As province touts recruits, new stats show 100,000 without a doctor

Stephen McNeil shuffles cabinet, but vows not to change course

Patch one wound and another one opens.

In the same week the provincial government announced three new family doctors for the Digby area and touted its collaborative care model as a recruiting tool, new data suggest even more Nova Scotians than thought are without a family doctor.

While the provincial health authority has said 25,000 people have reported not having a doctor, new Statistics Canada numbers peg the figure at more than four times that — 106,550, or 11.3 per cent of the population. The figure, which uses 2015 data, is below the national average of 16.8 per cent. (An estimate from the Canadian Institute for Health Information places the number around 90,000.)

Challenge will continue

On Thursday, Health Minister Leo Glavine said there would be more announcements in the coming weeks about new doctors, but he acknowledged the challenge. New doctors are also taking fewer patients than their predecessors, he said, another reason to shift to the collaborative clinics.

"Here we are with the most doctors we've ever had practising, but, again, the practice method of today and getting them in the right place certainly has been a challenge and will continue to be," he said.

Rural Nova Scotia is hardly the only challenge, with demand even higher in parts of the Halifax area. That could be because of people moving to the capital area, said Glavine, but it could also be because people who have traditionally used walk-in clinics are getting older and encountering issues such as cancer, cardiac and chronic disease, necessitating primary care to help deal with referrals to specialists.

"This is why we're seeing some surge now of patients needing a doctor," said Glavine. "They still have the walk-in clinic, but they need a primary care provider to meet the needs of those specialist reports."

104 current vacancies

Joanne MacKinnon, the physician recruitment lead for the health authority, said right now it is recruiting for 58 family doctor vacancies and 46 openings for a variety of specialists.

The 10-year update to the province's physician resources plan, released last June, predicts a need to recruit 1,070 doctors in the coming decade to help replace those who will leave the system and also address any increased demand. Almost half of those — 512 — are family doctors. That puts the annual average required at 107 overall and 51 for family doctors

Numbers from the provincial health authority show that in 2015-16, it recruited 84 doctors, 34 of whom were general practitioners. This fiscal year the total is 91 so far (35 are family doctors), with officials promising more to come.

"This has been a very, very good recruiting year," said Glavine.

'Always looking' for more doctors

With the merger of the district health authorities, recruiting has become a more organized and co-ordinated effort. The health authority now has five people on staff dedicated to recruiting, with a budget of almost $380,000 for salaries in the coming fiscal year. In 2015-16, the last year with complete data, the health authority spent $321,278 on recruiting trips, relocating doctors and marketing efforts.

MacKinnon said the health authority is also trying to get a better sense from doctors when they start thinking about retiring, but it's difficult to be precise. That's part of the reason recruiting is a continuous effort, she said.

"We're always looking and always trying to get a pipeline of physicians going."

'Only going to get worse'

Kevin Chapman, a director with Doctors Nova Scotia, said recruiting will continue to be a huge challenge as the province's doctors age along with their patients.

"When we've heard stories of folks without a family doctor, I sense it's only going to get worse over the next little bit."