Doctors who serve travelling cancer clinics in Yarmouth, N.S., and New Glasgow have stopped making the trips from Halifax due to workloads they say are no longer manageable.
Dr. Drew Bethune, medical director of the Nova Scotia Cancer Care Program, said he received a letter from the head of medical oncology earlier this month outlining their concerns and stating they would be suspending the services until they can get more help.
"It concerns me deeply," Bethune said in a phone interview from Yarmouth, where he was meeting with staff.
"I feel I have a real responsibility to help get care that people need."
The change affects about 50 patients in Yarmouth and 65 in New Glasgow.
'They're at the breaking point'
The clinics were established to bring cancer patients' care closer to where they live and reduce the need for them to travel to Halifax. Once or twice a month, two doctors from Halifax would travel to Yarmouth and two would travel to New Glasgow.
But Bethune said there's been a growing problem with work volume over time as the number of new cancer patients in the province increases with the aging population, new treatment types are developed and more drugs are added to the market.
"[There are] 150 new drugs between 2015 and 2020 and 300 new drug combinations that have to be absorbed into our system under the leadership of our medical oncology group," said Bethune.
"So a number of things have conspired to make their group — they're at the breaking point with respect to workload."
There are 13 medical oncologists based in Halifax, one in Kentville and four in Cape Breton, with one vacancy there. Bethune said the complement needs to be increased by at least two medical oncologists and possibly as many as four.
"If we had two, we could do this."
Contract talks ongoing
Bethune met with Health Department officials on Wednesday and briefed them in detail on the situation. Officials in the department and Nova Scotia Health Authority have also received a document from the head of medical oncology illustrating what is needed and why.
Although medical oncology is a specialty that's in high demand across the country, the program in Halifax is "quite highly regarded" and Bethune said he expects recruitment efforts would be successful if approval comes to hire more people.
The province and doctors are in the midst of contract talks, but Bethune said his sense is this change isn't about money, but the medical oncologists simply needing more help.
"They just are killing themselves. They need more doctors badly. They're not looking for more compensation."
Health Minister Randy Delorey said meetings on the issue continue and he expects it can be settled once a new master agreement is in place with Doctors Nova Scotia.
"I believe those negotiations are going very well and anticipate that they should wrap up in the very near future."
Delorey said the master agreement "plays a role" in how resources are managed in the health-care system.
"I'm quite confident that we'll resolve concerns in the not-too-distant future."
Patients and staff in the communities have been informed of what's happening. Bethune said patients will still have the same care they get now, but it will mean some will have to drive to Halifax to see a doctor. They're trying to reduce that need right where possible by expanding the virtual medicine component of the system.
"I think we can do quite a bit more in that direction."
The clinics have been a successful way to get treatment to certain populations that might not otherwise get it, and Bethune said he worries that without getting more doctors the situation could affect people's medical care.
"We really need to have the personnel so we can deliver this care," he said.
"It enables [people] to get treatments that they might not and in many cases would not go to Halifax [for] at all. They'd rather not have the treatment than travel to Halifax."
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