Emergency room doctors working at the Northside General Hospital in North Sydney are facing a $14 per hour pay cut. Pay rates are changing across the province for ER doctors and that's raised concerns about doctor retention, recruitment and possible ER closures in the Cape Breton community.
Kevin Chapman is director of finance for Doctors Nova Scotia, an association representing 3,500 physicians. A few months ago, a group of ER doctors from across the province were tasked with finding a way to standardize pay rates without requiring extra money.
"In any zero-sum game, if somebody goes up, somebody has to go down," Chapman said.
"One of the unintended consequences is that there are hospitals like North Sydney where the emergency room physicians would have a lower rate than they are currently receiving."
Emergency doctor salaries
Emergency room doctors at Northside General are currently paid $147.62/hour but the coming pay cut mean they will receive $140 less per 10-hour shift. ER doctors at Cape Breton Regional Hospital will receive closer to $200/hour because it's a larger hospital that sees more patients.
Dr. Chris Milburn works at emergency rooms at hospitals of varying sizes in Glace Bay, Sydney, New Waterford and North Sydney. He said the workload at Northside General often feels similar to a larger hospital since it is only open 10 hours a day, where a hospital like the Cape Breton Regional would have its patients it spread out over 24 hours.
"The actual number of patients that you need to see in an hour, how busy and difficult and stressful the job is, is about the same," Milburn said.
In a statement to CBC News, the Department of Health and Wellness said some of Nova Scotia's nine district health authorities had different agreements in place with emergency room doctors, so some were paid more than others even if the volume of patients were similar.
The Health Department, the Nova Scotia Health Authority and emergency department chiefs set a new, standard hourly rate, with the support of Doctors Nova Scotia, the statement read.
"These changes result in emergency department physicians at Fishermans, Queens, Roseway, Digby, Hants and Northside all being paid the same rates," the province said in the statement.
"Achieving equity means the Northside rate will go down and the other hospitals will see their rates unchanged or adjusted upward.
Milburn agreed the pay rates need to be standardized across Nova Scotia.
However, he said, the province needs to look and understand that the per-hour rate should not be the same for an ER open 10 hours per day versus one that is open 24 hours, if they see the same number of patients over that time.
Mulburn says they're not asking for special consideration, but sensible decision making.
"Northside compresses the work into 10 hours so the hourly rate should be different," he said.
Local MLA Eddie Orrell (Northside-Westmount) is also worried.
"You're going to have difficulty recruiting docs to any rural part of Nova Scotia," he said.
'It's common sense. If a doctor, or anybody, is going to do that same work for less pay, they are going to go where the more pay is at."
Defer pay cut
Meanwhile Doctors Nova Scotia has asked the Nova Scotia Health Authority to defer the pay rate change in North Sydney for three months so they can look at alternatives such as a collaborative care centre.
"This exercise was trying to mitigate emergency room closures," said Chapman.
"It would be an unfortunate and unintended consequence that if, as a result of this, we were challenged to find physicians for North Sydney because their rates are so low relative to what they were getting."
In a statement, the Health Department said the change at Northside will not take effect for several months "to allow time for further conversations with the doctors to ensure their concerns are understood and addressed."