Liberal candidate for Yarmouth, says the Liberal Party has been doing well with recruitment and retention but one of the biggest challenges is that while doctors used to take on 3,000-4,000 patients, new doctors are only taking on 400-500 on average.

To address that, the Liberal Party says it’s working on a new pay model to encourage doctors to take on more patients. They are also working to expand virtual care so that those who don’t have a family doctor will be able to access one virtually while waiting to get off the Need a Family Practice Registry.

“In terms of the waitlist, 30 per cent of people on our waitlist now are new to the community they’re living in, so they moved from out of province or they moved within the province to their community,” said Churchill.

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The PC government says their solution is working directly with health-care providers to come up with solutions.

“My message to doctors is that we will respect you, we will listen to you and we will support  you. Change is coming,” said PC Leader Tim Houston.

Houston has promised to increase overall health-care spending and to create individualized clinical health services plans for every region.

“Each region of this province will be empowered to create their own doctor recruitment strategy and have the local decision-making ability to make decisions that are right for their community,” said Houston.

An NDP government would aim to make telehealth permanent and to integrate physician assistants into emergency departments and primary care to reduce doctor’s workloads and patient wait times. The party also says it will open more collaborative emergency centres to bring emergency care closer to more people.

Read more: Nova Scotia doctors approve new, four-year labour deal that includes raises

Johnson says Doctors Nova Scotia has been in discussion with all three parties about the future of health care.

“Things we think would be helpful is a vision for primary care,” said Johnson.

“A primary care task force where all of the players get together and sit down and chat about what primary care should look like and make a plan so we have something to work towards.”

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Johnson says addressing the needs for primary care in the province will help to alleviate other challenges in the medical system.

“Most doctors will say that having a good basis for primary care prevents a lot of the other problems, it helps decrease emergency room visits it helps decrease specialist consults and helps support [patients] after they’ve been seen by specialists,” said Johnson.

Kellough says regardless of who wins the election, she hopes that addressing health care concerns will be a top priority for the next government.

“I hope that what they’re promising they can actually try to accomplish,” she said.

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