Recruiting Doctors for Nova Scotia

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Nova Scotia Health Authority is working every day to recruit health professionals for the entire province, including doctors. We are committed to ensuring Nova Scotians have access to quality primary care, and family doctors are essential members of the primary health care team. This effort is underway and we are making progress.

There has been recent confusion about physician recruitment and regulations for practising medicine in Nova Scotia. We feel it’s important that Nova Scotians have access to the facts and a better understanding of the work we are doing to improve access to quality care.

Here, we hope to answer many of the questions you have.

Is there a doctor shortage in Nova Scotia?

The annual community health survey has reported that 90% of Nova Scotians have a family doctor. However, we know that for the 10% of people who don’t have one, it can be very concerning.

There are many positions currently available for family doctors across the province and we are actively searching to fill them. We must keep in mind, that there will always be doctors coming and going. They leave either temporarily or permanently for any number of reasons: personal, health, retirements or for education and specialized training. In order to reduce the impact on patients, the health authority needs as much advance notice as possible when a doctor decides to retire or leave. It can take as little as one month, or as long as a year or more to recruit a new doctor to an area.

Why is NSHA telling doctors where they can and can’t work?

Until recently, a doctor could set up a new family practice wherever he or she liked. Doctors did not need permission from former district health authorities and did not need to notify those organizations of their plans. This resulted in a concentration of family practices in some areas of the province, yet a lack of doctors in other communities. This approach is disjointed and cannot meet the actual needs of communities, and that’s why we are finding today that regular access to a family practice is a challenge for some people.

It’s important for the health authority to know who is practicing medicine, and where they are practicing in our province. That way, we can see where there are concentrations and where there are gaps, so that when we are reviewing a request for a new doctor placement, we can consider the needs of the population.

Why must doctors be approved to set up a new practice? Who approves this?

We support family doctors in establishing practices that help Nova Scotians be as healthy as possible. We want them to work in ways that are satisfying and help them to be successful.

It is important that we put health resources where they are needed most. Under doctor approval guidelines, the health authority reviews each request for a new doctor placement, always considering the needs of the community. We are committed to working with doctors and will meet with them to talk about the options available.

Four committees are set up around the province to review and assess applications. Following review, a recommendation for a level of privileging is sent to the Nova Scotia Health Authority medical advisory committee and board of directors. The process takes approximately three months.

Why are you making it hard for retiring doctors to find replacements?

We want to ensure Nova Scotians are not left without care should their doctor retire or move away. All requests to replace family doctors who are retiring, or leaving their practice for any reason, are being approved to be replaced. Approval for a replacement position takes approximately one month.

Are you concerned we are not able to recruit the doctors we are training?

Our biggest supply of residents or family doctors in this province is from our residency programs, located in Halifax, the Annapolis Valley, Yarmouth and Sydney. From these we are recruiting about 80 per cent from the Annapolis Valley and Yarmouth programs, and about 67 per cent from Sydney and Halifax.

Why are you restricting doctors’ ability to work in walk-in clinics?
What is wrong with walk-in clinics?

Walk-in clinics play a specific role in health care and may function well at the time for people who cannot quickly access their own family doctor when they have a health issue. However, they are not ideal given that a health care provider who oversees your care for a one-time visit is not familiar with your health history. Having a regular primary care provider, who knows a patient’s health history, allows for more comprehensive care and promotes continuity. The development of a trusting relationship with a primary care provider who is familiar with your health history over time has been shown to improve the quality of your care.

In the future, we are looking to create a primary health care system where patients have access to a family practice team, which would offer same-day or next-day visits.

What is privileging? Why is it needed? What changes have been made and why?

All family doctors practicing in this province are now privileged by Nova Scotia Health Authority. This gives them access to services, such as laboratory results and diagnostic imaging, and allows them to provide care for patients in our facilities.

Privileging is a way of ensuring that family doctors who use health authority resources (e.g., ordering lab tests) have all the appropriate credentials and training to do so.

Those who have not previously been privileged (before April 1, 2015) have been automatically assigned “active without admitting privileges (community).”

Is the privileging process different or more restrictive now in Nova Scotia
than in other provinces?

All doctors who want access to laboratory and diagnostic imaging services in Nova Scotia must be privileged. This is the same as several other provinces.

What is NSHA’s role in finding doctors for people without them?

NSHA is committed to strengthening the delivery of primary health care across Nova Scotia. That includes our work to create better access to family doctors through collaborative family practice teams. Recruitment is ongoing and efforts to establish more collaborative practices are underway. It takes time for the system to adjust.

We understand the concerns of people trying to find a family doctor or family practice in their community. Family doctors are in private practice. When new doctors establish or join a practice, we encourage them to tell the community through advertising, especially if they are accepting new patients. 

What do I do if I don’t have a doctor?

We appreciate the concern and frustration of Nova Scotians who find themselves without regular access to a family doctor or nurse practitioner.

Nova Scotia Health Authority provides support for citizens looking for a family practice, and we are currently reviewing our process to best connect citizens with family doctors and nurse practitioners who are accepting new patients. Visit our website for contact information by area.

There are a few other options to access primary care. Citizens can call 811 and speak with a registered nurse or visit a local walk-in clinic. As well, some family doctors and nurse practitioners, while not “publicly” accepting new patients, may accept family members of existing patients. You may consider asking your family members, or even friends and neighbours, if they could approach their family doctor or nurse practitioner to see if you could become a patient of the practice.