Putting A Band-Aid On A Bullet Wound: Nova Scotia’s Healthcare System Is In Need Of Serious Reform

Over-crowded emergency rooms with wait times of over two hours.
Walk-in clinics bearing signs in their windows which read, “Currently not accepting any new patients.”
This is the reality that the chronically-ill living in Atlantic Canada face as they search for the medical care they require.

The effects of the physician shortage are being felt by all in Atlantic Canada, as families face an immense challenge in finding a regular doctor to perform routine check-ups and identify any changes in their physical health and well-being.

For those who live in rural and remote communities, finding a family doctor has proven to be especially challenging. Many new physicians are drawn to work in large cities with more opportunities to advance in their career and cater to their desired lifestyle. With a higher number of family physicians concentrated in main cities, many rural populations are left without access to continued health care.

“Family doctors in rural areas may feel isolated and not have access to the same support regarding ordering tests and access to specialists,” stated Glen Whiffen of the Chronicle Herald in an article published this past February. “Also, issues with the pay-for-fee service need to be addressed to reduce time spent on paperwork and more time to be spent on seeing patients – or a different method of payment to family doctors.”

Crunching the Numbers

Approximately 175,000 people in Atlantic Canada are waiting for a family doctor, according to the Governments of P.E.I., Newfoundland and Labrador, and Nova Scotia. In order to clear the wait-list, these three Atlantic provinces would need 146 new doctors who would be willing to attend to the needs of 1,200 patients.

The physician shortage is only amplified by the fact that Atlantic Canada has a large aging population. Not only does this put additional pressure on the health care system, but many of those aging citizens requiring medical attention are physicians themselves.

Data from the Canadian Medical Association show that in Nova Scotia alone, 387 practising doctors are 65 years or older.

But Canada has free health care, what’s the big deal?

Frequent visits to the ER are not a substitution for a family doctor.

According to data released by the NSHA in February, a total of 47,948 doctorless patients were admitted to Nova Scotia emergency rooms in 2018.
Dion Davidson is a vascular surgeon at the Valley Regional Hospital and has seen patients succumb to illnesses that could have been treated or even prevented with care from a family physician.

Davidson told the Chronicle Herald that if he had access to $10 million in health-care funding he would use the money to hire more family doctors across the province.

“There’s no doubt that it leads to mortality…a contributing factor for patients ending up in the ICU and dying is because they didn’t have a family doctor.”

The ‘S’ Word

Considering the data presented by both the NSHA and CMA, it is evident that this issue is: (say it with me now) systemic. The province’s health care crisis lies not within its ability to attract doctors, but rather, its inability to recognize the qualifications of incoming health care professionals.

Physician Assistants (PAs) are widely recognized across the United States and in many Canadian provinces – except for Nova Scotia. While PAs do not replace physicians, they are able to provide additional care for patients and relieve some of the stress placed on many doctors. Does Adam Smith’s pin factory ring a bell? The division and specialization of labour is efficient, especially in a medical setting. However, Nova Scotia’s health care system has not yet embraced this practice.

Nova Scotia’s health care sector also faces a significant brain drain as medical school graduates often relocate to large cities with more opportunity. With limited employment opportunities for recent graduates, the province’s young adults have little incentive to remain in the province. Until there are more jobs available for medical professionals, Nova Scotians will continue to feel the effects of this pressing issue.

Dr. Ajantha Jayabarathan has been a practising physician for 28 years and spoke out at a rally in Halifax earlier this month, revealing that this crisis was entirely foreseeable.

“Ten years ago we already knew 1,100 doctors are going to retire. Ten years ago we knew that 945,000 people that are the population of Nova Scotia would be 10 years older and would need health care services to the equivalent of 1.1 million.”

Premier Stephen McNeil publicly denies any existence of a health care crisis in Nova Scotia, an opinion which has been met with disgust by many across the province.

Where do we go from here?

The Nova Scotia Health Authority has implemented home-care programs for patients who live with chronic illness or disease. Programs such as these have proven to decrease the number of emergency room visits and provide patients with the adequate long term care they require.

NSHA is also encouraging individuals to call 811 to put themselves and their families on a waitlist to see a family doctor.

A Facebook group has been created, titled Nova Scotia Health Care in Crisis – Time to Protest, and has so far garnered attention from over 4,600 members. The non-partisan group aims to provide a space for people to share their stories about how the healthcare crises has impacted their lives to encourage the province to hire more physicians.

The voices of the ill cannot continue to fall upon deaf ears. The province’s politicians are the ultimate decision makers but that is not to say that the public does not have an influence in policy changes. From joining peaceful protests to writing to members of parliament, there are ways in which everyday citizens can change our broken system.