2021-06-16

Provincial Need a Physician waitlist increases by 20,000

Local Journalism Initiative Reporter

For residents of Nova Scotia looking for a primary care provider, the numbers can be staggering and discouraging.

A report released June 1 by the Nova Scotia Health Authority revealed that 66,404 residents of this province are on the Need a Family Practice registry. This includes 5,610 people in Queens and Lunenburg County.

That's nearly 21,000 more than when the figure that was recorded in June last year, although it's only 14,151 more than what the figure was in 2019.

The PC Party of Nova Scotia recently lambasted the premier and the Liberal government for the numbers, arguing they need to admit there's a problem in the system.

PC MLA for Queens-Shelburne, Kim Masland, said there is no excuse for the province to be in the situation that it's in.

"They have failed miserably on doctor recruitment. Back in 2013, they had a great campaign line, they said every Nova Scotian will have a doctor. Here we are eight years later and more than 66,000 people are still on the list," criticized Masland.

She noted it's the government's responsibility to provide access to health care to every Nova Scotian.

"We know this has been an issue for some time. It just didn't happen overnight and the current government has been in power for eight years now," she said. "You can't be a reactive government, you have to be proactive. You have to be able to plan and have comprehensive common sense plans to address the increase in population."

In Queens County, there are 1,359 people registered on the wait list, an increase of 47 from the previous month.

The figure for Queens is expected to rise even higher, as a long-term physician in the area time, Dr. Tim Woodford, is set to retire with about 1,500 people on his wait list.

Provincial Minister of Health and Wellness, Zach Churchill, said in a phone interview that the doctor-shortage issue is a multi-layered one.

"The PCs kind of think the issue is all around recruitment, but we're learning about that it's not just that," he said.

A rising population figure is a factor as well, he suggested.

"We surveyed the people that are on the wait list and 30 per cent of the current number indicated that they were new to the province or new to their community," he said. "So there has been a lot of people move here because of the safety here during the pandemic."

That puts extra pressure on the system. Meanwhile the issue of retiring doctors is ongoing, and trying to replace them is tough for several reasons, according to Churchill.

"The college has made some decisions to limit patient loads of doctors. So where the old school docs would take three, four or five thousand patients maybe, new doctors are taking in the hundreds," said the minister. "The practice is changing and this has kind of shifted under our feet over the last little while, and that definitely affects access."

Meanwhile, Robyn McQuarrie, the president of Doctors Nova Scotia, also attributes the continual rise in numbers of people on the wait list to people generally caring more about their health.

"It doesn't necessarily mean there's an increase in people who don't have a family doctor, but rather an increase in people that are looking at getting a family doctor," she said in a phone interview. "People may have been okay with not having a family doctor, but during the pandemic that limited access to things like walk-in clinics, made them realize they should have one."

Doctors Nova Scotia, a division of the Canadian Medical Association, is a collective voice for physicians in Nova Scotia. Its membership represents more than 3,500 physicians in the province. Commenting on the fact that newer doctors are taking fewer patients, McQuarrie suggested that doctors are busier doing many things.

"Family practices evolve into a lot of different things. In Bridgewater and Yarmouth they have family doctors that also do a prenatal clinic," she said. "There are lots of different things that they can do under the guise of family practice that would take them away from being in their office five days a week."

Dr. Heather Johnson, of Bridgewater has since been named president of Doctors Nova Scotia.

According to Churchill, it's recognized that there needs to be a shift in approach and that it's not just about recruitment. About 130 new physicians come to the province each year, while more doctors are being trained at Dalhousie than ever before and compensation for doctors in Nova Scotia is the best in Atlantic Canada.

"We have to look at how we're providing primary care to Nova Scotians," he said.

Chuchill pointed out that the provincial government is bringing nurse practitioners into more of a leading role, and 40,000 Nova Scotians have opted to use them as their primary care provider.

As well, a pilot program will be introducing virtual care to help support 21,000 people who are in areas where the majority of people are on the wait list.

"They will be able to access physicians for consults virtually for things like prescription refills and referrals," said Churchill. "This will take pressure off our emergency departments because many go there for non-emergency issues if they have no family doctor."

He said this is for the people that have been on the wait list the longest and many should have received, or will receive, an email to join the pilot. More than 3,000 people have signed up.

Meanwhile the government has also expanded the scope of practice for pharmacists, so they can now renew prescriptions for certain medications. They have also added primary clinics in each zone for people specifically on the registry. This can be used for people that have chronic issues or need monitoring.

"So, we're trying to adjust our model of primary care delivery to the new realities when it comes to family practice," he said. "On top of all things were also trying to recruit and retain doctors. There's a whole bunch of stuff going on to kind of deal with this pretty complex issue," said Churchill.

The PC Party of Nova Scotia recently released its answer to the health situation in a document titled Hope for Health.

The plan covers the addition of telehealth to give residents more access and reduce the burden on emergency rooms. It also covers recruitment and retention, opening up operating rooms 24/7 to address the backlogs, increase local decision making, establish a clinical health services plan in every region, increase residency seats, implement a universal mental health plan, further support foreign-trained doctors and implement a chronic illness treatment and prevention program for in-home treatment.

"The plan is big. It will take some time to implement, but I'm very positive," said Masland. "It's a roadmap for us to address the issues. The Liberals have been doing nothing but sitting on their hands and spinning their wheels," she said.