Road trips for doctors could address patient woes in rural Nova Scotia

Like a lot of people in rural Nova Scotia who need medical care, Cliff Schneider spends plenty of time on the road.

The Digby County resident makes frequent trips between his home and Halifax for a variety of medical appointments, none of which can be done at home. It often means bringing someone with him, in the event he isn't allowed to drive after a procedure.

'Money, money, money'

The cost adds up.

"Every time I turn around it's money, money, money," he said during a phone interview.

"And when you're a senior on a fixed income, it gets to the point where you can't keep doing this."

He, like many others, has put off trips or appointments because of money being tight.

Serving the under-served

Throughout the election campaign there's been plenty of talk about the need for more doctors and how each party intends to find more doctors.

But what is the solution for communities such as Digby, where there seems to be a revolving door for general practitioners and there simply isn't the critical mass to support certain specialists?

Joanne Mattinson has an idea.

Bring docs to patients

Mattinson also spends plenty of time on the road, often taking loved ones or friends to appointments. It's a reality of living in communities in and around Digby County, she said, and can present unique problems for access to the health-care system.

"You're screwed if you don't drive or you don't know someone who drives," she said.

Mattinson wonders why patients such as the people she's driving always have to be the ones on the road. Having specialists make even monthly visits for the most chronic conditions in a given community could make a major difference, she said, particularly for those who avoid travel or cannot travel and thus cannot get the treatment they need.

Current examples

"I believe over time that if you have a chronic patient who can see the same doctor on a regular basis that it's a plus to see this special person," she said. "You wouldn't be mentally stressed out about going to see someone or finding someone to see you."

There are examples of that happening now, said the director of health policy for Doctors Nova Scotia.

Kevin Chapman points to outreach clinics offered by the IWK Health Centre, geriatricians who do visiting clinics in Cape Breton, orthopedic surgeons from the Annapolis Valley doing work in Bridgewater and Truro-based pathologists regularly serving Amherst and New Glasgow.

Best to see patients at home

For those situations to work — and for there to be others — Chapman said doctors must have the necessary support in communities so that advance work, such as scheduling and gathering patient histories, can be done ahead of time and the doctors can maximize their time with the patients.

There's lots of evidence to show that seeing patients in their home communities is best, said Chapman.

"They're more comfortable, they have better support systems," he said.

"Seeing physicians, especially a specialist, is — for most of us, I think — a pretty traumatic experience. And so to be able to do it in your own community, I think, lessens that trauma to some degree."

More rural training would help

A recent report about healthcare in Digby County noted that one of the challenges related to access is that people in Halifax don't always appreciate the unique challenges, such as travel time and cost, that come with living in a rural community.

To that end, Chapman said Doctors Nova Scotia, along with Dalhousie University, is actively pursuing the creation of a program, similar to one used in New Brunswick, that would see third-year medical students do their placements in rural communities.

While it would serve as something of a recruiting tool, it would also give those who set up elsewhere after graduation a better understanding of the lives of rural patients, he said.