Medical residents endure long process to work in Halifax area

The organization that represents medical residents hoping to be family doctors says it's concerned about new limitations to work in the Halifax area and what that will mean for people who need a family doctor.

Prior to April 1, any family doctor licensed to practice in Nova Scotia could set up shop in metro. However, since the amalgamation of health zones, the Nova Scotia Health Authority requires new family doctors to first get their positions approved in the central zone. They're then required to go through a lengthy privileging process that can take months.

Dr. J.P. King, president of Maritime Resident Doctors, says the residents are worried about the timelines.

"I have a family resident that's ready to start in Musquodoboit that wants to jump in there and their application has just been pending approval," King said.

"There are family physicians that are ready to retire and have their resident who has worked with them over the past year ready to take their place — but that's not an option."

Orphan patients

Since the approval and privileging process can take several months, medical residents are feeling the pressure to file their applications before they graduate in July.

"They're panicking," King said. "They have six months left to finish and in that time they have to finish their exam, do all their licensing paperwork and find a job before July 1 comes and they have no income."

King said a lot of the residents are from Nova Scotia and have never intended to leave the province.

"They would like to stay here and work, but even from a government perspective, it takes an awful lot of resources to educate these residents and to put in those resources to have them leave Nova Scotia just doesn't seem to make any sense," he said.

King fears family practices are closing up shop to new patients because they're expecting an influx of orphan patients — those without a family doctor — as a result of the new limitations.

Communication breakdown

Dr. Lynne Harrigan, vice president of medicine and integrated health services for the Nova Scotia Health Authority, says there were delays because residents didn't know they had to go through the process.

On Monday, she received seven requests for family physician replacement positions in the province. She said she reviewed them, signed off and sent them to the health department where the approval committee meets every two weeks.

"From beginning to end of this process [it] would be, for most people, under a month and usually under three weeks now," said Harrigan.

She says family physician positions have been approved in the central region since April 1, although she was unable to provide the number, citing communication as part of the problem.

"I'm hoping we can help allay some of the fears we're hearing," she said. "There are plenty of jobs for primary care physicians in Nova Scotia. There are plenty of positions for primary care physicians in central zone."

Harrigan acknowledged that the privileging process can take longer — up to three months, but says a failsafe mechanism is in place where temporary approval can be given.

'There should not be panic'

Part of the problem, King says, is that the province made the changes without the consultation of patients, doctors and medical residents.

"Government can't do it on its own," he said, adding there should be quick stamps of approval for people that are trying to replace already-working physicians.

"What I would like to see come out of this is to realize that there is a problem with the system how it's drawn in the legislation right now," he said.

Harrigan said the position approval and privileging process have been in place elsewhere in the province for 3.5 years.

She's planning to speak with medical residents again "because there's panic setting in where there should not be panic."